As the Dalai Lama, the spiritual leader of Tibet, visits the United States to receive medical treatment on his knees, concerns over who will succeed him have become acute. While Tibetans around the world pray that the 88-year-old Tenzin Gyatso, the 14th Dalai Lama, still has plenty of life ahead of him, China is eagerly awaiting his demise so that it can install a puppet successor.

Tibetans regard the Dalai Lama as the living incarnation of Buddha, with a total of 13 reincarnations since 1391. When one Dalai Lama dies, the search for the next one begins, with a council of senior disciples taking responsibility for identifying the figure based on signs and visions. But in recent years, the Chinese government has insisted that only it has the right to identify the next Dalai Lama.

This would not be the first time China selected a leader of Tibetan Buddhism. In 1995, it anointed its own Panchen Lama, whose spiritual authority is second only to that of the Dalai Lama, after abducting the actual Panchen Lama — a 6-year-old boy who had already been confirmed by the Dalai Lama. Almost three decades later, the real Panchen Lama is among the world’s longest-serving political prisoners.