Feeling of Rightness

     “The transient vacuities of … success, peace, happiness, and distraction – pale before the question of whether or not one experiences this life as meaningful. Moreover, the test of meaning is not a cognitive decision, so one should not suddenly quit this present life for any quixotic mission. Meaning is found, over the long haul, through the feeling of rightness within.”
     Hollis J. “Finding Meaning in the Second Half of Life.” Gotham Books, NY, 2005.
 
     “Wisdom traditions, the paths followed by our patients and our own experiences suggest that a sense of integrity comes through establishing healing connections. That’s not quite it. It wasn’t that the wave needed to establish connections. It was connected — part of a greater whole. Its challenge was to recognize the connectedness that was already there.”
     Mount BM. The existential moment. Palliat Support Care 2003; 1(1): 93-6.

Connecting

     “… practice sharing the fullness of your being, your best self, your enthusiasm, your vitality, your spirit, your trust, your openness, above all, your presence. Share it with yourself, with your family, with the world.”
     Kabat-Zinn J. “Full catastrophe living. Using the wisdom of your body and mind to face stress, pain and illness”. Dell Publishing, NY, 1990.


     "I don't help everyone [in terms of cures] ... I help them to show their true humanity, their true spirit, despite adversity ... Each of my patients told me what a difference I had made in their lives. All I did was to recognize their true selves and coax those to the surface, despite everything else that was happening ... Hope - not despair, not denial, not giving up, not demanding success ... It comes from knowing that the Universe cares about us, even when our desires are not possible ... The peacefulness of integrating these apparent contradictions is truly a miracle."                                                                                                  Lewis Mehl-Madrona MD

      “Meaning is, broadly speaking, the awareness of connectedness, importance, and felt significance among perceived objects both external and internal; narrowly speaking, it is the attribution of positive value to a particular configuration of attitudes, ideals, and connections that stand close to the center of one’s identity and are the key to judging importance in relation to time, persons, events, and the natural world.”
     Parks SD. “Big questions, worthy dreams. Mentoring young adults in their search for meaning, purpose, and faith.” John Wiley & Sons, San Francisco, 2000.

Honesty

     “At the outset the focus was, in true medical tradition, on the patients. What was wrong with them? What was this ‘unhappiness’ within them and how could it be defined, captured, and nailed into a scientific classification? I soon realized that the phenomenon coexisted in the doctor and in the doctor-patient relationship.
     What about the unhappy doctor? Only after a while in general practice did I vaguely begin to feel that I was dealing with something more than physical and mental illness, something that was part of my and the patients' existence. I found there was no ‘cure’ in the frame of reference in which I had been trained or was working.
     My negative feelings centered, broadly speaking, on a negative premonition (heartsink), irritation, anger, and frustration. These reactions were not necessarily all present at each consultation and were of varying intensities and subtleties, ranging from mild impatience to intense dislike.”
     Ellis CG. Chronic unhappiness. Investigating the phenomenon in family practice. Can Fam Physician 1996; 42: 645-51.

       Mindfulness practice is “not a mental struggle – it is not about thinking differently; rather it comes from getting out of our heads and into our bodies – that is, into the physical experience of the present moment.”
     “With whatever arises, whether it’s pleasing or not, try to remember that all we can do is experience and work with whatever our life is, right now. No matter what life is and no matter how we feel about it, all that matters in practice is whether we can honestly acknowledge what is going on, and then stay present with the physical experience of that moment. This is the way we come to experience true appreciation for our lives.”                       Ezra Bayda

     “… practice sharing the fullness of your being, your best self, your enthusiasm, your vitality, your spirit, your trust, your openness, above all, your presence. Share it with yourself, with your family, with the world.”
     Kabat-Zinn J. “Full catastrophe living. Using the wisdom of your body and mind to face stress, pain and illness”. Dell Publishing, NY, 1990.

International Conference on Physician Health 2012

The 2012 AMA-CMA-BMA International Conference on Physician Health will take place in Montreal, October 25-27, at the Westin.

Send your proposals for an oral, poster or workshop presentation using the new online abstract management system

Stay tuned for registration details coming in July. For more information, please email physicianhealthconference@cma.ca or visit www.cma.ca/physicianhealth.

Quality of Life

     Movement on the quality of life “continuum toward an experience of integrity & wholeness may be thought of as healing, (while the movement) toward suffering & anguish (may be thought of) as wounding.”
     Mount BM et al. Healing connections: on moving from suffering to a sense of well-being. J Pain Symptom Manage 2007; 33(4): 372-88.

     “The key to self-development … is the experience of … a state of relaxed concentration in which the individual neither freezes out of fear nor clings due to desire. … the free flow of vital energy within the body and between the body and the universe.”
     Sayama MK. “Samadhi. Self-development in Zen, swordsmanship, and psychotherapy.” State University of New York Press. 1986.

 

Emotions are adaptive

     “Many doctors have difficulty handling their own emotions — sorrow, guilt, identification, and feeling a failure are just part of the range of emotions reported. There is little evidence that these difficulties get easier as doctors become more experienced.
     Doctors are unaware that a failure to disclose information honestly to patients might be an attempt to protect their own emotional survival as much as to help protect the patient.”
     Fallowfield L, Jenkins V. Communicating sad, bad, and difficult news in medicine. Lancet 2004; 363(9405): 312-9.

     Research shows that “some emotions … will be painful and unpleasant but will promote healing. This makes it impossible to separate positive and negative emotions as if they were healthy and unhealthy, respectively. Assuming that unpleasant or negative emotion is unhealthy overlooks the primary function of emotions as being adaptive. … none of the affective-meaning states are inherently pathogenic. ... getting stuck or persistently ‘repeating’ any one of these components will cause emotional disorder … (Whereas) a healthy self-organizing trajectory reaches its completion as a meaningful, emotionally differentiated, and integrative experience. … it may begin as a sense of intense, poorly regulated, and ill-defined global malaise.”
     Pascual-Leone A, Greenberg LS. Emotional processing in experiential therapy: Why 'the only way out is through.' Journal of Consulting and Clinical Psychology 2007; 75(6): 875-887.

     Suffering begins with a perceived threat of destruction and ends either when the threat has passed, or a sense of integrity is otherwise restored.
     Cassell EJ. The nature of suffering and the goals of medicine. N Engl J Med 1982; 306(11): 639-45.

Photo: ju_ju   www.dpreview.com

A journey

     “dying patients forced me to move from doing to being. Forced me to enter their experience, not observe their disease.
     I learned that the art of medicine represents the hero’s journey of awakening to the calling, a journey to the unknown, painful transformation and a return to service in the community.”

     Duffy J. Rediscovering the meaning in medicine: lessons from the dying on the ethics of experience. Palliat Support Care 2004; 2(2): 207-11.

When we had winters ...