Meaning, soul, state of mind, and hope.

Abstract

To the editor, In response to Dr Rachel Naomi Remen's “Recapturing the soul of medicine” ( West J Med 2001:174:4-5 [PubMed]), finding meaning in the profession of medicine is critical to our happiness and effectiveness as physicians. The biggest crisis facing American medicine is the lack of connection that many physicians have to the “heart of healing,” which is the soul of medicine, and its intrinsic rewards. National data from Med Stat in Ann Arbor, MI, for 1998 corroborate Dr Remen's California data in that 36% of physicians self-reported low morale, and 46% often thought about leaving clinical practice. This is a serious epidemic to which we need to pay close attention. Physicians are experiencing high levels of stress, but they seem to either not have recognized the problem or don't believe that in the current health care environment, it's possible to have a less stressful and more rewarding experience of practice. In fact, stress is the weight of negative thinking taken seriously over time, and regardless of the circumstances, it is possible to not experience stress. The physicians with whom I come in contact on a daily basis are frustrated and overwhelmed by time pressures, reimbursement issues, compliance, fraud, and liability issues; they have generally lost sight of the fact that their experience is a direct result of what's on their mind, of their state of mind. They are out of touch with their own psychological well-being, the depth of the intrinsic rewards of the profession of medicine, and the sacred nature of the work. As a result, meaning eludes them on a day-to-day basis, but it is just a thought away. It is possible for physicians to change the way they think, to see something new about the profession of medicine, and to regain professional satisfaction, efficiency, effectiveness, and meaning. Simply gaining a degree of understanding about the origins of the human experience in thought, and the effect of state of mind on experience, allows them to relax into enjoying the practice of medicine again. They are then able to reconnect to what called them to the profession and to their vision for medicine, as well as for their lives. There is a great deal of hope for deepening professional satisfaction and recapturing the sacred nature of the practice of medicine. Hope lies beyond our current distracted personal thinking; it is essential that we look to the impersonal nature of thought to regain our resiliency and responsiveness, our light-heartedness, and our deep joy. Physicians' state of mind holds the key to healing the entire health care system, and the sooner we focus our energy in this direction, the better off we will all be—physicians and patients alike. To heal, we must first heal ourselves; recapturing the soul of medicine will result automatically from clarity and undistracted, impersonal thought.