Mindfulness and meditation. Meditation and mindfulness. Allow me to elaborate.
I went to medical school in the 1980s. Nobody talked about complementary and alternative approaches to healthcare or mind-body medicine. It wasn’t because we students thought it was weird; it wasn’t even on our collective radar screen. It was, however, out there even then. Andrew Weil was busy in his movement toward integrative medicine, and Jon Kabat-Zinn was pioneering his Mindfulness-Based Stress Reduction program at the University of Massachusetts. I had only fleeting awareness of these activities peripheral to the traditional Western medicine taught at my medical school. I attended medical school in Kansas, which was not exactly a hotbed of creativity in the alternative medicine world.
Medical school was just as grueling in Kansas as it was anywhere else. Medical education then, as now, was fraught with stress and sleeplessness. Little exercise and poor diet were ways of life. Many of us accumulated debt exceeding six figures, and this has only worsened through the years. One of the cardinal lessons when entering medical school is that you may be the cream of the crop upon acceptance, but once you arrive, you are just one of many bright doctors-to-be. Needless to say, it was hard on the ego. When we add together all of these factors, it can be overwhelming for the medical student. Finding a clear way to cope with all of these difficulties is not readily apparent. Medical schools are not particularly known for teaching students how to deal with personal issues and stress. The end result is that we graduate doctors who are well on their way to burnout, cynicism, and depleted empathy even as they receive their freshly minted degrees. Unfortunately, residency will take an enormous toll as well, which then extends forth into the physician’s clinical career. We are producing physicians who start their careers already well on the path to burnout.
How do we teach medical students (and doctors) to deal with all this stress? How do we do it in an efficient and cost-effective manner? My answer is mindfulness meditation. Obviously, meditation has been around for thousands of years. All great religious traditions have contemplative practices and use meditation in some form, although mindfulness meditation is most often associated with Buddhism. I am not advocating that students partake in any particular religious exercise. I am proposing that they learn nonjudgmental present moment awareness through mindfulness practices, including meditation. Myriad studies over the last forty years support the use of mindfulness and meditation in reducing anxiety, depression, chronic pain, and inflammation and increasing resilience and well-being.
Mindfulness is what we need as doctors to function and survive in a complicated medical world. Mindfulness is also what patients need from their doctors as presence, and active listening is one of our most important but neglected skills. On a larger scale, mindfulness is what we need as a society as well. Mindfulness allows us to pause and assess a situation as well as to remain engaged in the present. It allows us to maintain compassion and equanimity, joy, and love for our patients, colleagues, loved ones, humanity–and even ourselves.
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