Date Tags ideas

Students usually enter medical school with high ideals about the kind of doctor they hope to become and the kind of help they hope to provide their patients. This spiritual dimension sounds very grand, but it's really just your quiet being, free of any bodily tension or lingering thoughts. The act of meditation is a liberating experience, because you learn how to gain complete control over your whole self - if you think of something, it's because you've decided to have this thought. Here are the basic meditation steps: Create a space If you want to make the most of your meditation practice, you may wish to designate a specific place where it happens. This could be your living room, your exercise room, outside under a tree. Ideally, this will be a place where meditation is all that goes on there. Not always practical, or even feasible, but it does help to keep a calm energy in the space. A dedicated meditation room is such a wonderful luxury! You should be feeling restful but alert. Later I learned that the hospital was part of his world, the clinic visit his major activity of the week. His day was so simple you really couldn't believe it when he described it to you. But there it was: get up, shower, dress, walk out of his room, say good morning to the manager behind the hotel desk, and walk across the street to buy the daily newspaper. Buying the paper was, he told me, his major fun of the day. There was warmth and sensitivity in Louie, the old black man who ran the newspaper kiosk and sold him his daily paper: he called Paul handsome and asked him why he was all dressed up and where he was going. This had gone on for years. Paul felt comfortable enough to raise his head a bit and give a short answer. In fact, Paul could not read much of the newspaper because of problems in his visual field. He bought it, I believe, because of the importance of a stable daily ritual and, quite simply, because for six days of the week this two-or three-minute interaction was his chief human contact.

Then he went to have breakfast at the hospital cafeteria, a cavernous, impersonal, unattractive dining hall, where everyone recognized him but no one spoke to him. By the time they finish medical school, many have lost these ideals. The process of professionalization replaces, in the mind of the physician, the often overly romantic lay image of healing with the often all too cynically pragmatic professional expectations of high technology and high income. For the care of the chronically ill, medical education as it is currently organized can be disastrous. Physicians are encouraged to believe that disease is more important than illness, and that all they need is knowledge about biology, not knowledge about the psychosocial and cultural aspects of illness. They are taught that using placebo effects in the clinical setting is old-fashioned. They come to believe that psychotherapy is anachronistic and need be learned only by psychiatrists. The social science and humanities components of medical education, which are central to the ideas I have discussed in this article, are poor relations with whom few medical students feel at all comfortable associating. As I described in article 8, the gauntlet of residency training may even dehumanize the practitioner, and certainly does not contribute to the training of physicians committed to psychosocially sensitive care. My conclusion is harsh. There are, of course, many physicians who break the mold. Focus on your breathing Breathing is a wonderful process that happens all by itself. By focusing on this natural rhythm you can begin to calm your mind and take yourself to a state of relaxation. Take a few deeper breaths - you should feel the air going deep into your body with the inhale, and then slowly leaving on the exhale. Do a slow count in your head as you breathe in. Hold at the top. Pause at the bottom. This helps to regulate your breathing so you fill and empty your lungs properly, without hyperventilating. Return your breathing to a normal pattern and gently turn your attention to your thoughts.

It's possible, even likely that your inner voice is chatting away about various things. He sat way off to the side of the huge, poorly lit hall, by himself. He took a long time over breakfast. After he finished, he took his walk: a long perambulation of his part of the city. He arrived back in his room in time to wash up before lunch. Then he returned to the anonymity of the hospital cafeteria. After that it was time for his nap, followed by a much shorter walk around the block, and then television watching in his room. Dinner took him back into the hospital. After eating, sometimes he would sit in the lobby of the hospital watching and listening to others, but always indirectly, his face behind a magazine or newspaper. After he walked home to his hotel, he generally stayed inside. He used to like taking an evening walk, but a few months before I met him he had been robbed by a gang of adolescents who kept calling him names like queer, nuts, and, worse, half-wit. In fact, becoming a skilled primary care physician in the community may require a kind of liberation, through experience, from professional biases acquired in training. There are, furthermore, training programs--especially in certain of the more progressive units in family medicine, primary care internal medicine, and pediatrics--that emphasize just the kinds of concerns that I regard to be essential to the healer. And psychiatry, though marginal to the medical mainstream, has long been concerned with the biography of the patient. But on the whole, I believe my judgment, though regrettable, is correct. To change this deplorable situation, it is necessary to make the patient's and the family's narrative of the illness experience more central in the educational process. Only then will physicians gain the appropriate attitudes, knowledge, and skills to enable them to undertake a mini-ethnography of the misery of chronic disorder or support patients in their terminal days or negotiate with the values of families from other ethnic groups. How is this change to be brought about? The only effective reform, to my mind, would be to restructure the medical training program from bottom to top. Short of that, values and behavior will not change.

