Medicine as Meditation – Scientific American

By | February 23, 2020

On a Thursday afternoon, I found myself walking the basement corridors of the hospital. Here I was, a wide-eyed medical student, lost and nervous, looking for a sign saying “Spiritual Care” to demarcate the home base of clinical chaplains.

I had entered into medical training not just to provide physical healing but for the spiritual healing as well. In the past, I considered being a monk, but realizing I wanted to merge theory with action, I opted to be a physician instead. Medicine became my daily spiritual practice, merging the material with the metaphysical. I knew little about clinical chaplaincy, only once overhearing a chaplain explain her profession: “We accompany patients in their journey without looking for a destination.” Medicine crafted me into a solution-generator, a differential diagnoser. What did healing look like outside of that?

Chaplain Bruce Feldstein MD, BCC, with his gray hair and gossamer glass frames, swept me into an eager handshake. Bruce did not confine himself to social norms; he was the type of person that created them. He was an emergency medicine doc until after nearly 20 years in the when a back injury prompted him to shift careers. He became a chaplain, continuing his work with patients.

I walked at a steady pace in silence alongside Bruce, a sharp contrast to pacing the halls with other physicians I had shadowed previously, wherein the physician and I were both occupied with discussing the patient’s pathophysiology and treatment plan. After an awkward nonexchange of words, Bruce finally broke the silence to say, “Feel the air move past your forehead. Imagine it blowing aside your preoccupations.” We made it to the end of the hallway, turned our feet and walked back down the same corridor a couple more times in silence.

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At first, I felt uneasy. Other doctors cut around us to quickly get to their next room, looking down, thinking about to-dos. Compared to the typical hectic environment of the hospital, it felt strange to just walk. Just as I allowed the calm to settle in, we finally arrived in front of our patient’s room, stopping at the gel dispenser.

Bruce’s voice dropped to let me in on his secret. “Every time, as I gel in, I do two things. I set my at-tention and my in-tention.” I placed my hand underneath the dispenser. Foamy antiseptic gel plopped out. Attention. As I rubbed it into my hands, I felt the coolness cleanse my palms, evaporating away everything but the present. Intention. Bruce spoke his intention out loud for me to hear: “May I be of service. May I meet you, my patient, in your world as it is for you, and may I accompany you from there….” I felt calmer. We knocked and prepared to cross the threshold into the patient’s room.

As we were about to enter, my sense of calm short-circuited for a moment. I realized that I knew nothing about this man. As a medical student, I was accustomed to charging in prepared, scribbled notes in hand, taken from the patient’s chart. I was accustomed to knowing details about such things as the diagnosis, the patient had been here, their medications and the most recent laboratory findings. Here I only knew his name, age and religious preference.  

I whispered to Bruce. “What did he come in for?”

Bruce assured me, “We’ll find out soon enough. Let us be simply be present – open, caring and curious.  What matters for him is what matters for us. Let us identify and respond, bringing all our life experience as well as training. May we be of service.”

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Bruce and I walked up to the bedside and tactfully introduced ourselves. James was speaking with a woman, his wife and welcomed us to join them. As we engaged in conversation, the encounter felt light and heavy at the same time. Lightness came from the fact that we talked about anything that came up: the beautiful flowers outside the hospital window, laughing at a funny remark, connecting over hometowns and learning of James’ newborn daughter at home. James was a vibrant and loving husband and father, not a patient pinned with a medical label. A heaviness broached its head when I remembered we were still in a hospital room, IV drip to the right, monitor beeping, on the oncology ward.

A short while into the conversation, James offered up the information that he was in the hospital for recurrence of his cancer. Only in his 30s, James had been met with a swath of unknowns these past few months. They were waiting to find out results of tests and prospects for further chemotherapy, this time with his firstborn baby girl in the picture.

Without prompting, James took a moment to step back from his cancer and reflect on the lessons it had given him. “Cancer’s taught me a few things, like how to live day by day. I’m just luckier than others because I get to learn this lesson sooner in life rather than later.”

Bruce listened, responded with admiration, paused then asked. “May I offer you a blessing?”

The patient, pleasantly taken by surprise, sputtered, “Uh…sure.” James and his wife looked back eager to see what would happen. James’ mother, who had just entered into the room, fell still.

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Bruce asked James, then his family,“What would you like this blessing to mean for you?” He listened carefully and selected a special blessing. With a rumbling deep voice, Bruce began sing.

A palpable wholeness embraced the hospital room. Everyone felt it. The only sound besides Bruce’s voice was the beeping monitor and even that seemed to quiet down. Bruce sang in Hebrew, yet the family could sense the underlying meaning of the song—grace, strength, and overwhelming protection. I looked over to James’ mother. Glistening streaks flowed across her cheeks, gently diverted by her fingers. As Bruce ended the song, a fullness of silence lingered for precious seconds. We all knew we had experienced something transcendent. Something different from the healing of medicine through an IV, yet arguably just as powerful.

The encounter ended, and we said our good-byes. I walked back into the hallway, trying to hold back my tears while gelling out. If medicine means to heal, I thought, then I could do this with my patients, chaplain title or not.  With the right attention and intention, I could simply be present. The healing would happen just by authentically showing up.

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