The deliberate and intricate melding of philosophy, the study of the mind, and a reverence for the highest metaphysical reality with art is a de facto way of life across the Indian subcontinent. For almost four thousand years, gifted saintly composers, poets, sculptors, painters, and philosophers have attempted to distill the essence of nondual philosophy into works of art in temples from lofty heights of the Himalayas to the edge of the southernmost tip overlooking the vastness of the mighty Indian ocean. In the land of the most ancient spirituality, the temple is a divine conduit transporting one’s being into a higher plane that transcends material concern and transient emotion. I was taught, as most children growing up in India are, that the temple was a sacred point to seek vidyā (knowledge) and buddhi (intellect), a place where art is deeply and profoundly revered.
The ancient and glorious tradition of classical carnātic music — moving, inspiring, and ethereal, is closer to a melo-expression of aesthetic emotion or bhāva than a rigid, inviolable musical structure. Learning carnātic music – vocal or instrumental- takes decades, and children start learning it as early as the age of two. It would be difficult to explain to a Western audience how extraordinarily venerated classical music is in India, defying definition even by the most erudite scholar. I must have done accumulated some very good karma in my previous lives to merit being exposed and trained to carnātic music in this one. I don’t know where or who I would be without its constant presence – a friend, a mentor, a soulmate, and a bridge to a cosmic plane vibrating with maternal energy.
Recently while attending a grand round talk at Mass General Hospital and after observing a collaborator and colleague, I pulled him aside and merely asked, “what’s going on?”. He began to sob. In medicine, practitioners seldom do as they preach. Physician burnout, the vagaries of everyday life, and the suppression of one’s neurodiversity are serious inevitabilities in medicine worldwide.
I was invited to give a special earlier this week – but it was unlike any other talk I’ve given because all of it was delivered in carnātic music. I used as my canvas the great polymath genius Muttusvāmi Dīkśitar’s magnus opum composition, śrī viśvanātham bhajēham. Vibrating lyrics in 14 rāgas that mysteriously represent 14 ways of elevating cardiometabolic wellbeing, with 14 astonishing parallels in probability theory. Irony be dissolved, cardiology departments need more heart. Heart that further integrates the physical body with the emotional body.
Muttusvāmi Dīkṣitar, one of the three venerated carnātic trinity of composers has produced works of such radiating mastery that I often wonder if a piece of a divine star fell on our planet to deliver him to us. All of his compositions are in Sanskrit. Sanskrit (like Japanese and Hebrew), is a language that vibrates with primordial energy and expresses subtle and complex constructs with precision and brevity.
Muttusvāmi Dīkṣitar’s Śrī Viśvanātham Bhajēham is a profound spiritual odyssey, meticulously crafted to glorify the cosmic grandeur and compassionate essence of Śiva. Through its caturdaśa rāgaālika structure (a garland of 14 rāgas), the composition unites music and devotion – portraying the cosmic energy known as Śiva as the omnipotent master of creation, preservation, and dissolution, the source of wisdom, bliss, and emancipation. Each stanza serves as a meditative portal, blending inspiring poetic imagery and philosophical depth to reveal the interplay of the divine with the cosmos and the human heart. The composition invites the listener to transcend worldly limitations, embracing the harmony of existence and the purity of spirit, while fostering a deeper connection to the timeless truths of the true nature and the transformative power of divine energy.
Here, Dīkṣitar’s uses 14 ragāms (caturdaśa rāgaālika or a garland of 14 ragāms), and each every stanza sung in a ragām also a ragā mudra — a symbolic or literal signature embedded in the lyrics of a rāga). The mudra is a subtle or overt reference to the specific rāga being performed. It can appear in various forms within a composition, often acting as a poetic or artistic identifier. It serves as a way for Dīkśitar to pay homage to the rāga or evoke its particular emotional or spiritual resonance.
A recording Dr. M. L Vasanthakumari’s rendition is here.
I (śrī raga)
śrī viśvanātham bhajēham
caturdaśa bhuvana rūpa –
rāga mālikābharanadharanāntahkāranam
I mediate on the radiating energy known as Viśvanātha, who embodies the fourteen worlds, adorned with the garland of rāgas, sustaining and dissolving the cosmos.
In Vēdic cosmology, the universe comprises fourteen worlds, with Viśvanātha (Śiva) as the all-encompassing deity responsible for the creation, preservation, and eventual dissolution of these realms. The reference to a “garland of rāgas” reflects cosmic harmony, mirroring the order of rāgas in classical Indian music that underpins the structure of the universe.
