If you are one to see the word meditation and think, “No way! Not even close. What? I’m supposed to chant “OM” and sit with my arms open signing ‘asshole’ with my thumb and first finger?” (See pic below).
Taken from a chapter in my new book (in process), “A Bitter Pill.”
“Doctor, Please Take a Breath”
“One conscious breath – in and out – is a meditation”
— Eckhart Tolle —
Don’t worry, to understand this section you don’t have to ring bells, chant “om,” or burn incense/sage. With all the platitudes used in our language, “Just breathe,” is definitely one of the most overused sayings, as in “Don’t worry about your pending divorce, just breathe.” It’s an empty platitude without specific direction. For all intents and purposes, they are breathing! Frustrating isn’t it?
As we will read later, (Why Doctors Burn Out), physicians are classically over-worked, overwhelmed and some would say underpaid, which all create the perfect storm for physician burnout. Sometimes, physicians just need to take a moment to reinvigorate themselves so they can get through their busy day. There are plenty of things that one can do to center oneself and prevent the dreaded burnout. Metaphorically, when someone is centered, they aren’t easily tipped over in either direction. When things get tough, they stand stable, sway a bit with the environment, but rarely tip over. So, in an effort for a physician to maintain their “stability” during days that seem never-ending, busy, monotonous or just plain slammed, physicians should be taking moments for themselves to regroup so that the next patient doesn’t suffer from the wrath of their frustrations. The energy from one visit, may follow the physician into the room of the next, if the physician isn’t present (aware) enough to tame it. If they don’t, not only does the physician suffer, but the patient as well. There are some exercises physicians can do during a visit without anyone knowing to re-center and re-group. I call it the auscultation meditation.
The word auscultation is the Latin verb for listening. Doctors do this all the time, especially when ‘auscultating’ the lungs for breath sounds, or as said in meditation circles: “paying attention to the breath.” This meditation developed out of my own laziness for meditation. I was having trouble committing to a daily meditation practice, and I remember Eckhart Tolle, Author of The Power of Now and A New Earth (and more) say, “just take 4 breaths a day to start.” I thought, “Really?! I can do that.” Henceforth the origin of “auscultation meditation” was born. Most general physicians (Internists or Family Practice) see an average of 20 (or more) patients per day, and of those, listen to about 14 or so chests. I listen to each chest with my stethoscope in 4 areas, so the way I see it, that is 56 uninterrupted breaths I can take in a meditative way every day while seeing patients:
THE AUSCULTATION MEDITATION:
When I am ready to listen to my patient’s lungs, I set myself up next to them. I put on my stethoscope (plug in my ear pieces) and everything becomes silent except my breath, which is beautifully louder than it was a second ago–as if you plugged your ears with your fingers and breathed. Yes, like that! I then place one hand on their shoulder and place my stethoscope on their back and close my eyes. “Really deep breath now,” I say, as I tap on their shoulder gently. Magically, their breath becomes the predominant sound in my ears, and at this point our breaths synchronize. I tap their shoulder again indicating to take another breath and move to the next zone and repeat the process. I am paying the utmost attention to their breath as I breathe in-concert with theirs. My hearing is now extremely acute and all that exists are the breaths we share. Interestingly, I am so present during the meditation that I can hear better, and pick up subtleties in their lung sounds that may have eluded me if I wasn’t in that state. I do this for two more zones until I have heard all 4 lung locations. I stand there for 1 second as I remove my stethoscope from my ears. I open my eyes, and for a short moment, the world is totally bright, still, silent and calm. This is how I know my ‘auscultation meditation’ worked. “Sounds good!” I say (or whatever it sounded like). My patient didn’t even know what I just did. A meditative state doesn’t mean you go away into some trance-like state–It means you are ever so present. You can do this anytime, anywhere and auscultate the world if you want without a stethoscope. Just pay attention to the sounds of the world. Pay attention to your breaths. Pay attention to the sounds between the sounds. Just giving it a try makes it work.
Dr. Linzer, Director of the Division of General Internal Medicine at Hennepin County Medical Center in Minneapolis, has studied physician burnout since 1996. He so elegantly stated, “As physicians, we want to be altruistic, but one of the keys to altruism is self-care.”