The Main Points about Karma
Dr. Alexander Berzin
Karma refers to the mental urges that bring us to act, speak and think in compulsive ways. Acting out these urges, we reinforce our old habits. As a result, we experience our moods going up and down and uncontrollably repeat our patterns of behavior. But these karmic results are not predetermined, they’re not fixed: we can affect what we experience. We can make them lighter since their intensity depends on many factors that are within our power to affect.
Karma is a central topic in Buddhism. We can see its importance by looking at how it fits into the four noble truths, the four facts seen as true by any highly realized being. Buddha taught these four as the basic structure of his teachings.
The first fact of life is that life is difficult and is filled with problems. What are these problems? They are basically the feelings of different levels of happiness and unhappiness that we have in each moment. This is the true problem.
We sometimes have experiences of gross suffering, unhappiness and pain, which are obviously a problem. But then sometimes we experience happiness, but that is fleeting, it doesn’t last. This fleeting happiness has a lot of problems; it’s called “tainted happiness,” tainted with confusion. What that means is: not only does it not last, but it doesn’t give us satisfaction. We have the happiness of eating a nice meal and being full, but it doesn’t last; it doesn’t eliminate the problem of being hungry forever. Also, the more we eat at one meal, the happier we should become; but that is not the case. If we eat too much, we get sick. Also there is no certainty about what is going to follow our happiness when it ends. We might be happy about something else or we could feel unhappy or just neutral. We can’t find any security from this fleeting happiness, so it is a problem. We may enjoy that fleeting happiness for what it is, but it is not something that can really solve all our problems. We always want more and more.
The third type of true problem is experience in which we have a neutral feeling. We go to sleep and feel sort of neutral, not much is happening. But, again, that doesn’t solve our problems; we can’t stay asleep forever.
One of these feelings – happy, unhappy, or neutral – is going to accompany every single moment of our samsaric existence. This is what Buddha described as the true problem; it is not just that I can’t find a job. It is very important to realize that we are talking about every single moment, not just sometimes.
All of these problematic experiences of life come from a cause. Basically the cause of these problematic experiences is karma and the disturbing emotions and disturbing attitudes. Let’s leave it at that. The true problems are the ripening of karma and the true causes are karma; so the true stopping is the true stopping of karma and the disturbing emotions, and the true path or pathway mind is the understanding that will bring about that true stopping. Thus, karma is a very central theme in the Buddhist teachings, so it is very important to understand what it is.
Karma is defined differently in different Buddhist systems, like almost everything in Buddhism. Let’s stick here to the simplest version, according to which karma is a mental urge (sems-pa). It is the mental urge that brings us in the direction of a particular experience. Karma is not an action itself. Often people get confused, thinking that it is refers to actions, especially since some translators translate karma as “action.” It’s not the action at all; karma is the compelling urge to act. If karma were actions themselves, then to stop building up further karma, all we would have to do is stop doing anything! That’s absurd.
This urge that will cause us to act is a mental factor and is always accompanied by three other mental factors. The first is distinguishing (‘du-shes), usually translated as “recognition.” We distinguish an object from within a sense field: this person as opposed to that person, this object as opposed to that one. We need to distinguish the object at which our action will be directed. The second is an intention (‘dun-pa), which is also like the aim: what do we intend to do? We intend to hurt this person or to help them. Then third, there is an emotion that goes with it. It can be a disturbing emotion, like anger, or a positive one, like love. We want to hurt them because we are angry or help them because we feel love for them. The urge that brings us to commit the action is the karma.
Another word here that is sometimes confusing for us in the West is “motivation” (kun-slong). In our Western usage of this word, it usually refers to the emotion behind something. We say that we are motivated by anger or love. However, when we hear the word motivation in a Buddhist context, it is translating a word that doesn’t mean motivation in the Western sense. The intention or aim is the main aspect of a motivation from the Buddhist point of view and the emotion that supports it is secondary. Probably better than translating this word as “motivation” is the “motivating mental framework.”
For instance, in the beginning of any teaching, when we hear “reaffirm your motivation,” it means primarily to reaffirm the aim, which means our purpose: why are we here? The purpose is to learn something to help us to go in the safe direction of refuge or to reach enlightenment to be able to benefit others more fully. That is what we strengthen or reaffirm. The emotion that is accompanying that aim would be compassion and love for all beings, but that is not the main emphasis in strengthening our motivation. Of course, we need also to reaffirm our love and compassion, which is, from our Western point of view, the emotion that is motivating what we are doing. But Buddhism is referring to a much larger mental framework.
