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“Mindfulness is a purposeful attentiveness to one's inner life in order to achieve some sense of clarity, compassion, and wellbeing.” —Dr. Ronald Epstein
Ronald Epstein MD—family physician, teacher, researcher and writer—has devoted his career to understanding and improving patient-physician communication and clinician mindfulness. His groundbreaking research on communication in medical settings and innovative educational programs have been among the most widely cited in the medical literature and have a major impact on thousands of medical practitioners and trainees. With Mick Krasner, he developed Mindful Practice workshops which have helped clinicians worldwide experience greater self-awareness, resilience, joy and effectiveness in practice. In addition, Dr. Epstein co-directs the Center for Communication and Disparities Research and Mindful Practice Programs at the University of Rochester School of Medicine and Dentistry where he is Professor of Family Medicine, Oncology and Medicine (Palliative Care). A graduate of Harvard Medical School, he is recipient of numerous lifetime achievement awards relating to communication and humanism, a Fulbright fellowship in Barcelona, fellowships at the University of Sydney and the Brocher Institute in Geneva, and, in 2018, the American Cancer Society’s highest award, the Clinical Research Professorship. He has published over 300 articles and book chapters. His first book, Attending: Medicine, Mindfulness and Humanity, was released in January 2017 to wide critical acclaim.
For further information about Dr. Epstein, including upcoming workshops, please go to www.ronaldepstein.com.
Dean Tran is a fourth year medical student at Tulane University School of Medicine, who is going into Family Medicine. Since high school, Dean has been drawn to teaching. Just before entering medical school, Dean taught secondary school students at an after-school academy. He feels that being attentive to who students are--learning about their interests and life outside the classroom--helped him be an effective teacher. In medical school, he learned to be attentive to his own feelings and body, learning meditation to help him cope with the stresses of medical training. In the past few months, having seen patients and their family with an inpatient palliative medicine team, he has begun to see how practicing mindfulness as a clinicians allows them to hold patients’ hands through the most difficult of times.
Mindfulness is not the same as meditation
Meditation is a tool to help you be mindful. In the same way that a musician might practice scales to get fingers in shape to be able to make beautiful music, sitting on a cushion every day is practice for being mindful when it really matters. In medicine, the mindfulness that matters is when you’re with patients and members of your team.
The mind-body connection helps us regulate our emotions
Emotions often arise in physical sensations. The mind predicts the threat, the heart races, then we feel the emotion of fear.
Try to identify the first thing you notice when your stress level starts to rise, and use that as a barometer. Body scans, softening the body, noticing the breath, can be helpful.
When things are heating up, check in with those places in your body. You'll get better at identifying changes sooner, and take the breath or engage the thought pattern sooner.
Eventually those course corrections become smaller, almost second hand, part of your natural reaction.
Practicing mindfulness with patients (and beyond)
Pause before entering room, touch the door handle, take a breath. With that breath set intention, trying not to bring residual feelings about last patient into the new room.
Try deep listening: commit to spending 90 seconds at the start of a patient visit simply listening.
Spend at a minimum two minutes, twice a day, doing nothing else except paying attention to your state of being.
UC San Diego Mindfulness & Compassion Resources
Guided meditations & timers from The Free Mindfulness Project
UCLA Free Guided Meditations from UCLA Mindful Awareness Research Centre
From Dr. Epstein
We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing by Dr. Jill Horton
How To Train A Wild Elephant And Other Adventures in Mindfulness by Dr. Jan Chozen Bays
How Emotions Are Made: The Secret Life of the Brain by Lisa Feldman Barrett
From Dean Tran
Being Mortal: Medicine and What Matters in the End by Atul Gawande, MD
An Imperfect Offering: Humanitarian Action for the Twenty-First Century by James Orbinski, MD
From The Open-Hearted MD Team
Attending by Dr. Ron Epstein
What does it feel like to be present in your body? In your mind?
Where do strong emotions show up in your body? Stress? Joy?
What does it mean to have a beginner's mindset?
Think of the last time you made an assumption about a patient or new acquaintance that turned out to be untrue. What could you have asked yourself that might have shifted that assumption?
GOAL: Pick one mindful practice and practice it each day. Notice how it feels to come back to the practice each day. Try to commit to practicing daily for a month and notice how you feel.
Host: Dr. Rebekah Byrne, MD
Guest: Dr. Ronald Epstein, MD
Student Interviewer: Dean Tran
Producer: Erika Bennett, Dara Bramson
Sound Design: Timothy Knowlton
Original Music (Composed & Performed): Timothy Knowlton