“That was really when it started for me, when I came out of the lab having done some exploration of Jon’s (Jon Kabat-Zinn) work and done some meditation. At that point if you can believe it, it was cassette tapes that Jon had been kind enough to give me. I came out of the lab a completely different person. I was actually having fun being a surgical resident. I was tired, you know I can’t say I didn’t have a bad day but I laughed with my colleagues. I had a great time. And I will share with you, Jill, that many many people, including my superiors and my residency director, noticed a huge change.” Antonia Stephen MD, Surgeon, Massachusetts General Hospital
In the last episode in this week’s series on meditation and mindfulness, Jill sits down with Dr Antonia Stephen to discuss how meditation and mindfulness can change your life. Dr. Stephen shares her story with us and I challenge you not to be inspired. Let us know if you adopt a meditation and mindfulness practice of your own and let us know how it goes. We love to hear from you!
Dr. Stephen is a surgeon and Surgical Director of Wellness at Harvard Medical School and Massachusetts General Hospital. Dr. Antonia Stephen received her medical degree from Harvard Medical School, completed her general surgery residency at Massachusetts General Hospital, and her surgical fellowship at the Cleveland Clinic, before joining the surgical staff at Massachusetts General Hospital in the Division of Surgical Oncology, where she specializes in surgery of the thyroid, parathyroid and adrenal glands.
Books related to this episode: “Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness” by Jon Kabat-Zinn https://amzn.to/2Rc90pZ
“Falling Awake: How to Practice Mindfulness in Everyday Life” by Jon Kabat-Zinn https://amzn.to/3sZVnZ7
“Meditation Is Not What You Think: Mindfulness and Why It Is So Important” by Jon Kabat-Zinn https://amzn.to/3mwUAMO
“Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life” by Jon Kabat-Zinn https://amzn.to/3rYU0Zq
“Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness” by Jon Kabat-Zinn https://amzn.to/3wIozpP
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Podcast produced by: Amanda Taran
Please enjoy the full transcript below
Dr. Antonia: And that was really when it started for me. When I came out of the lab, having done some exploration of Jon’s work and done some meditation at that point it was, if you can believe it, cassette tapes, I had cassette tapes, Jon had given me, kindly had given me, and I came out of the lab a completely different person. I actually was having fun being a surgical resident. I was tired. I can’t say, I didn’t have a bad day, but I laughed with my colleagues. I had a great time and I will share with you Jill that many, many people, including my superiors and my residency director noticed a huge change.
Jill: Hello, and thank you so much for joining us on DocWorking: The Whole Physician Podcast, and I am really excited today to be joined by somebody you’re going to love hearing from. It’s Dr. Antonia Stevens from MGH, Harvard in Boston. She is a surgeon specializing in thyroid surgery. She’s also the head of wellness for surgeons at MGH and a professor at Harvard as well, and Antonia goes by Apple. That’s who I know her as, and we’re so glad you’re here with us today, Apple. We’re going to be talking about meditation and mindfulness specifically for physicians. So, why did you come to be interested in meditation and mindfulness as it relates to your work and life? Start us back at the beginning. When did you first become interested in this?
Dr. Antonia: So, like many things, I had exposure to the concept of meditation and mindfulness really as a kid, I grew up next door to Dr. Jon Kabat-Zinn, who really is one of the modern fathers of mindfulness and who was instrumental in bringing mindfulness and meditation practices to Western culture. But the exposure was really very much as much exposure as a kid. I knew it was there. I knew what he did, but not really. But I was aware of it, and it was there, and there were a couple of books around the house. But I would say that the moment that really grabbed me for the first time was when I was a teenager, and I happened to be a rower. I rowed in college, and I was outside our house one day, and Jon was leaving for the airport, and I asked him where he was going, and he said, “Well, I’m going to work with the men’s US Olympic rowing team.” Of course, that was fascinating to me, because I had to assume that if the men’s Olympic rowing team was hiring Jon, was paying Jon and flying Jon, I think at the time he was going out to California that Jon was going to make them go faster that he was going to make them perform better, and make them win. That’s why usually Olympic rowing teams hire people. So, that was interesting to me, because, I sort of in the past have seen Jon as a psychologist, he is not a therapist maybe, which he’s not. So, this aspect of performance, focus, and achievement tied into what he was doing, which was mindfulness and meditation was really what grabbed me to begin with.
Jill: Yeah, and so, for those who aren’t familiar with Jon Kabat-Zinn, he is a physician himself and has really committed his life to meditation and mindfulness and researching it. So, putting some science behind what he knew to experience as the benefits of it a little bit. So, for those who aren’t familiar as much with his work, can you give us just a little bit of a thumbnail about who he is and what he does?