This cosmic balance aligns with the homeostasis essential to human cardiometabolic health. Just as Viśvanātha maintains harmony among realms, a balance between pro-inflammatory and anti-inflammatory processes is critical in preventing chronic inflammation that disrupts bodily harmony. As physicians, it is often easy to overlook the complex system in search of a singular hack or a pill. But at the root of it all, both physical, emotional, and spiritual, is harmony and homeostasis.
The reference to Śiva as the cosmos’ sustainer and dissolver mirrors the normalization concept in probability distributions. Just as Śiva ensures balance among the realms, normalization ensures that the total probability across all possible outcomes equals one, maintaining harmony within the probabilistic framework, resisting reduction in favor of integration.
II (ārabhi raga)
śrita jana sansāra bhītiyāpaham
ādhyātmikādi tāpa traya manobhītiyāpaham
To the energy which removes the terror of worldly existence for those who seek refuge in its enveloping grace; which soothes the threefold miseries that disturb the mind—arising from within, from others, and divine sources.
The “tāpatraya” (suffering) represents three forms of suffering in Vēdic philosophy: ādhyātmika (internal afflictions from body and mind), ādhibhautika (external pain caused by others), and ādhidaivika (cosmic forces beyond human control). Viśvanātha’s role as a liberator from these hardships relieves seekers from life’s suffering, symbolizing peace and transcendence.
This threefold suffering parallels the multifaceted sources of inflammation, influenced by physical health, interpersonal stress, and environmental factors. Chronic stress, in particular, is known to heighten inflammation levels, increasing risks of cardiometabolic diseases. Interventions that manage stress and mental well-being—such as mindfulness—have been shown reduce inflammation markers and improve health outcomes, reinforcing the importance of holistic care.
The “tāpatraya” aligns with the law of total probability, which divides a complex probability space into simpler, non-overlapping events. Just as Śiva alleviates these afflictions, probability theory simplifies complex events by addressing them in parts, combining their contributions for clarity.
III (gaurī raga)
śrī viśālākṣī gaurīśam
sakala niṣkala rūpa –
satcitananda-mayaṁ
I revere the consort of Śrī Viśālākṣī (the benevolent Goddess with expansive vision), who embodies the dual nature of the universe—both with form and without form, and who is pure being, awareness, and bliss.
Viśālākṣī, Śiva’s consort, embodies divine grace, embodying a nurturing vision of wisdom and compassion. Śiva’s aspect here, as both “sakala” (with form) and “niṣkala” (formless), signifies his transcendence beyond physical limits, embracing all aspects of existence. This energy personifies Sat-Chit-Ananda, the highest state of bliss, consciousness, and pure existence, a central concept in Indian thought.
This union of form and formlessness suggests an integrated approach to cardiometabolic health, combining the tangible with the intangible. It is often said that it is only with his consort Viśālākṣī that Śiva becomes animate. Too many physicians neglect their families because of their work. And the neglect shows in their physiology.
The duality of sakala (manifested) and niṣkala (unmanifested) forms of Śiva resonates with Bayesian priors and posteriors. The prior represents unmanifested, subjective belief, while the posterior incorporates evidence to manifest an updated, objective belief system, akin to Śiva’s dual aspects.
IV (nāta rāga)
citra viśva nāṭaka prakāśam
jagatprakāśaka bhāskara –
śaśāṅka koṭi prakāśam
To the energy that illuminates the enchanting drama of the universe, who shines forth like countless suns and moons, bringing light and life to the eternally shifting world.
Here, the universe is seen as a grand, divine drama (līlā), illuminated by Śiva’s eternal presence. This energy’s radiant light—like the sun and moon—symbolizes knowledge, awakening, and clarity, dispelling darkness and ignorance. This verse reflects the essence of Śiva as both the source of enlightenment and the radiant force sustaining life.
This contrast of light and dark mirrors the importance of maintaining circadian rhythms in health. Research shows that aligned sleep and wake cycles are crucial for metabolic health, as disrupted circadian rhythms can lead to increased inflammation and heightened risk of cardiometabolic disease.
The illumination of the cosmic drama, just like sleep, parallels the entropy of information theory, which measures the uncertainty or randomness in a system. Just as Śiva illuminates the dynamics of the universe, entropy quantifies and reveals the hidden order within probabilistic systems.
V (gowḷa rāga)
govindādi vinuta gowḷāṅgam
kṣīra kundendu karpūradī –
vijaya bhasito’d’dhūlita gowḷāṅgam
To the white-limbed Śiva, venerated by the great preserving forces at work in the world and others, adorned with sacred ash whiter than milk, jasmine, the moon, and camphor.
