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Escape to Nature | David Iglesias, MD, MS

SGO WellnessWellness
Jun 23, 2021

David Iglesias, MD, MS

It is a late spring evening following a long day in the operating room.  As I drive home and reflect on another missed dinner with the family and whether I will make it in time to read the book about dragons to my daughter before bed, my mind wanders to the medical records I have not yet had a chance to close and the faces and lives that they belong to. What about the test results that have undoubtedly populated my inbox and will require complex decisions amid another busy clinic tomorrow?  When will I be able to finish that manuscript?  This complicated reverie is disrupted by the familiar vibration of my phone, alerting me that either I have a page from the hospital or maybe it’s a reminder for a committee meeting later this evening – I can’t decide which I would prefer.


Can you relate?  How do we manage all of this?  With our lives now more connected and busier than ever, there is a growing understanding of the threat this poses and the need to seek physical and mental “wellness”.  This concept has become so mainstream that it is now rare not to see speakers at national meetings promoting the virtues of mindfulness or meditation.  I will be honest; I was a late adopter.  A few good friends found success with more “traditional” meditation techniques, but I just couldn’t.  I tried and struggled to find value in what seemed like time lost…until one day, when I was invited on a hike.

Cascade Falls – Pembroke, VA

Not long ago, a friend asked me to accompany him overnight along a stretch of the Appalachian Trail not far from where I now live in southwest Virginia.  I was a bit apprehensive at first, unsure of what to expect or even pack – in the end, it was transformative.  I was compelled to temporarily step out of my hyper-connected life, freeing me to shift attention away from the cluttered internal dialogue of my mind, refocus and find some clarity.

In the years since, I have taken many hikes – some short, some long, many alone, and many others with family or friends.  I have had time for quiet self-reflection, and I have also had deep and meaningful conversations about life, faith, marriage, and family. Most times I cannot wait to get outside on the trail, but other times I try to make excuses and must nudge myself along.  I have never regretted it.

Escaping to nature does not always require roughing it in the backcountry for several days.  Positive physiologic and mental effects have been reported with even smaller increments of time in nature [1-3].  The Nature Pyramid [4,5] is a tool that I found useful as a framework to get started.  You may choose to begin with a simple 30 minute walk through a local park sans phone a few times per week, or maybe a 3-4 hour hike in a state or national park [6-8] each month, or a 3-night camping trip once per year.  As mid-summer arrives, consider dedicating time this week to get outside and see for yourself.

Sunrise over the Peaks of Otter, Southwest VA

Back in my car, I put my phone down and take a deep breath.  As I get closer to home, I come to the crest of a hill.  There I see it; the last rays of the sun as they extend over the bluish-green hues of the forested mountains.  For me, this is my escape in the moment.  I pull over, get out of the car, and sit on the hood to watch the setting sun.  With my phone in the car and safely out of earshot, I listen to the wind rustling through the trees, the final call of the birds, and the gentle movements of the deer in the tall grass of the nearby field.  I just sit and listen and watch.  When I arrive home, my daughter and the book about dragons awaits me, and I am present.




  • Bowler DE, Buyung-Ali LM, Knight TM, Pullin AS. A systematic review of evidence for the added benefits to health of exposure to natural environments. BMC Public Health. 2010;10:456. Published 2010 Aug 4. doi:10.1186/1471-2458-10-456
  • Scott EE, LoTemplio SB, McDonnell AS, et al. The autonomic nervous system in its natural environment: Immersion in nature is associated with changes in heart rate and heart rate variability. Psychophysiology. 2021;58(4):e13698. doi:10.1111/psyp.13698
  • Jimenez MP, DeVille NV, Elliott EG, et al. Associations between Nature Exposure and Health: A Review of the Evidence. Int J Environ Res Public Health. 2021;18(9):4790. Published 2021 Apr 30. doi:10.3390/ijerph18094790
  • Thriving with Nature. The Nature Conservancy. Published June 22, 2020. Accessed June 18, 2021. https://www.nature.org/en-us/about-us/where-we-work/united-states/new-mexico/stories-in-new-mexico/thriving-with-nature-florence-williams/
  • Easter M. Use the “20-5-3” rule to make yourself happier and stronger. Menshealth.com. Published June 4, 2021. Accessed June 18, 2021. https://www.menshealth.com/fitness/a36547849/how-much-time-should-i-spend-outside/

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David Iglesias, MD, MS, is an Associate Professor in the Division of Gynecologic Oncology at Virginia Tech Carilion School of Medicine and Carilion Clinic in Roanoke, VA.