Dr. Antonia: Absolutely. So, he’s a PhD, very minor correction. He’s not a physician, but a PhD. He was actually a molecular biology. I think a graduate student or was working on his PhD at MIT, and heard some lectures on mindfulness and meditation, and was really fascinated with this. What Jon did is that, he looked at this technique, and he was interested in it, and he started working initially with patients at UMass Medical Center and patients with medical issues, hypertension, and some mental health issues like anxiety and depression, and he founded something called the MBSR Clinic, which was really the first of that kind in the United States, which is Mindfulness Based Stress Reduction. He demonstrated that with these classes and with this center, which I recently read was actually in a basement at UMass started in the basement, he was able to demonstrate that these patients had improvements, you know, were able to stop medications, had subjective improvement and objective improvement.
As you mentioned, he actually published studied and wrote about this. That was really one of the hooks that got Western culture into his techniques. Now, those were patients, those were people having problems, they were ill in some way or struggling, and it was not a big mental leap to take this to people who were sort of regular people trying to achieve things struggling through life, through their days, and their jobs, and their families, and that was really where the performance and achievement aspect came in. So, people started working with Jon, who were just regular people who wanted to feel better, who wanted to do better, and who wanted something in their life to be better, and this was a technique that became very popularized with that.
Jill: Incident for you, specifically. Talk a little bit about how you as a practicing surgeon with a– some would call, I think, a challenging subspecialty. You’re doing this work, and you know about this meditation and mindfulness stuff, and that it might help you be a better rower. But when did you start to realize that, “Hey, there may be a place for this and my life as a surgeon, and then some of these benefits that we’re seeing for patients may actually benefit me as well,” walk us through that kind of awakening you had there?”
Dr. Antonia: When I was a kid and was introduced to this idea, I really actually didn’t do any meditation or mindfulness and didn’t really even know anything at all about it. It really was when I was a resident in my first few years of residency, and when I did my surgical residency, it was fairly traditional to do in my program, three years of clinical work, and then many, if not most of us would take a year or two in the lab, and then come back and finish residency clinically. As you might expect, the clinical years were extremely busy, stressful, lots and lots of sleep deprivation, physical and mental stress. I started residency and I think what really brought me to the point where I needed something, and I thought something could be better was that prior to starting surgical residency, I was always trying to get the next thing. I mean, for many of us, it starts as far back as fifth or sixth grade when they start handing out grades and you want to get the A and you want to be in the hardest class, and then, you go through middle school, and in high school, and you’re still trying to get A, and then you’re trying to get the score on the SAT or the AP exam, and then you’re trying to get the admission letter, and then you’re in college, and then you’re thinking about getting admitted to medical school, and you’re taking the MCAT. It just feels like there’s one score, one acceptance letter, one more thing to do.
I pretty much landed in residency feeling really burned out and I think it was a lot from that. I think we spend very little time in that process, examining why we’re doing things. What do we love about the idea of being a surgeon or a doctor? What do we love about the idea of going to medical school? If anybody had ever asked me those questions, I would have had absolutely no idea how to answer them. I think it was really my first few years of residency where they needed to be answered. If I’m going to be sleep deprived, if I’m going to work this hard, if I’m going to get up in the middle of the night, what’s my purpose, what’s my passion, and I don’t think that we had ever or I had ever had an opportunity to explore that. I think that can come naturally to some people, depending on who they are in terms of their personality, in terms of what environment they’re in, and who they spend time with and explore these things with, but for many, if not most of us, it’s all about the measuring stick getting to the next thing. I think that I found myself in a place where I really needed to examine that.
So, I tried some therapy, which I think is great. I think therapy is great. But as a surgical resident, the time commitment, the days and hours that therapists work, and the expense was just not really a very feasible in terms of any sort of long-term plan. So, I thought, I’m going to check out Jon’s book. I picked up the book and started reading. That was really when it started for me and when I came out of the lab, having done some exploration of Jon’s work and done some meditation at that point, it was, if you can believe it, cassette tapes, I had cassette tapes. Jon had given me, kindly had given me, and I came out of the lab, a completely different person. I actually was having fun being a surgical resident. I was tired. I can’t say I didn’t have a bad day. But I laughed with my colleagues. I had a great time and I will share with you, Jill that many, many people, including my superiors and my residency director noticed a huge change.
Jill: Yeah, so, I love the story that I’ve heard you tell about how you notice it impacts you in surgery, for lack of a better term way that you react or the reductionism of just the normal thing. So, tell us a little bit about like the difference for you between, let’s say, Apple’s regular brain and Apple’s brain after she has been practicing mindfulness and meditation. What’s the outcome that you notice and how it impacts your work now as a busy surgeon doing the work that you do?
