The National Institutes of Health (NIH) has put itself firmly on record as being deeply concerned about our national epidemic of stress at the individual, organizational and societal levels. NIH’s National Center for Complementary and Integrative Health (NCCIH) broadcast on September 7th its annual Stephen E. Straus Distinguished Lecture in the Science of Complementary Therapies. The lecture was titled A Nation Under Pressure: The Public Health Consequences of Stress in America.
The American Psychological Association (APA) recently documented a worrisome increase in stress in the U.S. population (Stress in America https://www.apa.org/news/press/releases/stress). Uncontrolled stress can cause or worsen anxiety, depression, PTSD and a wide range of clinical conditions affecting every organ system. Medical students, residents and practicing physicians experience higher levels of stress than their age-
Of all the sciences, medicine uniquely combines all domains of the human condition-
Medicine has always attracted the best and the brightest. Most applicants to medical school are also inspired by a desire to be of genuine service and express their deepest human values through their professional lives. This ethic of altruism, compassion, meaning and service distinguishes medical students from most other professional students.
This new patient was a desperate, mid-
Modern life is taking its toll on our nation’s mental and physical health. Physicians and their patients both suffer from stress-
Former Surgeon General Vivek Murthy MD has sounded the alarm regarding our country’s epidemic of stress.(1) He calls for a serious national effort to mitigate the corrosive effect of chronic stress on every organ system. He calls for a nationwide campaign to spread a preventive, behavioral lifestyle prescription of healthy eating, physical activity and genuine social support (other than social media). Based on solid peer-
Behavioral medicine research confirms the value of mind-
Relationships are at the very heart of medicine. I recently saw one of my favorite patients whom I had not seen in 10 years. I have thought of her often since the hospital took over my Estill County practice in Irvine and I moved to Lexington. Wanda always lifted my spirits. She always asked me how I was doing because she cared about me. We joked and laughed while managing her chronic medical conditions. She was good medicine for me.
Defining resilience: The American Psychological Association (APA) describes resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress, such as family and relationship problems, serious health problems or workplace and financial stressors. It means ‘bouncing back’ from difficult experiences.” APA further describes resilience as “ordinary, not extraordinary. People commonly demonstrate resilience.
Wayne Jonas MD is clinical professor of family medicine, Georgetown University, retired Lt. Colonel United States Army Medical Corps and a complementary medicine researcher. He previously served as Director of the Office of Alternative Medicine at NIH, which is now called the National Center for Complementary and Integrative Health. He has recently proposed the HOPE note (Healing Oriented Practices and Environments) as a clinical tool to help physicians….
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young children. Moments of awe can easily pass us by. We adults need to learn to ‘stop and smell the roses’ anywhere, anytime.
When given the opportunity to reflect on the experience of awe in medical training, most medical students can easily give examples. Though their resident or attending physician rarely reports sharing their experience, students talk about the deeply moving experience of first hearing fetal heart sounds, delivering their first baby, assisting in major surgery or being with the dying.
These experiences of awe are not typically validated and reinforced by the culture of medical training. Medical electives, and occasionally required courses, seek to correct this deficiency in the training of the physician as a whole person. The Healer’s Art–Remembering the Heart in Medicine is an elective taught to students and residents at over 100 medical schools (including UK for the last 15 years). Mindful Practice is an elective created for students and residents at the U of Rochester.
These courses cultivate the qualities of exemplary clinicians that transcend a purely biomedical model. They enhance the self-
Some skills taught in these courses include-
To develop our exemplary physicianhood and humanity, we need to develop a kind of ‘double vision.’ We must focus on the biological, physiological and pathological in the conventional medical scientific care of our patients. And we must simultaneously focus on the unique human being we are treating-
The developers of Mindfulness-
Emotional Intelligence (EQ)
In explaining our diagnostic processes and decision-
The future of medicine is bright, in part due to the growing emphasis on the training of emotionally mature and aware physicians and health team members. Those in health care leadership and administration can also maximize their effectiveness, communication, career satisfaction and the satisfaction of their workforce by the intentional fostering of EQ through emotional awareness, fluency and flexibility.
Our entire societal education system is recognizing the importance of preparing learners of all ages to maximize their inborn skill of emotional intelligence-
Moments of awe may be fleeting. We can train ourselves to be ready for them. If we look closely, awe is as close as your own remarkable human physiology. The wisdom of your body is truly awe-
The growing research applications of mindfulness include promoting resilience, managing stress, preventing burnout, cultivating compassion, growing our sense of gratitude, joy in medicine and the potentially life-
Of all the sciences, medicine uniquely combines all domains of the human condition-
This humanistic trend in physician/ physician relationships and physician/ patient relationships can be nurtured without traversing the potentially hazardous terrain of conflicting religious or spiritual beliefs. An encouraging sign of this maturing transpersonal humanism in medicine is the respect and serious study being given to awe as worthy of our professional attention.
What is Awe?
Most physicians never heard the word ‘awe’ mentioned in medical training as something worth taking precious time away from more ‘serious’ study. Yet, some of our greatest medical and scientific minds (the ‘father of modern medicine’ William Osler, current director of NIH and the Human Genome Project Francis Collins, physicist/ pacifist Albert Einstein, astronomer/ cosmologist Carl Sagan) have spoken about awe as a primary motivation for medical and scientific inquiry.
Though awe is a transcendent, often reverential, experience filled with wonder that needs no logical rationalization, it is not necessarily rooted in one’s religion or spirituality, though these may be involved for some people. Researchers view awe as perhaps a uniquely motivating driver of the scientific search for truth and a hopeful environmental future as nature-
Awe is an emotional experience–not an idea, thought, opinion, fact or cognition. It is often beyond words. It is the experience of being in the presence of something larger than ourselves–something vast and unexplainable. In your own life experience, recall the ways you have been moved, touched and inspired by the depth of love, loyalty and commitment you have witnessed or experienced. Recall your response to the courage and the will to live you have seen in a family member or patient.
Spending time with pre-
Dr Patterson chairs the Lexington Medical
Senator Alvarado earned his bachelor's degree in biology from Loma Linda University (California) in 1990, and then went on to receive his Doctorate in Medicine in 1994. He completed his medical residency in Internal Medicine and Pediatrics at the University of Kentucky in 1998. Society's Physician Wellness Commission and is certified in Physician Coaching. He is on the family practice faculty UK College of Medicine and teaches nationally for Saybrook School of Integrative Medicine and Health Sciences (San Francisco) and the Center for Mind Body Medicine (Washington, DC). After 30 years in private family practice in Irvine KY, he now operates the Mind Body Studio in Lexington, where he offers integrative mind-