It is helpful to differentiate all the mental factors that are discussed because then we can adjust them when there is something inadequate with any of them. If we don’t make this differentiation, then it is very difficult to know how to correct or adjust our state of mind.
So, we have an urge or karma. When we speak about physical, verbal and mental karma, it is the urge to do something, to say something and to think something. This latter one is usually not drawing us into thinking about something for just one instant, but to think about something for a period of time, like thinking about how to get revenge on someone, plotting it out. When we talk about physical and verbal acts, these usually start with mental urges, a mental karma. The urge to do something comes before. Like, “I think I’ll go and call someone.” That is a mental urge. It has its own emotion accompanying it, its aim and so on, and its own distinguishing of the object. Then the actual physical or verbal karma is the urge with which we start to do the action and the urge that comes each moment to sustain the action until it is finished. That’s the physical and verbal karma.
Of course the accompanying mental factors could change from what they originally were. For example, we thought that we were going to speak with our friend, but the daughter picked up the phone and we thought it was her mother’s voice and started talking. Or originally the emotion was love, but then in the middle of the conversation we get angry with them. We had the intention to say something nice or say something nasty to them, and while we were talking we got distracted and forgot it. All of these things are changing variables and the karma is only the urge to do it, like the urge to talk. Of course the urge doesn’t happen by itself – it happens with all these factors together – but none of these is the action itself. The action itself is something else.
The action itself is what I call a “positive karmic force” (bsod-nams) or a “negative karmic force” (sdig-pa). That is usually translated as “merit” or “sin.” It is referring to the action itself, which acts as a karmic force. When it is finished there is its karmic aftermath, which continues imputed on our mental continuums – karmic potentials, tendencies and constant habits. They are nonstatic – so they can be affected by circumstances – and are neither forms of physical phenomena, nor ways of being aware of something. I won’t go into a discussion of the different types of aftermath because it is too complex. But when disturbing emotions and attitudes activate them, this karmic aftermath ripens into various consequences in our moment-to-moment experience.
The Ripening of Karmic Aftermath
What do the karmic aftermath ripen into?
Feelings of happiness, unhappiness, or neutral – we could be doing the same thing today and yesterday, but yesterday we felt happy doing it and today we feel unhappy doing it. That is the ripening of karma. I will use “ripening of karma” in a very loose way here.
Experiencing our rebirth aggregates and the environment in which we are born and in which we find ourselves – the type of body we have, the mind we have, our intelligence or lack of intelligence and so on – and in that rebirth, feeling different moments of happiness and unhappiness.
Feeling like doing something similar to what we did before – for instance, “I feel like calling somebody; I feel like yelling at you.” “What do you feel like doing?” “I feel like scratching my head.” That is the ripening of karma: what we feel like doing. From feeling like doing something can come the urge to do it. Feeling like doing something (‘dod-pa) and the urge to do it are two different things.
Experiencing a situation similar to what we did, with the same things happening back to us – for example, we are always yelling at others and now we experience people yelling at us, or we are always being nice to others and we experience people being nice to us.
All of these things go up and down, each at a different rate. That means that different things are ripening at different moments, mix together in different ways, and we never know what is coming next. We never know if we are going to feel happy or unhappy in the next moment and we don’t know what we are going to feel like doing five minutes from now. That is changing all the time. People call me on the phone and want to sell me something or…who knows what is going to happen? Sometimes these things are nice and sometimes there are very unpleasant. It goes up and down all the time and we have no idea what is coming next – this is the uncertainty. It is horrible, isn’t it? Not only that, but on a grosser level our rebirth states are going to go up and down as well.
“Periscope perception” – we can only see a little bit of what is happening and its causes. We have no idea why things are happening to us, or what the results of our actions are going to be, so we have this very limited tunnel vision. That is also a result of karma. It makes us “limited beings,” beings with limited minds, as opposed to omniscient Buddhas.
All of this ripening of karma is the first noble truth, true problems. I think we can get a little bit more of an appreciation now of what Buddha meant by the first fact of life, true problems; it is the ripening of karma. What is so terrible is that we are so filled with confusion that we cause karma to ripen and cause more urges to arise to perpetuate the cycle. That is described by the twelve links of dependent arising.