The image of Śiva covered in sacred ash (vibhuti) symbolizes purity, detachment, and transcendence over worldly ties. The whiteness of the ash, surpassing the brilliance of milk and moonlight, signifies the absolute clarity of spirit and the triumph of wisdom over ignorance. Śiva’s ascetic form emphasizes his renunciation of desires and attachments, presenting him as an ideal of spiritual liberation.
Śiva’s detachment parallels the importance of emotional resilience and an anti-inflammatory diet in reducing inflammation and boosting immunity. Emotional regulation, particularly the management of stress and negative emotions, has been shown to lower inflammatory markers such as C-reactive protein (CRP). This reduces the risks of cardiometabolic diseases, supporting overall well-being.
Emotional resilience and an anti-inflammatory diet align with the concept of dependence and independence in probability theory, where events are conditioned or unconditioned on external events. Śiva’s asceticism mirrors the dependence and independence of probabilistic events, ensuring clarity and purity in analysis, untainted by external factors at work. No matter what the circumstance, eat well and practice emotional resilience.
VI (mohana rāga)
guru guha sammohana-kara liṅgam
pañcī-kṛta pañca mahā bhūta
prapañcādi mohana-kara liṅgam
To the captivating one who fascinates Kārttikeya, blending the five great elements creates the illusion of the phenomenal world.
Śiva’s mastery over the pañca mahābhūtas (earth, water, fire, air, and ether) represents his role as the creator of the māyā (illusion) that envelops the universe. His creative energy captivates even Guruguha (Muttusvāmi Dīkṣitar’s signature reference to Kārttikeya), showcasing the mesmerizing balance between creation and mystery. This māyā is not deceptive but rather a reminder of the transient beauty of the physical world.
The blending of elemental forces parallels the body’s need for balanced nutrition, where macronutrients and micronutrients work synergistically to maintain health. Research has shown that diets high in unprocessed, nutrient-dense foods reduce inflammation and lower risks of cardiometabolic conditions. It is also quite important the sequence with which macros are consumed (eat carbs at the very end and little).
This act of combining elements reflects the concept of joint probability, where the probabilities of independent events come together to form a new, interconnected outcome. Just as Śiva creates the cosmic illusion through integration, joint probability combines individual events to reflect the complexity of reality.
VII (sāma rāga)
sadāśivam sāma gāna vinutam
prakṛtyādi sapta rūpa sāma gāna vinutam
To Sadāśiva, the eternal Śiva praised in the sacred Sāma Veda chants, who manifests in seven primordial forms that pervade the essence of creation.
The Sāma Veda, one of the oldest scriptures, is dedicated to divine worship through music and chant. Sadāśiva, as the eternal form of Śiva, resonates with the primal vibrations that sustain the cosmos. The seven forms mentioned here (sapta rūpa) could represent the seven swaras (musical notes) or the seven energies underlying creation, highlighting harmony and order in divine manifestation.
The reference to sacred chants aligns with the benefits of sound-based practices like Vedic chanting, which reduce stress and calm the nervous system. Research has shown that practices like singing involving rhythmic breathing and chanting can lower cortisol and inflammatory markers, positively affecting cardiometabolic health. Music is not just art. Music is well-being.
The harmonious vibrations of Sāma Vedic chants parallel Markov chains, where each state evolves based on the previous state in a structured yet dynamic sequence. Just as the chants progress rhythmically, Markov chains illustrate the probabilistic evolution of systems in a predictable yet fluid manner.
VIII (lalita rāga)
sanmātram lalita hṛdaya viditam
kāma krodhādi rahita lalita hṛdaya viditam
To the one who is the pure essence of bliss, known only by those with tender hearts, and who is free from desires, anger, and other vices.
Śiva, described here as sanmātram (pure being), embodies a state of ultimate bliss and detachment. Free from negative emotions like anger (krodha) and desire (kāma), he represents an ideal of spiritual serenity. This purity can only be understood by those with lalita (gentle) hearts, signifying the receptiveness required to experience divine bliss.
This transcendence over negative emotions reflects the importance of emotional regulation and mindfulness in reducing inflammation. Research has shown that practices like mindfulness meditation that annihilate destructive emotions can decrease markers of systemic inflammation, such as interleukin-6 (IL-6), which are associated with cardiometabolic diseases.
This avoidance of destructive emotions mirrors the concept of outliers in probability theory—rare, extreme values that deviate from the expected norm. Just as Śiva transcends such extremes to embody balance and purity, robust statistical measures aim to neutralize the influence of outliers, ensuring the integrity of probabilistic analysis.
IX (bhairava rāga)
cidākāśa bhairavam pura haram
vidhi kapāla tri-śūla dhara bhairavam pura haram
To Bhairava, who dwells in the infinite sky of consciousness, wielding the trident and the skull of Brahmā, and who destroys the cities of ignorance.
