The National Institutes of Health (NIH) has put itself firmly on record as being deeply concerned about our national epidemic of stress at the individual, organizational and societal levels. NIH’s National Center for Complementary and Integrative Health (NCCIH) broadcast on September 7th its annual Stephen E. Straus Distinguished Lecture in the Science of Complementary Therapies. The lecture was titled A Nation Under Pressure: The Public Health Consequences of Stress in America.
The American Psychological Association (APA) recently documented a worrisome increase in stress in the U.S. population (Stress in America https://www.apa.org/news/press/releases/stress). Uncontrolled stress can cause or worsen anxiety, depression, PTSD and a wide range of clinical conditions affecting every organ system. Medical students, residents and practicing physicians experience higher levels of stress than their age-
Of all the sciences, medicine uniquely combines all domains of the human condition-
Medicine has always attracted the best and the brightest. Most applicants to medical school are also inspired by a desire to be of genuine service and express their deepest human values through their professional lives. This ethic of altruism, compassion, meaning and service distinguishes medical students from most other professional students.
This new patient was a desperate, mid-
Modern life is taking its toll on our nation’s mental and physical health. Physicians and their patients both suffer from stress-
Former Surgeon General Vivek Murthy MD has sounded the alarm regarding our country’s epidemic of stress.(1) He calls for a serious national effort to mitigate the corrosive effect of chronic stress on every organ system. He calls for a nationwide campaign to spread a preventive, behavioral lifestyle prescription of healthy eating, physical activity and genuine social support (other than social media). Based on solid peer-
Behavioral medicine research confirms the value of mind-
Relationships are at the very heart of medicine. I recently saw one of my favorite patients whom I had not seen in 10 years. I have thought of her often since the hospital took over my Estill County practice in Irvine and I moved to Lexington. Wanda always lifted my spirits. She always asked me how I was doing because she cared about me. We joked and laughed while managing her chronic medical conditions. She was good medicine for me.
Defining resilience: The American Psychological Association (APA) describes resilience as “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress, such as family and relationship problems, serious health problems or workplace and financial stressors. It means ‘bouncing back’ from difficult experiences.” APA further describes resilience as “ordinary, not extraordinary. People commonly demonstrate resilience.
Wayne Jonas MD is clinical professor of family medicine, Georgetown University, retired Lt. Colonel United States Army Medical Corps and a complementary medicine researcher. He previously served as Director of the Office of Alternative Medicine at NIH, which is now called the National Center for Complementary and Integrative Health. He has recently proposed the HOPE note (Healing Oriented Practices and Environments) as a clinical tool to help physicians….
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as well as prayerful talking to a higher being. She also had a more personal meditation practice involving spending time with a thought or a word. Simply spending time with a higher power was always a part of her life. She maintained close relations with friends from her Orthodox Christian community. She also felt tremendous support speaking regularly by Skype with her long-
Losing Hope and Losing her Husband
Life became more complicated after moving to Lexington and beginning work in an RVU-
This improvement in her quality of life could not have been better timed. Not long after making these practice changes and recovering some sense of coping and control, her husband had a sudden cardiac arrest. He was on life support and had no advanced directives. She and her two sons had to make the decision to withdraw life support after attempts to revive him proved futile. She credits a single casual family conversation about end-
Coming Home to Self Care
That was September 2016. Her New Year’s resolution this January was to re-
Next comes heart-
This meditation is followed by chanting out loud a liturgical prayer from her childhood and lifelong Christian tradition, ending with the Lord’s Prayer recited in her mother tongue. She sometimes adds a healing touch practice to her feet and a brief energy practice followed by 4 deep breaths using alternate nostril breathing. This 30-
Healthy Lifestyle and Work-
She tries to weave the following tips for healthy living and healthy working into her own life and her counseling to residents and patients:
From India to North Dakota
In the mission hospital she saw a different kind of medicine from medical school, surgical training and research–a type of medicine that addressed the whole person, not just the biomedical, anatomical or surgical perspective. After passing her US licensing exam and having two young children, she wondered how to train and practice in the US. She decided that practicing surgery in the US was not an attractive option for a woman with young children. At that time, in the 1990s, family medicine included a lot of procedures and would permit her to use her surgical training. She completed a family practice residency in
North Dakota after which she was employed by the local hospital. She was able to practice the whole person medicine she had loved so much in her mission work.
Discovering Integrative Medicine
She emphasized lifestyle medicine, behavioral approaches, the importance of social connections and spirituality in patient care in her small-
Taking Self Care for Granted
Despite the responsibilities of training and practice and feeling like a single parent for many years due to her husband’s travel demands, she never really felt severe stress or burnout. She practiced daily liturgical prayer from her Christian tradition
Dr Patterson chairs the Lexington Medical
Senator Alvarado earned his bachelor's degree in biology from Loma Linda University (California) in 1990, and then went on to receive his Doctorate in Medicine in 1994. He completed his medical residency in Internal Medicine and Pediatrics at the University of Kentucky in 1998. Society's Physician Wellness Commission and is certified in Physician Coaching. He is on the family practice faculty UK College of Medicine and teaches nationally for Saybrook School of Integrative Medicine and Health Sciences (San Francisco) and the Center for Mind Body Medicine (Washington, DC). After 30 years in private family practice in Irvine KY, he now operates the Mind Body Studio in Lexington, where he offers integrative mind-