Is Being Present Possible in Medicine

I went to a concert this weekend in a large arena. Before it started, there was an announcement that the artist was requesting no video/photos during the show as it distracts both her and the audience from experiencing it.

Now I don't think asking for people to do this is particularly novel. What was novel is that people actually did it. I have gotten used to seeing people's cameras blocking me at most concerts (yes, i'm also short). That didn't happen. And it was less distracting and it felt like all of us could actually be present and experience the show as it was intended.

There are a number of studies, books, and advice about how staying present is beneficial for...well, apparently everything. Getting tasks done, being creative, mental health, getting to your goals etc. However, it is a hard thing to do in medicine. Whether due to the burdens of patient volume, the competing tasks, the stress of administration, medical records, keeping up with CME, tasks we aren't paid for, all of it tends to overshadow the patient care.

In my medical career it was hard to do that. The emergency room is known to be chaotic, often 3 people would try to speak to me or get my attention and there is noise everywhere. It takes tremendous organization and skill to keep threads of disparate information together. There are always jokes about how EM docs have short attention spans but it's not necessarily funny when it's done for survival rather than a natural way to work.

However, on the flipside, if someone was coding or ill or some emergent intervention was required, it did feel like everyone was fully 'present' as that was your one and only focus. Everyone pulls together in those moments and that is the only thing you're doing even for a short while.

In telehealth, one of the first things I noted was that difference between sitting on my computer 1:1 with a patient vs the ED. I could concentrated and spend time with one patient. Of course, that didn't always last. As both TH practices I was in became busier, the patient queue would be distracting.

While all of those parts would benefit from being present, the patient visit is the most important. Without it we can miss patient cues that are valuable and takes away our human ability to connect.

There is not a great or easy solution to this in medicine. However, I realized how much better it is - listening to music that way led to a fantastic experience. And how much it would have been great to practice EM that way, maybe would have helped with burnout. Who knows. But this is something that we miss out on despite knowing the benefits.