How practicing mindfulness between patients makes you a better doctor


Mukhwas are the Indian equivalent of an after-dinner mint. Sweet and flavorful, but typically only distributed through one tiny spoonful at a time, mukhwas are the perfect way to completely clear your palate, wiping clean the last remnants of a tantalizing meal. A small dosage of the mukhwas completely nullifies the aftertaste, so that the attention is no longer on the meal that has just passed. It’s the gustatory equivalent of a reset button, clearing and preparing you for whatever sensory experience comes next.

Being a physician, I am aware of also needing a reset button in between each patient. I had found that I become immersed in a patient’s story, allowing the ebb and flow of her subconscious waves to wash over me. And then I have a few minutes to reset and mentally prepare for the next patient. Early in my career, I would’ve dismissed any need for “resetting” as simply hogwash and an unwanted distraction, because my focus and emphasis was on being as efficient as I could be in a high volume practice. It is easy for us physicians to reject any form of self-care or self-compassion as being unnecessary or irrelevant. However, I quickly learned that the need to compassionately clear my mind between patients was the single most essential thing I could do to have a successful, thriving practice that was based on efficiency and high-quality care.

When I was a resident, I hid a carton of Oreo ice cream in the communal freezer; in between patients, I dashed to the break room to take a bite of it. In that moment of luxurious indulgence, my mind would forget where I had just come from and where I was going to; instead, my senses would be completely drawn to that moment. Although it worked (for my mind, but not for my waistline, unfortunately), I recognized a need to achieve the same results through a mental process.

This is the concept of taking a moment, just a moment, to do something that felt organic, indulgent, calming to the senses. In short, mindfulness. Mindfulness is focusing one’s awareness on the present moment. Taking a moment to break from the energy of the last patient, as well as to break from the anticipation of the next one, feels essential to good practice and to surviving a busy day in medicine.

Why is mindfulness in these moments important? It’s important for you, because you deserve a moment to take a breath. And for the patient, because she deserves your complete mental presence. Because if you are running on autopilot, meaning not truly being aware or present in any moment, you really aren’t fully able to engage in whatever responsibilities you might have at that moment. Because mindfulness is proven to reduce overall stress. Because when we become mindful, we are far less likely to be easily reactive or overwhelmed. Because once you start to regularly practice mindfulness, you’ll be more easily to be present during other times in your life (i.e., being able to actually leave work at work, being able to be mentally present when you are home with your family, being able to actually focus on emotionally connecting when you grab that cup of coffee with your friend, etc.). Because even all it achieves is to make you healthier and happier, you’re worth that investment in yourself.

How does one start practicing mindfulness? If the ice cream thing just doesn’t work for you, here are some tips on how to incorporate mindfulness into your practice:

Breathe. Either sitting or standing, take a deep breath. Focus on your breathing and on exhaling and inhaling but especially the momentary pause in between. Pay attention to all aspects of the breathing; make note of the feeling of air entering and leaving your nose/mouth and the rise and fall of your belly as your breathe.

Pay attention. Take a moment to listen to the other sounds around you, the ones that you might not have noticed before. For example, listen to the air conditioner switch on and off. Or the cars whizzing by outside your office window. Bringing your attention to that moment draws you into the present.

Accept your emotions. Take inventory of all the emotions you’re feeling at the moment. No matter what you are feeling (anger, sadness, happiness, frustration), accept it openly. Remember that you are not your thoughts (i.e., feeling a moment of anger does not make you an angry person). And then let it go and let your mind clear.

Easy right? And while many sources will advise you to take a block of time to sit down in a quiet environment with a cushioned chair, most of us simply don’t have that luxury in our busy inpatient or outpatient practices. I have found that mindfulness practices have been helpful no matter how little time I had or where I was located, whether I was operating on a full census on a consult service in the medical wards, in between patients in my outpatient practice, or barefoot at home on a quiet evening. Your practice of mindfulness can start in your car before you walk into your clinic. And in between patients it feels almost essential; taking a moment to sit quietly at your desk or in the break room could be a quick way to practice before you go about the rest of your busy day.

The best part is that anyone can practice and benefit from mindfulness, no matter the age (even a toddler!), practice setting, religious background or medical history. It’s a compassionate way to bring calm and harmony to your mind and allow your mind to be it’s most powerful version of itself. It’s a wonderful, simple way to bring yourself into the present, so that you can be the best possible doctor for your patients and the healthiest possible version of you for yourself and your family.

Aparna Iyer is a psychiatrist.

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