It is important to remember that the discussion of karma includes urges that bring on not only destructive behavior, but also constructive behavior mixed with confusion and unspecified behavior mixed with confusion. A constructive action mixed with confusion would be like: “I want to help you because I want you to like me and be nice to me.” Or “I want to help you so that I feel needed, because it makes me feel important and useful.” Or it could be the urge to do something unspecified, meaning neither constructive nor destructive, like constantly twiddling our fingers or tapping on the table or making our knee go up and down or something like that. It is mixed with confusion. We are naive because we don’t really understand that this really is annoying to other people or makes us look ridiculous.
The Four General Laws of Karma
There are four general laws of karma.
The Certainty of Results
This is phrased in a very special way. If we experience unhappiness, it is certain that this is ripening from our previous destructive behavior. It is not saying that if we commit destructive actions, it is certain it will ripen in unhappiness. Why? Because we can purify negative karma. If it were stated in that second way, it would suggest that it is impossible to purify karma. If we do experience unhappiness, we can be sure that it came from destructive behavior; if we experience happiness, we can be certain that it ripened from constructive behavior. This relationship between behavior and feeling a level of happiness or unhappiness is very important to understand. We are not saying that if you act destructively, it produces unhappiness.
Let’s look at the many variants of this relationship between feelings and actions. We are not talking here about the happiness or unhappiness that our actions cause others; there is no certainty of that. For example, recently I gave my computer to a store to be repaired and it was stolen from that store. I was very happy because that computer was always breaking and now I can collect the insurance money from it and buy a new one. The theft did not cause me unhappiness. This law of karma is talking about the experience of happiness or unhappiness of the person who commits the action.
It is also not certain what we are going to feel while doing a certain action; it is not necessarily related to the action. We could refrain from committing an inappropriate sexual act, like having sex with somebody else’s partner, and in doing that feel very unhappy. It is also not at all certain what we are going to feel immediately after the action either: “I was helping someone, then they left to go home, and I got very depressed.” And, as we said, it is not even certain that these feelings will ripen later on, because we can purify ourselves of the karmic consequences of our actions. The only thing that is certain is that if we are experiencing these feelings, no matter when that happens, they are the result of some previous constructive or destructive action. If we are feeling unhappy while refraining from committing adultery, that is the ripening from some previous destructive action.
Also I should mention, since some people may get confused about this: what is a constructive action? Restraining ourselves from killing is one of the ten constructive actions. I don’t think about going out and murdering people, so the fact that I don’t murder people is not the constructive action of refraining from killing people. The constructive action would be like if there were a mosquito buzzing around my head and I felt like killing it, but then I think about the consequences of killing it and don’t. At that point, restraining myself from killing is the constructive action of not killing. When we talk about this type of constructive behavior of refraining from the destructive actions, it is very active; it is not just, “Well, I never kill, so I might as well take a vow not to kill.” That is not strong enough. Of course taking a vow is always beneficial, but the real constructive action is restraining ourselves from a destructive action when we feel like doing it and restraining ourselves because we understand the consequences. Of course there are also the constructive actions of actually helping someone or giving something to someone. That is another kind.
The Increase of Results
From a small action very large results can follow. We say something nasty to our partner and the longer we leave it without trying to resolve the problem, the more the resentment grows. We all know this from our individual experience.
Many people die in an airplane crash, but a few people survive. Why? They haven’t committed the cause to die in that crash, so they don’t experience the results. If we have really purified ourselves completely of all our karma, then there is nothing to be afraid of. Even if we go into a dangerous place with thieves and so on, we will not experience being robbed because we have purified ourselves of the karmic cause of being robbed. Nobody could hurt the Buddha, for example.
The karmic aftermath is not going to get so old that it doesn’t ripen. Eventually, at some point, unless we purify it, it will ripen. It may take a million years, but it will ripen unless we purify it away.
These are the general laws of karma. Also, one action can give many results over many lifetimes. The example used in the texts is somebody called a bodhisattva a monkey and was reborn as a monkey five hundred times. Whether or not we can relate to such an example is beside the point; the point is that it is not so linear, this whole thing. One action can have many results over many lifetimes and many actions all together can cause one result. This example is helpful if it makes us thinks twice about calling the police “pigs.” The Four Factors Needed for Karmic Results to Be the Fullest
When we speak about a karmic action, four factors need to be complete for the results to be the fullest. If any of these factors is missing, the result will not be so strong. But that doesn’t mean that there will be no results.
