When Dr Tsering casually made this remark in a conversation about Tibetan medicine, it was almost fifteen years since he had crossed, as a teenager, the mountainous border between Tibet and Nepal, and made his way to Dharamsala in India. His brother was already a monk there, and his letters, promising good schools and the opportunity to learn English, had convinced Tsering to go and try his luck. While visiting Tsering in the Tibetan clinic in the hills of northeastern India,² where he worked as the resident physician oramchi, I was struck by the change in outlook represented by