Arrayed before me on colorful yoga mats, fish-festooned beach towels or standing in a corner, the students engaged in a 30 minute body scan. Same body, different day. They concluded the body scan by grouping into dyads and sharing their experience of the exercise this time, guided to stay focused on this particular body scan. The bells marked a transition into the larger group and a discussion of this body scan and the practice during the week. The question was raised about the issue of falling asleep when doing it at home and I had to share my own experience: “You think it’s tough falling asleep while being led, imagine how it is for me when I nod off (as I did twice this afternoon) while leading!” This brought a laugh from the crowd, but somehow I think sharing my own “failings” put them at ease.
Discussion of the Nine Dots exercise highlighted people’s preferred modes of solving problems, or not solving them, as some were willing to share. A few folks noted the sense of relief they feel when they mindfully choose to give up on a difficult task (like this one, or a recent med school assignment that apparently gave many of them fits).
The readings for the week included some early chapters from Full Catastrophe Living by Jon Kabat-Zinn and an article entitled The Virtue of a Common Life by physician David Loxtercamp, but the one that triggered the most extensive discussion was Rachel Remen’s Recapturing the Soul of Medicine. When I rather offhandedly asked if med school “squeezes the soul out of medicine” it was like an earthquake in a bobble-head doll factory! But nonetheless, the ensuing discussion highlighted how many work to find balance in their lives, both within (in some cases) and in spite of (in others) medical school. We talked about finding balance as a moment-by-moment process rather than a grand gesture, and many students shared their own approaches to balance and fulfillment, as well as their fears of not being able to continue to maintain them as the demands grow.
Sitting in the presence of these amazing ambitious beings, I could clearly feel the welling up of strong feelings around making one’s way through medical school without losing their real reasons for wanting to become doctors in the first place (exactly Remen’s point) and how each has made his or her own way toward staying close to the dream while staying firmly rooted in the world as it is. I have a feeling this is going to be an interesting journey . . .
After suddenly realizing that I had taken a temporally overindulgent lunch break, I powerwalked to class only to find, to my immediate chagrin, that class had begun with a body scan meditation. Most people were already catatonic and peaceful, with only a few other latecomers conscious enough to flash me a rueful smile as the opening door rudely announced my arrival. With all the floorspace taken up, we were relegated to sit or stand awkwardly as our fellow classmates contemplated the deeper philosophical implications of their left toes. Needless to say, I was less than pleased that I wasn’t able to take a body nap, erhm, scan, and frustrated that it was my fault in the first place. Sitting uncomfortably in the back of the room, I started to wish I was outside in the sunshine, or that all of our tests were canceled forever, or that I could fly, or that… well, so much for meditation. After a solid 10 minutes of sullenly frittering away my time I decided to do some stretching, since I love to stretch; hell, I thought, Dr. Hickman’s only on the right shinbone, I’ve got some time to burn. Instead of my usual stretching routine (which was limited due to Rich’s legs on my left, sleeping David on my right, a door to my posterior and a roomful of ever-so-slightly-twitching zombies in front of me) I decided to try executing simple motor actions with the specific intention of being aware of my body’s compensations and adjustments: mindfulness, if you will. Even just raising my arms up in front of me was much more involved than I usually gave it credit for, and it made me remember the age-old yoga encouragement/chastisement of “keep your shoulders down away from your ears”. I spent the remainder of naptime feeling and experiencing how my body would subtly avoid certain movements and overcompensate with certain muscles as I moved my arms in different directions. Quite entertaining and enlightening indeed. As I was finishing up my modified tai chi, I opened my eyes to see some of my dazed friends glance up at me with quizzical amusement. Hey, Sleeping Beauty, I wasn’t the one drooling.
As Dr. Hickman recalled us from the depths of our body scan, he mentioned in casual passing a profound insight: We only notice our bodies when something goes wrong.
I had one of those moments of deep resonance. Just like most things in life, we take our bodies for granted. We often approach our physical self as any other machine that allows us to function in our fast paced, uber efficient whorlwind sphere of work, study, play, ect. When we malfunction physically, we notice; but only to be irritated and frustrated by this slowing of productivity.
In this class we are exploring mindfulness and in that exploration, we hope to cultivate our own practice of awareness and non-judgment (or at least less judgment…). If health is our goal, what if we slowed down and listened to our bodies first, before they break down…and if they do, what if we approached our healing with a little less judgment and a little more compassion? That would be nice…
When we were assigned the 9 Dots exercise for our homework, I immediately had the reaction, “Oh piece of cake, I’ve done that before, I know the answer.” So I proceeded to postpone doing it until Wednesday night before class. I knew that I had completed this before and I had a clear picture in my mind of what I had to do. When I drew out my lines though, I realized that what I thought would only take 3 lines was actually going to require 4, against the rules of the game. This was an interesting moment for me, as I was stalled in my tracks from full speed. I started to second guess myself and wonder whether I really knew how to do it. Only at that point did I let myself actually focus on the problem and think about it, and once I did that, I was able to successfully complete the exercise. I realize now that my brain was on auto-pilot – I saw something that I knew I had seen before and automatically assumed I knew exactly what it was and what the solution was. It is the same type of unthinking automatic behavior that I am in this class to help tame. As a medical student it is so easy to fall into the pattern of just doing, without thinking. But as something as simple as this little dot exercise showed, this method is not without error. And I hate to imagine the errors that arise from doctors (and everybody in society) who act without letting themselves take in the whole situation or think about what the actual problem is. Mindfulness in my perspective is just the opposite – being aware, taking a moment to acknowledge all factors that are contributing to a particular incident. I am realizing though that this change of mindset away from autopilot towards mindfulness takes time, dedication, and patience. It will certainly require more effort than the 9 Dots exercise, and it’s not something I can procrastinate until Wednesday night (even if I am procrastinating my musings on the topic until then…).
I’ve been thinking about what we have discussed in class and what it means to be mindful. The concept seems easy enough when someone tells me that is my task for the next 5-20 minutes, but my problem is that there isn’t always someone there to do so. Two days ago we took an exam and for some reason I felt horrible when it ended. I felt like there was a weight hanging in my chest pulling me down, but I wasn’t consciously thinking about anything, it was just a feeling I was only vaguely aware of. That’s what is scary about all of this; when someone is there to tell me to get in touch with my body and mind I can do so, but without that I don’t even notice anything is wrong, let alone consider what is causing it.
Later that day I went for a run and for about 45 minutes all I thought about was breathing and not falling and although I hadn’t been thinking about my sadness before, after my run I felt much lighter. My mind was more at ease and it didn’t even occur to me until well after my shower that I had a score to check. I am starting to realize that I like yoga and running because I am forced to think about nothing but breathing and how my body is feeling; I am in touch with a part of me that doesn’t always get that much attention. This is similar to what my experiences in class have been like. Maybe I’ve been trying to be mindful all along, I just wasn’t calling it that.
The current state of our lives is often stressful. We live to study, eat to avoid hunger, and pass through each day forgetful of the last. A las is the life of the medical student—paying his/her dues in hopes of making a difference (not as self deprecating as it might sound, haha).
As I opened the door to the class, I found something I hadn’t seen as a first year medical student—true relaxation. No one was scrambling through books, rushing to a review session, or stressful of the upcoming exam—what a relief!!! I lay on the floor to begin my second body scan meditation, more happy and excited as a medical student than in the past 5 months.