Bhairava, a fierce form of Śiva, represents destruction—of ignorance, ego, and attachments. His trident signifies mastery over creation, preservation, and destruction, while the skull symbolizes his detachment from the physical realm. Bhairava resides in cidākāśa (the space of consciousness), reflecting his boundless awareness and ability to guide devotees toward liberation by dismantling illusions.
The destruction of ignorance and ego parallels the importance of self-awareness in controlling inflammation. Chronic stress triggers inflammatory pathways, but stress-reducing practices such as yoga and mindfulness, as highlighted in research, significantly lower these markers, improving cardiometabolic health. Too many physicians suffer from vanity and forms of ego that are the root of chronic stress.
Bhairava’s act of destruction aligns with conditional probability, which refines understanding by introducing conditions that eliminate irrelevant outcomes. Just as Bhairava clears ignorance to reveal ultimate truth, conditional probability eliminates uncertainty by narrowing focus to the relevant scenario. A focus on moving from the unreal to the real – discard what doesn’t matter.
X (sāraṅga rāga)
citsabheśvaram sāraṅga dharam
dārukāvana tapo-dhana –
kalpita sāraṅga dharam
To the energy which presides over the consciousness-stage (citsabha), bearing the deer (symbol of tranquility), and who accepted the saranga (bow) created by the ascetics of the Daruka forest.
Śiva as Citsabheśvara signifies he who dances in the inner space of consciousness, symbolizing the rhythm of life and enlightenment. The deer he carries represents peace and purity, while the saranga bow signifies focus and spiritual discipline. The reference to the Daruka forest highlights Śiva’s embodiment of life, embodying simplicity and detachment.
The tranquility symbolized by the deer mirrors the importance of calmness and managing anxiety in reducing systemic inflammation. Meditation and mindfulness practices have been shown to lower levels of pro-inflammatory cytokines, improving heart and metabolic health.
The interplay between movement (the dance) and focus (the bow) reflects stochastic processes, where randomness (movement) coexists with structured probability laws guiding outcomes. Śiva’s dance embodies this balance between randomness and order in the probabilistic world.
XI (śaṅkarābharaṇa rāga)
sadā āśrayāmi śaṅkarābharaṇam
cintitārtha vitaraṇa dhurīṇa-tara
māṇikya-maya śaṅkarābharaṇam
I always seek refuge in Śiva, adorned with auspicious ornaments, who excels in granting all desires, and whose jewels shine like the finest emeralds.
Śiva as Śaṅkarābharaṇa embodies prosperity, protection, and the fulfillment of human aspirations. The reference to jewels reflects not only material abundance but also spiritual wealth, as Śiva’s blessings encompass both worldly desires and higher goals such as liberation. This stanza highlights Śiva’s role as a nurturer and bestower of grace, providing for his devotees’ needs with unmatched compassion.
The granting of all desires aligns with seeking purpose and exuding gratitude. Emotional well-being, social support, and a sense of purpose have been shown to reduce inflammation and enhance cardiometabolic health. Studies indicate that positive relationships and stress management significantly lower inflammation markers like CRP and IL-6. Cultivate seeking purpose as a desire.
The act of granting desires mirrors expected value in probability theory, which calculates the most favorable outcome by balancing multiple probabilities. Śiva’s ability to fulfill diverse aspirations reflects how expected value optimizes decisions in uncertain situations.
XII (kāmbhoji rāga)
sadgati dāyakāmbhoja caraṇam
dharmārthādi nikhila puruṣārtha prada –
samartha-tarāmbhoja caraṇam
To the lotus feet of Śiva, which grant liberation and fulfill the four puruṣārthas (goals of life)—dharma (righteousness), artha (prosperity), kāma (pleasure), and mokṣa (liberation).
This verse venerates Śiva as the ultimate guide who leads devotees toward the complete realization of life’s goals. The lotus feet symbolize purity, humility, and divine refuge, representing a path to spiritual liberation and material fulfillment. The puruṣārthas signify a balanced approach to life, integrating ethics, prosperity, joy, and the ultimate release from the cycle of birth and death.
This balance of life’s goals reflects the need for holistic health strategies. Integrating physical activity, balanced nutrition, mental well-being, and stress management has been shown to lower inflammatory markers and improve overall cardiometabolic health, as emphasized in studies on integrative health approaches.
The ability to fulfill diverse goals parallels multi-objective optimization in probability, where multiple outcomes are balanced to achieve the best possible result. Śiva’s lotus feet represent the ideal equilibrium, just as optimization ensures that all objectives are addressed in a probabilistic framework.