A basis – there needs to be a basis, a being or an object at which the act is aimed. We thought that someone was in the bathroom too long and we started yelling at them, but then it turned out that there was nobody there. This is not as strong as if there actually were someone there. There has to be someone who hears our yelling, understands it, and believes that we mean it. If the person is deaf or had the radio playing and couldn’t hear us, it is not so strong.
The urge – meaning the karma itself, and the other factors that accompany the urge. So there needs to be a correct distinguishing of the object. For example, I thought that was my umbrella that I took, but I was mistaken and I took your umbrella by mistake. If we do this by mistake, then it has a much weaker result than choosing the best umbrella and taking it. But, even though we took it by mistake, it is still a destructive action; it is just that it is not so strong a destructive action. The second accompanying component is the intention. If the intention is not there, it is like when we are dancing with somebody and we didn’t intend to step on their foot, but we did. That is much less heavy than if we did it intentionally. Then the third component is that there needs to be a disturbing emotion if we are talking about a destructive action. If we kill a mosquito that is buzzing around our baby’s head and we do it not because we hate the mosquito but we have love for our baby and want to protect it; that is very different from killing the mosquito because we hate it. All of that was the second factor, the urge.
The action – we have to actually do it. If I was planning to yell at you, but then somebody came to the door or the telephone rang and I didn’t actually do it, it is not as heavy as actually doing it. If I just dreamt of killing you, I didn’t actually do it in real life. Although that dream killing is a destructive action and could be accompanied with a lot of anger and so on and we could very intentionally kill the person in the dream, it is not as heavy as killing the actual person because there is no action involved.
The finale – if we shoot at someone intending to kill them and miss and just shoot them in the arm, our action didn’t reach the intended conclusion, so it is not as heavy. If we really wanted to hurt someone by what we said and it didn’t hurt them at all, because they didn’t believe us or whatever, it is not as heavy as if it actually had hurt the person. The same if we lied and they didn’t believe us. We can see that the results of our actions are really quite complex; there are many different factors involved.
It’s the same for positive actions. For example, I meant to help you, but helped someone else instead. I didn’t really intend to help you, but what I did helped you anyway, or I did something to help you and it didn’t help you at all. This often happens. We make a nice meal for someone in order to please them and they choke on it and go to the hospital. Or they hated it; it tasted terrible to them. All of these things are there with constructive actions as well.
Throwing and Completing Karma
Throwing karma (‘phen-byed-kyi las) is an urge that will throw us to a future life. To be more specific, it is an urge to do something that is so strong that its karmic aftermath can throw us to a future life. It can shape the type of rebirth that we take, for instance as a dog or as a human. This is when the urge is accompanied by a very strong intention and a very strong accompanying emotion. If we actually act that urge out and it reaches its intended finale, it can shape the type of rebirth that we take. That is called “throwing karma.”
Completing karma (rdzogs-byed-kyi las) is when the intention or motivation and the accompanying emotion are not so strong. This will result in the circumstances that complete the rebirth in this particular rebirth state, for instance whether we are a stray mangy dog in the streets of India or a poodle in a rich person’s house in the West. There are four possibilities: there can be positive throwing and negative completing, negative throwing and negative completing, and so on.
Built-up karma (bsags-pa’i las) refers to any karmic urge that has built up further the karmic potentials and tendencies on our mental continuum, in the sense of having reinforced and boosted their strength. These are karmic urges that have been deliberated beforehand.
From this distinction, we can see that there are four possibilities. For example, I planned to hurt you or help you, but I didn’t actually do it; I didn’t plan to help you, but I did; I planned to do it and I actually did; or I didn’t plan to do it and I didn’t.
Now, very often people misunderstand this classification and think that there are some actions that are not certain to produce any results and other actions that it is certain that there will be results. That is not the distinction being drawn here, although it is the case that if we purify our mental continuums of the karmic aftermath from destructive actions, we do not need to experience their results. But, when we talk about the certainty of results in the context here, we are talking primarily about the certainty of when they will ripen. For actions that we plan but then don’t actually do, there is no certainty of when they will ripen. They could ripen at any time – in this lifetime, in the next lifetime, or in any lifetime after that. If we don’t believe in future lives, as many Westerners don’t, it is important to know what actions will ripen in this lifetime. Mind you, these have to be planned and actually committed. Karmic Actions, the Results of Which Will Ripen in This Lifetime
In general, there are four types of karmic actions, either destructive or constructive, that bring about results that will start to ripen in this lifetime. Their ripening may, however, continue into future lives as well.
