Music The context
and the practice of medicine just seems
to be accelerating. The hustle and bustle
of residency training, it’s quite a fast pace,
and it’s very grueling. It is a relentless
exposure to suffering. And the numbers of
things competing for our attention
is just incredible. There’s not much time to reflect on how the process is
shaping you and impacting you, as well as reflecting
on the sort of impact that you’re having
on your patients. No matter what happens to you
or to your patients or anything like that that you’re
not allowed to sort of — even have an emotion, I
mean, let alone express it. That can create a situation in which you are the
opposite of mindful: mindless. Music Burnout is
a systems problem, and our program offers real
skills that can be used at every level, not only to
build individual resilience but to change the system
through awareness building at every level, from leadership
down to the rank and file. Think of a time when you
experienced a conflict with a patient or a colleague. The cost of a mindfulness
program or other programs that try to mitigate burnout
is incredibly inexpensive. So if you’re trying to
make a business case, take a good hard
look at what burnout and errors are costing
your institution. We teach doctors to meditate,
and even if it’s just for 30 seconds or just for
3 seconds, taking a breath between patients, but to really
recalibrate their inner lives and be more aware. Practices themselves, the
formal meditation practices, are not about actually
getting good at them. They’re like exercises. They’re like if you’re
trying to become more fit, you would go to the gym. You may run on the treadmill. You may lift weights. Not because you want to get
good at running on a treadmill or lift weights but
because you want to improve your overall
wellbeing so that you can live your
life in a more healthy way. The actual meditation is
actually the work that we do from moment to moment, whether
it’s with our family at home, whether it’s in the exam
room with our patients, whether it’s talking about
cases with our colleagues. And the formal practices
are merely exercises to improve our ability
to be present, to understand the thought
drivers, the emotion drivers, and the physical sensation
drivers of our behaviors, our decision making, how
we relate to our patients, how we relate to our colleagues. Choose who will be taking
the hit first and just do it, and then stop and talk
about what was that – what was that like for
you, and then switch. It is immersive,
so you are going to be getting a good
dose of skills. But it also builds in the
reality of – how are you going to put this into
your day to day? Can you imagine a
conflict or a situation in which it was unexpected? I think people can come from
this and make choices about – “I could incorporate this
exercise or that exercise,” and put it right into
their day-to-day practice. This is how you might
get yourself ready from a tough encounter
to the next, as well as this is how you
might construct a program that would create this
for medical students. Put your own oxygen mask on
and then go with the flow. It’s a retreat that
we’re staying overnight, and you’re here for days. I think that actually
enhances the experience because that really separates
you from all the work stuff. By doing this over the
course of a couple of days, it really allows
you to slow down. It’s really peaceful and
calming and allows you to sort of really find that
sense within yourself. Everything you have
is there to be lost. Yeah. Which points,
then, to making the most of the moments while it’s there. Yeah. The ambience that
was created was one of tremendous support
and kindness. So quite often in the arenas that we work, it’s
high intensity. There’s not a lot of room
or space for any of this. It’s very nourishing. There are experiences
that we share and traumas that we experience that I
think, by the commonality of our experiences,
it’s a little bit easier to have certain conversations
that you can take for granted that a certain context
already exists. If we talked about the
impact of losing a patient, we didn’t have to explain it. So it’s your people. Right? The core of medicine
is human understanding. And without that we don’t
have anything. We’ll ask people
to write a story about a meaningful experience
or when they were involved in a medical error or when
there was a conflict and share that story in a very
structured way, in which their partner
is instructed in how to listen deeply. The three things that we talked about were aging,
illness, and death. When we’ve been practicing
listening deeply, what we’re really practicing
is letting go of our own agenda in the interest of
creating a crucible for someone else to
speak their truth. Right? People get a sense of
what it’s like to be listened to in this way and the power
of having been listened to and the power, also, of
the ability to tell stories about important formative
events in one’s career that often are never discussed. Sometimes you need to speak
truths that are very painful, but that doesn’t mean that they’re not
useful and appropriate. There’s a lot of power in
telling your own story, and that’s so much of what we’ve
been doing here at this retreat, is strangers sharing
their own stories and then something magical
happening where you feel like you’re no longer strangers. Hearing your story,
opening to my own, I feel a little bit stronger. Loss and fear – it
doesn’t make them better. I feel a little bit
more spacious, like I could tolerate more. It’s a safe environment, and
it’s – the brilliant thing about it is we all
live these experiences, and the great thing here
is no one’s judging you. It’s rather delightful to see
what happens when you kind of cut away the small talk and
let your walls sort of melt away so that you can really
have meaningful engagement with others, meaningful
conversation. It allows me, I think, to
embrace more of this human kind of vulnerability in a way
that feels very courageous. So I see it now as more of a
strength as opposed to something that I kind of need to
protect myself from. It does create this camaraderie
and friendship and community which is so supportive
and sustaining. We have to figure out a way,
through cultivating community, to make the culture reflect the
sort of humanness that we carry and that we want to see
injected back into medicine so that our patients can benefit
and so that we, as providers, can continue to do this work. The skills I got here were
little things I could do in my day-to-day work life which I can see helping
me in the future. I can sort of really
see how they fit. In many clinical situations it
can be really anxiety provoking, or you can be kind
of on high alert. So if you’re able
to practice kind of just slightly slowing down, just becoming a little bit
more aware of what’s happening on the inside, then I
think that that enables me to actually engage
in a different way, a way that’s actually
a little clearer. And I think, really, through
mindful practice that’s actually – it’s helped me to
be a better physician. Music