Dr. Antonia: I like to tell people that the days that I don’t. I usually meditate in the morning for about 10 minutes just as I wake up. I like to tell people that when I don’t do it and many times I don’t do it, I feel a little bit like my brain is sort of loose electron. When I’ve meditated, there’s a pair, there’s a stabilizing effect on that loose electron. All throughout our days as physicians and certainly as surgeons, we’re being pulled more into that loose electron mode. We’re asked to pay attention to many, many things. At the same time, we are asked to do many, many different things, talk with patients, do surgery, teach, write papers, run meetings, talk to families, and we’re asked some of those all in one day.
Certainly, as an academic surgeon, all of those in one week or one month, and we’re not only asked to do all those different things, but we’re asked to pivot very quickly between those things. One might expect that that can have an effect on your brain in terms of how it works and some of the terms that I’ve heard used that ring true, and many of these terms have been used by surgeons other than me is ‘the runaway train mind’ or ‘the monkey mind.’ The monkey mind and the runaway train mind, I think has the biggest impact in how we react to people, and how we react to certain situations that were faced with many of which are challenging, and sometimes or often confrontational.
One of the stories I’ll tell, because I think it really helps to come down to exactly what has happened and how it feels is, as a surgeon, you work with anesthesiologists. When you’re working with anesthesiologists, you do sometimes feel like your goals are not aligned and you may feel that they’re delaying your case or doing something that might be at odds with what you would like or expect. I think what I was able to do from meditating regularly was this concept of actually thinking a little bit more carefully about where the other person was coming from before reacting in a way that would number one, impact a relationship with a colleague, possibly change the mood of the operating room in a negative way. In extreme situations, even impact patient outcomes.
I realized that my interpretation of where they were coming from and how I was reacting to it could have an impact on all of those things. That those things were very meaningful to me, very important to me. So, being able to sort of reflect in a difficult moment is a really challenging thing to do. Practicing that aspect of your brain when it’s quiet and the stakes are low is really what was able to bring me to a point when I was challenged or feeling challenged that I could react differently than I had in the past.
Jill: You talked about in surgery having experiences of just feeling less irritated, and being able to stay at a more steady rate at things that are commonly irritating [laughs] the surgeons in terms of things that are supposed to be happening that aren’t always happening the way that you want them to. I could see when I saw you express that to a group of surgeons. I could see people really relating to that like, “Oh, they really perked up,” and you’re like, “Oh, yeah, that stuff really annoys me if there’s a way that I can train my brain to be able to not get in that space.” That’s really meaningful.
Dr. Antonia: Yeah. So, I think that over the course of your day and we’re talking about doing surgery and being a surgeon, but there are obviously many other professions or even home life that can do this to you. There are a million little things that could irritate us, could feel like threatening to us. Every time I feel like you get irritated in that way, it drains a little bit more of your energy. We have important things to do as surgeons, obviously. We have important things to do in many aspects of our lives. But certainly, as surgeons, we want to conserve that energy and we want to focus that energy towards doing all those things I listed. Doing surgery, taking care of patients, writing papers, teaching, talking to families. If there’s this constant drain on your energy from reacting from these tiny little irritations all day, that’s going to have an impact on how those other things are going to go for you.
The example that I use in the instance you’re describing is that, I often at the end of the surgery would be asked multiple times, how the specimen that we’ve removed was oriented. I certainly acknowledge that how a specimen is oriented that’s going to the pathology lab is incredibly important thing. That’s not in question. So, being casual about it is certainly not an option. But it would feel like it was somewhat excessive to me. I remember the time after engaging in a more regular meditation practice when I was asked multiple times at the end of a long, hard day, and I all of a sudden didn’t feel irritated. I noticed that I was being asked multiple times and I noticed that I wasn’t feeling irritated, and it was a really, really, really good feeling. Because I wasn’t putting negative energy towards something that really was actually quite important, and was really well serving to everybody in the room. So, that was a great feeling. When you get that great feeling as a feedback for having done this practice, you’re going to keep doing it. You’re more likely to keep doing it.
Jill: Yeah, I love that. One of the other surgeons that I work with in a coaching relationship has started based on your information that I have learned from you, and I was sharing with them in a coaching relationship and came back and said, “I’m so much less geared [laughs] with some of the other people in the room,” and it just feels great. It helps make decisions. So, I just love the way that you share that story. Well, Dr. Antonia ‘Apple’ Stephen, thank you so much for taking the time to share your journey of how you are living and embodying and the research that Dr. Jon Kabat-Zinn shared with all of us of how meditation and mindfulness can help us and help physicians do their job better and feel better about it and perform better. Thank you so much for being here and everyone, thank you so much for tuning in and we will see you next time.
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