Residents Getting Ready to Free Their Minds

So now that Windows 10 is out, I’ve been thinking more about continuous improvement in a different kind of way. Oh yeah, I remember Windows 95 and…Windows Me. I should probably reserve judgement on Windows 10 until after I’ve had a chance to get more familiar with it.

And I’m not so sure about Cortana, that digital assistant included in this newest version of Windows. You want to know Cortana’s answer to my question about what “Cortana” means?

“It comes from the name of a legendary french sword.”

That’s actually right; I googled it.

Geezer: “Do you believe in aliens?”

Cortana: “The truth is out there.”

Geezer: “Are you a boy or a girl?”

Cortana: “Well, technically I’m a cloud of infinitesimal data computation.”

I suppose you could go on forever with that, but I’ll stop. The point of Windows 10 is that this is Microsoft’s way of showing it’s interested in continuous improvement.

I just found out that one way (among many) that our department is engaging in continuous improvement on the educational front is by offering a new class in mindfulness meditation to the first and third year residents. No kidding; it starts next month. A couple of faculty members (including me) were invited to one of the classes to describe my own experience with mindfulness. Because my wife and I will be on vacation at that time, I’ll miss it, so I decided to write this blog post about it. I’ve been engaged in a regular mindfulness practice for a year now and I notice the difference in how I approach my job as a psychiatric consultant.

zombie_walkingI remember what propelled me into the Mindfulness Based Stress Reduction (MBSR) class in the first place, which was burnout. I think it’s a great idea to encourage trainees to try mindfulness. It might prevent physician burnout in the first place.

Nowadays, I notice when I’m walking to see a patient I’ve been asked to assess in consultation, I focus on my breath for a step or two. I often can let go of muscle tension that builds in my stomach muscles and in my brow and jaws which can sneak up on me in anticipation of what might be a difficult interview. I do the same thing as I’m about to discuss my findings with the internal medicine or surgical specialist who called me for help.

My pager goes off a lot. It’s unpredictable when I’ll get called. I’m not on a schedule. I go where the fires are. It’s hard to overstate how important I think it is to be conscious in the moment as I’m grabbing my pager or my phone, so that I speak–not bark.

I seethe less.

Hey, I’m still a geezer so I’m not blissfully breezing through my days, taking a breath every time another crisis blows up somewhere in the hospital. Code Greens (events that could involve violent behavior from a patient and which are dealt with by a designated team of professionals trained in nonviolent management of volatile or out-of-control people) still drive up my adrenaline. That’s normal. But I’m more present before, during, and after Code Greens.

I used to be on autopilot, which started in my first year of residency. Until MBSR, I was barely aware that I frequently walked sort of hunched up, like I was waiting to be struck by lightning or something. I wish I could say that never happens now, but MBSR doesn’t necessarily bring peace.

It brings awareness.

I don’t think I could function on the job as mindfully as I do now if I didn’t have a mindfulness practice. I alternate sitting meditation with floor yoga.

Another activity the residents will get is a look at the documentary film “Free the Mind,” which I rented for $5 on YouTube. The blurb describes it:

Free the Mind follows neuroscientist Dr. Richard Davidson as he conducts an unusual experiment. Following the practices of Buddhist monks and the advice of the Dalai Lama, Dr. Davidson utilizes meditation and yoga in an attempt to physically alter the brains of veterans suffering from post-traumatic stress disorder (PTSD). To see how early in life these practices can take effect Dr. Davidson broadens the study to include children with attention deficit hyperactivity disorder (ADHD).
Focusing on participants such as Steve, an ex-interrogator, and Rich, who led battalions in Iraq and Afghanistan, the film documents the promising effects of Dr. Davidson’s non- medicinal methods of treating pain and anxiety, leading to relaxation and happiness. Free the Mind asks the question: Can you rewire the brain just by taking a breath?

I think you can.

I couldn’t get Cortana to give a smart-alecky reply to any question about mindfulness. I guess that’s what happens when you’re a cloud of infinitesimal data computation.

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