How mindfulness helped this physician ’s primary care journey

“Paying attention in a particular way: on purpose, in the present moment and nonjudgmentally.” That’s how Jon Kabat-Zinn, PhD, describes mindfulness. In the book Zen Mind, Beginner’s Mind, another thought leader in mindfulness, Shunryu Suzuki, says that, “In the beginner’s mind there are many possibilities, but in the expert’s there are few.” In my experience, I’ve found that cultivating a beginner’s mind opens doors and improves clinical diagnosis. Medical training has phases, and clinicians in different phases think differently. In medical school, students learn all the zebras. To a student, every vomiting infant is thought to have volvulus or a metabolic disorder. Every abnormal CBC is leukemia. Then, in practice, most vomiting infants are found to have gastroenteritis and most abnormal CBCs have a more-benign explanation, such as a routine infection. Skilled physicians try to keep an open mind about having a broad differential diagnosis, but the parade of the routine can dull the mind. I’ve had my own experience with a “zebra” condition and its evaluation by a perhaps weary clinician. After an ER trip for severe pain, a follow-up CT scan and numerous examinations, I was discharged with no diagnosis and no treatment plan. End of inquiry. Later providers did more to take a full history and let curiosity sink in. After many painful weeks, I had my diagnosis: zoster sine herpete. Shingles without a rash. Continue reading ... Your patients are rating...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Primary Care Source Type: blogs