Berks County Medical Society Medical Record Spring_2018 - 15

Mommy, Are You Paying Attention?
by Vinti Shah, D.O., Chief, Section of Palliative Medicine, Tower Health Medical Group

I

still recall my first overnight call as a medical student. There was
a tiny call room that was next to the elevator. Even if somehow
I was able to ignore the noise, the sterility and coldness in the
room could not be overlooked. All this was irrelevant though
because, as I soon learned, the room was a mere formality. The
senior resident and I spent much of our night in the Emergency
Department and on the units, addressing patients' clinical needs.
I recall feeling exhilarated the following day. I had been up for over
30 hours! This call really served as my indoctrination into "real"
medicine, as I called it. The excitement and charm of overnight
call quickly wore off, though. As I became a resident and took my
4th overnight call, the exhaustion took over. My husband was also
a resident, and there were periods in our marriage where we went
days without seeing each other. The empty laundry basket was an
indicator that I had been home, and the TV set to a sport channel
was my indicator that he had been home.
I am a Hospice and Palliative Medicine physician now and
am married to an Emergency Medicine physician. We have two
children, ages 6 and 8. We have a very interesting dichotomy
where our roles in a patient's life are frequently very different, as
are the emotional burdens we carry: providing peace at the end
of someone's life vs. trying to save a patient's life through extreme
measures. My world is a calm world where my patient is a narrator
who shares his intricate story that is frequently interwoven with
various layers of emotional depth. I have met a holocaust survivor,
professional baseball player, a single mother trying to stay alive for
her young child, and a son who is grieving the death of his mother
the day after himself being diagnosed with terminal lung cancer.
My husband has cared for patients who have suffered from strokes,
have been victims of horrific child abuse, and who have airway
compromise from severe trauma. All physicians face these emotional
stressors, regardless of what specialty we choose.
Approximately two years ago I realized that my days were getting
longer and I was starting to carry some emotions home with me. At
one point I remember hearing frustration in my son's voice as he
asked, "Mommy, are you paying attention?" I clearly wasn't. I was
actually thinking about my patient from that morning. She was
trying to stay alive for the birth of her first grandchild and for the
wedding of her second child. It is impossible not to get immersed
in the patients' stories at times. However, I also needed to be able to
give the same attention to the other aspects of my life. That is when
I landed on mindfulness.
Last May I asked two friends who were also struggling with
stress to accompany me to a mindfulness course near Rochester,
NY. It was a life-changing experience. It forced me to put into
practice the advice that I had been giving to my patients about
being compassionate to themselves. I practiced the meditation
techniques for the first few months after I returned, and I recall
feeling less stress. To be clear, the stressors were no different but

my reaction was inherently changed. My focus was better. My
connection in conversations was a bit deeper. I was less distracted.
I am embarrassed to admit, though, that I stopped practicing.
Between my work, family, and the holidays it wasn't feasible to
fit the meditation practice back into my schedule. Fate worked
in my favor, though, and this time Reading Hospital offered
a mindfulness course in conjunction with U. Penn. Over 20
physicians-of different ages, specialties, and stages of practice-
and I have been practicing mindfulness for nearly 8 weeks. We
also participated in a one-day silent retreat. My husband and I
have been taking the course together and have noted how difficult
it is to take the time to commit to the practice. What we have also
noted, though, is that while the stressors are unchanged we are
handling these stressors in a more healthy way: we are being more
kind to ourselves, our focus is better, and-not surprisingly-we
are much happier. I do not know what the future will hold, but
it is my hope that I will continue to practice mindfulness. While
our n=2 is not impressive, larger studies have shown the benefits of
mindfulness in stress reduction. I would encourage anyone who is
even considering it to give it a try.

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Berks County Medical Society Medical Record Spring_2018

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