20 years old and after receiving the full precepts in Nara, Saicho left that center of established Buddhism and built a meditation hut on Mt Hiei. There, praying in seclusion, he vowed to realize a better and more sincere way to benefit the people, to carry out his bodhisattva intentions. For an object of offering and concentration, he carved a statue of the Medicine Buddha, and performed his prayers and meditations facing it.
His efforts were successful. The Emperor followed Saicho's example when several years later he moved his capitol from Nara to Kyoto at the foot of Mt Hiei. The two became friends, and subsequently Saicho was able to travel to China, absorb the Dharma in Mt Tien-tai and other places, and upon returning to establish the Tendai sect which flourishes to this day.
Due the intensity and sincerity of Saicho's original prayers in front of the Medicine Buddha, Tendai priests still today make the curing of peoples' sufferings their number one responsibility.