Destructive actions that are brought on because of extreme attachment to our body, possessions, or life, and the constructive actions that come from extreme disregard for any of these three. For example, I am so attached to my car and you banged into it, so I go over to your car with a baseball bat and smash it. Or it could be that I am so attached to not getting sick that I refuse to help someone with a contagious disease. On the other hand, I could be so detached from my body that I rush into a burning building to rescue a child trapped inside.
Destructive actions brought on by extreme thoughts of malice toward anyone, such as torturing an enemy prisoner, or a constructive action brought on by extreme thoughts of altruism and love, such as nursing a wounded enemy soldier.
Destructive actions brought on by an extremely strong wish to bring harm to the Buddha, Dharma or Sangha, spiritual masters, and so on, such as destroying a monastery and executing the monks. It also includes constructive actions brought on by extreme confident belief in the good qualities of the Three Gems and the spiritual teachers, such as building a stupa or making a donation for a Dharma publication or for building a Buddhist center.
Destructive actions based on a total lack of gratitude and respect and which are directed against someone who has helped us greatly, such as our parents or teachers, or constructive actions directed toward them and based on wishing to repay their kindness. For example, not taking care of our parents when they are old and sick or helping our spiritual teachers with their projects. But remember, we have to really think about engaging in such actions and not just do them spontaneously or be forced into it.
Factors That Affect the Strength of the Ripening of Karma
The karmic aftermath of our actions can ripen into something strong or heavy or into something light and trivial. So the last thing I want to discuss is some of the different factors that affect the strength of the results that ripen from either positive or negative karma. The list is rather long.
The nature of the action or phenomenon involved – this is in terms of the suffering or happiness that such an action causes the other person in general. Killing someone is heavier than stealing their car; saving someone’s life is stronger than giving them some money.
The strength of the emotion, disturbing or positive, that accompanies the urge – hurting someone with really strong hatred is much stronger than hurting them with just a little bit of anger. To save time, I’ll give examples for the rest of the list mostly for destructive actions, but you can infer examples for the constructive actions as well.
The distorted, compelling drive – in other words, whether or not a distorted antagonistic attitude accompanies the action and we think there is nothing wrong with doing it, it’s good to do. For example, we go to war to kill everybody from a certain ethnic group and we think that this is perfectly right and anybody who thinks this is wrong is stupid. That is a distorted antagonistic attitude. Or it is perfectly all right to kill animals because they have been created for our use. If that kind of attitude is there, it is heavy.
The actual action –this is in terms of the amount of suffering caused to the victim when the action is done. Pulling the wings off of a fly is much heavier than just smashing it with a flyswatter.
The basis at which the action is aimed – this varies according to the amount of benefit we or others have received from that being in the past, or will receive in the present and future, and according to the good qualities of the being. Those good qualities include the goal that the being has achieved or toward which they are aiming. For instance, killing a monk or a nun is heavier than killing a layperson because of their aim and their qualities. Or assassinating Mahatma Gandhi is heavier than executing a criminal or slaughtering a chicken.
The status or accomplishments of the being toward which the act is aimed –it is heavier if the victim is someone has just finished a retreat. If we hurt someone who is sick as opposed to someone who is healthy, it is heavier.
The level of the consideration and amount of respect we have toward the being – to hurt someone we respect is different than hurting someone we don’t know. I have a lot of respect for my spiritual teacher, so lying to him is heavier than lying to a stranger for whom I do not particularly have any respect.
The supportive condition – it is heavier to kill when we have taken a vow not to take the life of another being, than if we’ve not taken any vow.
The frequency or habitude – if we have done a certain action many times in the past, it is heavier. If we have always hunted all our life, it is heavier than just shooting a deer once.
The number of people involved in committing the action – if we are part of a whole gang that beats up somebody, it is heavier than just doing it by ourselves. On the contrary, doing a puja with a large group of people is a stronger positive action than just doing it by ourselves in our room. That is why the Tibetans like to do pujas with large groups.