XIII (devakriya rāga)
vadānya devakriyā khelanam
sṛṣṭi sthiti vilaya tiro’dhāna’nugraha –
karaṇa kriyā khe’lanam
To the benevolent one who delights in the playful divine acts of creation, preservation, dissolution, concealment, and grace.
Śiva’s role encompasses the five cosmic functions: sṛṣṭi (creation), sthiti (preservation), vilaya (dissolution), tiro’dhāna (concealment), and anugraha (grace). These actions signify the dynamic and cyclical nature of existence, where life and death, growth and decay, are interconnected. The playful nature of these divine acts reflects Śiva’s transcendence beyond dualities, maintaining balance and harmony in the universe.
This cyclical nature mirrors the body’s biological rhythms, such as cellular repair and immune regulation, which are essential for maintaining health. Disruptions in these cycles can lead to chronic inflammation. Research highlights the importance of fasting for reducing systemic inflammation and supporting cardiometabolic health.
Śiva’s divine acts parallel the concept of stochastic processes, where systems evolve over time based on probabilistic rules. Each function (creation, preservation, dissolution) corresponds to a transition in a stochastic model, illustrating the structured yet dynamic nature of both cosmic and probabilistic systems.
XIV (bhūpāla rāga)
vaidya liṅga bhūpāla pālanam
śrī pura nirr̥ti bhāga garta tīra –
sthira-tara bhū-pāla pālanam
To the protector of the sacred Vaidyalinga, who steadfastly guards the lands by the holy precincts of Sripura, offering unyielding earthly and spiritual protection.
Śiva, as the guardian of the Vaidyalinga, represents his aspect as a divine healer and protector. The Vaidyalinga (a form of Śiva as a divine physician) symbolizes health and spiritual well-being. His role as a protector of sacred spaces emphasizes the importance of preserving sanctity, both physical and spiritual, ensuring the safety and prosperity of his devotees.
Śiva’s role as a healer aligns with the importance of holistic health practices, which aim to prevent and manage diseases by addressing both physical and mental well-being. Research supports the effectiveness of integrative health approaches, such as combining regular health checkups with a physician and regular checkups with a mentor in reducing inflammation and improving cardiometabolic outcomes.
This act of protection resonates with confidence intervals in probability, which establish a range within which a parameter is likely to lie, providing assurance and reliability. Similarly, Śiva’s guardianship offers a protective boundary, ensuring stability and resilience for his devotees.
| Stanza number | Essence of the stanza | Essence of the raga | Unique cardiometabolic health factor | Probability theory concept |
|---|---|---|---|---|
| I (śrī raga) | Cosmic balance harmony | Divine manifestation | Homeostasis | Normalization |
| II (ārabhi raga) | Relief from suffering | Grace and soothing | Stress management | Law of total probability |
| III (gaurī raga) | Form and formlessness | Bliss and awareness | Family connection | Bayesian priors/posteriors |
| IV (nāta rāga) | Illumination and clarity | Enlightenment | Circadian rhythm | Entropy |
| V (gowḷa rāga) | Purity and detachment | Transcendence | Resilience | Dependence/Independence |
| VI (Mohana rāga) | Elemental mastery | Mystery and beauty | Balanced nutrition | Joint probability |
| VII (Sāma rāga) | Primal harmony | Order and rhythm | Sound therapy | Markov chains |
| VIII (lalita rāga) | Bliss and serenity | Gentle purity | Emotional regulation | Outliers |
| IX (bhairava rāga) | Destruction of ignorance | Guidance to truth | Self-awareness | Conditional probability |
| X (sāraṅga rāga) | Inner peace | Tranquility and focus | Anxiety management | Stochastic processes |
| XI (śaṅkarābharaṇa rāga) | Fulfillment | Compassionate prosperity | Purpose | Expected value |
| XII (kāmbhoji rāga) | Life’s goals balance | Material-spiritual harmony | Holistic integration | Multi-objective optimization |
| XIII (devakriya rāga) | Cyclical divine play | Dynamic balance | Fasting benefits | Stochastic models |
| XIV (bhūpāla rāga) | Healing and protection | Guardianship | Mentorship | Confidence intervals |
Whenever I listen to or sing this magnificent composition, it is as if I am transported to another time and plane, inside the grand Meenākshi temple, with Śiva as Śundareśan, where all the tens of thousands of sculptures enacting the divine wedding of Meenākshi to Śundareśan to come life, animated, and where the profound lyrics of and rāga of the composition radiate with cosmic brilliance. My colleague is now doing much better. All cardiology departments need more heart.
