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Lions Roar : January 2011
SHAMBHALA SUN JANUARY 2011 50 at the School of Medicine and public health at the university of Wisconsin–Madison showed that health care practitioners who are empathic seem to be able to reduce the duration of the com- mon cold in patients and boost their immune systems. When i was being trained as a physician, we weren’t taught about things like listening or empathy. Even when you have empathic medical students at the start, by the time the social- ization experience of medical school is done with, much of it has been wrung out of them. Mindfulness could serve as an antidote to the incredible pressures that young clinicians are exposed to. they would benefit from learning skills to help maintain inner resilience, so they can maintain an open, com- passionate, receptive place for their patients while also taking care of themselves. it’s like the instruction on the airplane to put on your own oxygen mask first and then help others put theirs on. We’re not giving oxygen masks to these clinicians. they’re understandably overwhelmed and depressed, and often feel hopeless. they don’t know what to do with their own emotional world, so they just withdraw. Everyone suffers because of that. SuSAn BAuER-Wu: i heartily agree. And i would add that their own health suffers under the strain. When nurses get burned out, they often get sick and can’t show up for work. that becomes a burden to the health care system. professional caregivers are also less attentive when they’re sick and burned out. Errors occur and overall safety decreases. patients are put at risk and costs rise. i believe that physicians and nurses who practice mindfulness are better diagnosticians. they are more sensitive to the subtle- ties of the whole person, not just the physical symptoms that the patient presents with at the time of the appointment. Some colleagues of mine and i have been doing work on the idea of “compassionate silence.” Mindfulness and compassion practices can help clinicians to be fully present and spacious in the very condensed time they have to meet with a patient. physicians and nurses are not generally taught how to be okay with silence. When a clinician learns to hold whatever is arising, instead of trying to fix it, push it away, run out of the room, or ruminate about the next pressing thing they have to do, that’s profoundly healing for the patient. We also know that clinicians find those experiences some of the most rewarding as well. JOn KABAt-Zinn: until very recently, physicians were not trained in how to be in relationship with another person who is suffering, who is frightened and doesn’t understand a lot of what’s going on. the potential benefits for both the patients and the physicians of cultivating that kind of empathic presence and silence—and perhaps embodying silence as a way of being—is unbelievably important. it’s also helpful for doctors to have the humbleness to know that they can’t immediately fix everything. there are lots of things that cannot be fixed in medicine. While it would be wonderful if there were more cures—and more research should definitely bring more cures in the future—healing is always possible, even without curing. if we recruited our patients as participants in fostering greater health and well-being, while coming to terms with whatever illness they may face with self-compassion and wisdom, it would cost the system a lot less money. You wouldn’t be throwing fixes that aren’t actually going to work at people who really don’t need them. But our system continues to do that out of a kind of desperation. it would make an enormous difference if mindfulness were made available at the wide mouth of the funnel, so to speak, before people wind up with a serious condition which requires surgery or a long hospital stay. Our hospitals and medical centers have the potential to become centers for integrative health care. if patients and their doctors have access to mindfulness training, it can revive the sacred dimension of the doctor–patient relationship based on the hip- pocratic principles. it can move treatment more in the direction of healing the whole person rather than fixing body parts. the pa- tient would be engaged as an important part of the process, doctors would be happier, nurses would be happier, and hospital adminis- trators would be happier. it would cost a huge amount less. DAniEL SiEGEL: Mindfulness is a part of a much larger frame that society has to move to: embracing the importance of our rela- tionships with one another and seeing that the mind, though it’s not measurable like physical things are, is actually a real entity whose workings have monumental effects on the shape of our world— physical and otherwise. from a scientific research standpoint today, there’s much more support for putting understanding of relation- ships and mind on an equal footing with understanding the work- ings of the body. i see it becoming a fundamental part of how clini- cians are trained, and i see a new unifying vocabulary emerging that will allow us to talk about subtleties that were left unexamined in our previous ways of talking about and practicing medicine. We now have worthwhile research results to present to a sci- entifically hungry medical student population. We can show them that these aren’t “soft things.” they aren’t elective, optional concerns. the dynamics of the mind and relationships with oth- ers are fundamental to what it means to be human and what it means to bring healing into the world. ♦ opposite: tetrarch 3:38pm 8th october 2008 You can be in the midst of great difficulties and yet find immense composure and clarity. — daniel sieGel