The importance of mindfulness | Kimberly Resnick, MD
“… Not being lost in thought, not being distracted, not being overwhelmed by difficult emotions but instead learning how to be in the here and now; how to be mindful, how to be present. I think the present moment is so underrated. It sounds so ordinary and yet we spend so little time in the present moment that it’s anything but ordinary.” Andy Puddicome, TED Talk
On Monday morning our clinic in downtown Cleveland was abuzz. Less than 12 hours earlier the Cleveland Cavaliers had won the National Basketball Association title, ending the city’s half century major sport championship drought. LeBron James kissed the ground. Attending physicians looked weary after a late night. At the nurses station, medical assistants watched the final game moments on YouTube. Patients came and went—needing chemotherapy, radiation, and shoulders to cry on.
Mr. X was clearly agitated. He and Mrs. X had been in clinic for two hours already, patiently waiting for her lab results. He grew increasingly impatient as the morning wore on. “I don’t care that the Cavs won the championship,” he declared. “I want Mrs. X to get her chemo!”
Given this situation, what should a clinician do? In this circumstance, practicing “mindfulness” can be a benefit to the patient and her caregiver as well as the health care practitioners involved.
Mindfulness is defined as a “moment-to-moment, non-judgmental awareness or binging one’s complete attention to the present experience…” (1). Originally emerging out of the teaching of Guatama Siddhartha, mindfulness can be practiced free from “-ism” or religious beliefs (1). Jon Kabat-Zinn, at the University of Massachusetts Medical Center, has developed the mostly widely-used mindfulness program for patients who are without hope for treatment for chronic issues (2). There is strong evidence supporting that therapeutic gains made from this instruction persist long after the teaching. But those of us wearing the white coats can benefit from this principle as well.
It is apparent that a mindful clinician, one who is grounded in the present doctor-patient interaction will be more effective at communicating, coping, treating and healing. McGill University in Montreal has undertaken an eight week mindfulness training for health care professionals (2). Pilot data demonstrated that these participants all reported an improvement in psychological well-being and in their ability to disengage from distractive thoughts.
To practice mindfulness, clinicians need to dis-engage to engage, bringing their full attention to each and every patient interaction. On this particular Monday, my wonderful charge nurse was mindful of Mr. X’s needs. She disengaged from the background noise regarding the Cleveland Cavs celebration and allowed herself to interact with Mr. X free from judgment and clatter. Afterwards she spoke of his needs, his fears for his wife, and his need to connect with a provider.
My advice to my fellow physicians would be to start your day with focus–focus on your breath, on your body–focus on what you are “bringing to the table” on that particular clinic day. And try to let it go. Allow Mr. X a centered encounter. You too will feel at ease.
1. Baer RA. Mindfulness training as a clinical intervention: a conceptual and empirical review. Clin Psychol Sci Prac 2003; 10:125-143.
2. Whitesman S. Mindfulness in Medicine – MBSR www.mbsr.co.za › Article
- Mindful Doctors, Happy Patients (University of California, Berkeley)
- Easing Doctor Burnout With Mindfulness (New York Times)
- Mindful Practice (JAMA)
Kimberly Resnick, MD, is the Division Director of Gynecologic Oncology at the MetroHealth Medical Center at Case Western Reserve University in Cleveland, OH.