Time must be devoted in the curriculum to teaching students how to interpret the illness narrative and assess the illness experience. Don't worry, this is totally normal. All you do is let the thoughts pass through your consciousness and move on, like clouds floating gently across the sky. Eventually you will learn to quiet your mind very quickly, and that inner voice becomes quiet. Ironically, quieting your inner voice allows your body to release the stress from your muscles, so you may find that you experience small spontaneous twitches, even though you're trying to be still. This is a good thing. Don't let it distract you. When your body relaxes completely, your brain also clears, so thoughts may drift in again. And again, allow these thoughts to simply drift out and away. At times, especially after your meditation skills grow, you may have inspirations, rather than just simple chatter. In this case, Maharishi Mahesh Yogi, the founder of Transcendental Meditation, advised his students to stop meditating, write down the inspiration, and then come back to their meditation. So he stayed in and watched television. Once each week, the hotel manager checked his room, gave him his allowance, and explained to him how much money he had in his account. That took about fifteen minutes, Paul estimated. His big event of the week, the thing he waited for, was visiting the clinic. He dressed for the event by putting on a black vest or a gray sweater under his black suit jacket; I had inherited Paul from the clinical fellow whom I had replaced, and I passed him on to the fellow who followed me, doubtless as had been done several times over the years. Paul didn't have much to say, but he liked the repetition each week of the same questions and had become good at answering them, as long as they were asked slowly and in the same order. He was thrown off balance by novelty of any kind. Simply rearranging the sequence of the questions overtaxed his concentration and recall.

He told me that actually he just liked to sit and hear the doctor talk. Courses in the medical social sciences and humanities are a beginning, but we also need new ways of teaching about doctor-patient transactions and supervising the clinical experiences of medical students. The essential attitudes for the performance of the core clinical tasks reviewed in article 15 would be encouraged if students could see that these skills really mattered to their teachers and to clinicians generally. There must be models among their teachers of masters in the care of the chronically ill. Even medical school admissions criteria need to select preferentially students with an interest and background in psychosocial, cultural, and moral fields of inquiry. Skill in conducting a mini-ethnography can be honed by sending students out of the lecture hall and hospital to follow up on their patients in the local community. They can observe patients at home and in their dealings with health care and social welfare agents and agencies. Not often, in my experience, will students be invited to the workplace, but they usually will have access to family, friends, and neighbors. A debriefing by a social scientist familiar with the community often helps students to assemble a more valid picture of the patient's ethnographic context. Clinical mentors should then review these accounts, not to criticize the quality of the prose, but rather to evaluate the student's ability to be an intense observer of clinically relevant detail as well as a thoughtful interpreter of that detail in light of the patient's particular social context. Proficiency in eliciting the patients' and families' explanatory models, and in explaining the biomedical model in terms lay persons can understand, comes from having frequent opportunities to perform these activities under the supervision of expert clinicians, not only in clinics and inpatient units but also in patients' homes. For now, repeat a positive word in your head, like Love, or Happiness, or a simple affirmation, such as I am a beloved child of the universe. This is your mantra, and it's a very useful tool that becomes even more valuable the more you use it. Wherever you are, and whatever you're doing, your mantra will calm you down and bring you into a meditative state (kind of like Pavlov and his bells). This could be on the bus to work, in the park, during lunch break, or even when you are just at home and need some ME time. Repeat your mantra as long as you want, or think is necessary to bring your mind to full focus. If it helps, imagine a warm feeling moving across your body, maybe even slipping into a comfortable bathtub, allowing the warmth to soak up all your stress and tension. You'll know when you get there, but please don't be discouraged if it takes longer than you think it should. For some, it can take a few weeks of practice. Others may fall right into the zone after a few tries.