The follow-up – whether or not we repeat the action in the future
The presence or absence of opposing forces – in other words, if we do something destructive, whether or not we counterbalance it with a lot of constructive things; or if in the past we did something constructive, whether or not it is offset by a lot of destructive things.
Although this seems like a very long list, and perhaps a bit tedious to go through, it nevertheless indicates some points that are very helpful if we need to do something negative or positive and wish to know how to make it weaker or stronger respectively. If we have to do something destructive, like fumigate our house for cockroaches or something like that, we can try to do it without hatred, not do it so frequently, and don’t invite all our friends to come over and have a party for killing cockroaches and think it’s great fun. On the contrary, if we are doing something positive, it is quite good to invite our friends to join us and to do it with a strong positive feeling and to do it frequently, like doing puja at home.
So these factors give us an indication of how to influence the results of our actions even while we are still acting compulsively and with confusion. If we are going to help others, we can start by helping those who have been the kindest to us, our parents for example. If we have to hurt or disappoint someone, like when we don’t have time to call everyone that we need to call, don’t disappoint somebody who has been very kind to us, like our parents. This is not just a list, but something that we need to work with in our daily lives in our actions with others.
The Absence or Presence of Opposing Forces
The last point in that list, the absence or presence of opposing forces, is especially important. This is where we get the beginning of the discussion of purification of karma, which I won’t go into in detail. But let me mention a few important points. A destructive action is very heavy if:
We don’t regard it as a mistake and that it is going to have negative consequences – what opposes that is openly admitting that it was a mistake and was improper. Even if we didn’t think there was anything wrong with it when we did it, if we admit that it was a mistake afterwards it will start to purify the consequences and at least make them less heavy.
We did it with joy, have no regrets, and delight in having done it – to oppose that there is regret.
We have no wish or intention to stop repeating it – it’s like thinking, “I am going to continue playing my music loudly at all hours of the night. I don’t care if it keeps my neighbors awake.” The opponent for that is thinking, “I am going to try not to repeat the action.”
Not thinking to repair the damage – what counters that is applying the counteractive constructive actions.
We need to add to this point about absence or presence of opposing forces one more item:
We do something with no sense of moral self-dignity or care for how our actions reflect on others – we don’t care about our own personal honor and we don’t care what people think of our families, teachers, fellow countrymen, and so on. The opponent for that is, with a sense of self-dignity and care for how our actions reflect on others, reaffirming our safe direction and bodhichitta, “I am doing something positive in my life.” An example would be a German going somewhere and being very loud and making all kinds of disturbance and not caring about what people think about Germans because of that.
Question about Collective Karma
With the present epidemic of foot and mouth disease, the authorities have decided to cull all the cattle. Because I’m a member of the society in which this is happening, that killing of all the cattle would be a group action, wouldn’t it? Will I have to suffer the collective karmic results of that group action or not? How do I avoid that?
First of all, remember the fourth law of karma: if we have not committed an action, we do not experience the result. If we have not killed the animals, we are not involved in the karmic action. The various people who are actually doing the killing are the ones actually involved with the karmic action.
However, there is the point concerning rejoicing in the actions of others. If we rejoice in the constructive actions of others, we build up positive karmic force; and if we rejoice in the destructive actions of others, it builds up a negative karmic force. So if we really think this culling of the cattle is a wonderful thing to do, it is one thing. But if we think this is a terrible thing that they are being killed and feel great compassion and so on, this is a positive way of thinking.
We need to be careful not to accompany this with naivety, however. These animals, these cattle, were all going to be killed for meat anyway, and so it is just a matter of when they are going to be killed. To have compassion for them just because they are being killed because of this epidemic, but not caring if they are killed for meat is naive. Our thinking with compassion here is a constructive action, but it is accompanied by the disturbing emotion of naivety. So, we always need to analyze carefully all our thoughts and actions.
We can see how important it is to understand the various factors of karma because, although it is complex – it’s the most complex thing in Buddhism – nevertheless, the more we understand it, the more we can start to affect and shape our behavior and the heaviness of its consequences. Like in this example, we can try to develop compassion in general for the cattle, not just because they have a disease.
May whatever positive force has been built up by this grow stronger and stronger and may whatever understanding we have gained get deeper and deeper, so that slowly we can start to weaken the effects of our karma and eventually overcome all our karma, so that we can be of best help to everyone.