A Personal Journey by Kristin Kaelber MD, PhD
When I first attended the AMI physicians’ conference, my intention was to heal from burnout. At that time, I truly believed that if I found the “right” job, then (and only then) I would be able to heal. I never imagined that healing could occur within the same job. I thought I needed to find a job where the clinic allowed me to emphasize lifestyle practice for reversal of disease, gave me enough time to see patients, and diligently supported physicians so that they could focus only on doctor work and not menial tasks.
However, Yoga Science has taught me that when I change my perspective, I change my experience as well. Over the past year or two, as I’ve worked the same job, my perspective has changed. My practice of Yoga Science has allowed my medical practice and experience as a physician to be reimagined into a form more aligned with my own inner wisdom and my deepest driving desire to be of service wherever I find myself. I have also come to realize that if I had switched to the “perfect job” without experiencing the purification accomplished through my spiritual practice (which is known as sadhana in Sanskrit), I would not have found any new job to be the ideal imagined in my fantasies.
Prior to coming to the conference I felt that patients brought me burdens that I had to handle for them. Frankly, I was sometimes angry that they dumped them on me. When I came into the examination room their problems became my own. I had not noticed the stress that this caused my body, but I did often take their problems home with me at night. As a consequence, I mindlessly ate too much, drank alcohol or watched reality television to ease my self-created burden. Now I
can witness patients’ problems with much less attachment. For example, a patient might begin to cry because their spouse has recently died. I recognize their sadness, but no longer react in the same way. I used to try to solve their sadness. I now honor and witness their sadness. I focus all my attention on their words, their body language and my knowledge of the patient. Because I remain an observer, I can allow the discriminating part of the mind (buddhi or conscience) to discern what is to be done and what is not to be done in real time. I can support the patient with my words and my attention. (I hear Leonard Perlmutter’s teaching that “attention is love.”) I have noticed that I am able to choose my words more carefully. I used to think that simply listening was not much of a therapy. I recognize now that attentive listening is an effective healing technique—often more effective than a pill or advice. A few years ago, if I had not prescribed something or advised something to a patient, but only listened to them, I would have felt that I did not help the patient.
I have always given all my patients my best effort, but now I’ve begun to let go of my attachment to the outcome of my effort. In the space of a clinic visit, I spend my time trying to serve the wisdom (known as shreya) reflected by the buddhi. I still have limited time with patients so I now make more discriminating choices about how I spend that time. I make sure that I touch on lifestyle choices with every patient but am much more careful about how I do this. I might choose just one thing to discuss. I used to wear myself down telling each patient that they needed to exercise, eat right, sleep well and stop smoking. Through more focused attention with patients, I can sense which ones seem to be open to this advice. Those patients get a few more moments of counseling about lifestyle.
I realize that the shreya in my office visits is not always to talk about what the patient needs to do to improve their health. For some patients, who have heard my counsel before and are not open or able to change, I choose to spend the limited office visit time in a different way. I give them my attention, my love. I get to know who the patient is that has the disease. I listen to them talk about their granddaughter’s upcoming visit or enjoy complimenting them on their choice of nail polish. We both smile and I actually enjoy seeing the patient.
Many of my patients are elderly and lonely and this moment of interaction is a compassionate expression of loving kindness, a form of “medication” I am giving them. Our becoming connected actually has been shown to improve patient health in some recent studies. I now truly enjoy these interactions. Before my commitment to the practice of Yoga Science I hurried through the greetings because I needed time to go through everything on my list. Now, however, my priorities are different.
I still end my patient visits by refilling their medications for chronic medical issues, but I no longer get upset that they are still on these medications. I used to beat myself up because I could not cure them of their chronic illness. I know that if they just made different choices with their lifestyle they could get off many of their medications, but I realize that this is not in my hands. I don’t hold myself accountable for their illness or lack of change. This is so much more enjoyable. And I also enjoy the holy mystery when someone I thought would never change comes back in with significant improvement because of their work.
A primary care physician’s day can be hectic—but only if you allow yourself to experience it that way. (Before Yoga Science, I never understood that I could choose how I experience my day.) For most of my career as a physician, I spent a lot of time and energy being worried that I was late to see a patient. I experienced so much anxiety, and I got angry at others because they had not roomed the patient faster or the patient had arrived late. I did not consciously set out to work on this through my Yoga Science practice, but I realize now that this old habit pattern has been largely extinguished. Now, when I enter a room, knowing there are also two other
patients waiting for me, I choose to sacrifice my fear. I choose to focus on what the buddhi endorses as the shreya—which is to see the patient before me, and serve them as best I can. I notice that I am able to pay very close attention to the patient, and am less distracted by my thoughts and by events outside our interaction. It helps me see the patient with greater clarity. This one-pointed attention saves me much needed energy, which I can then apply in the next patient interaction, and
I am routinely asked to make difficult decisions for patients or to give them advice in situations where there are no clear, quick answers. Here again, Yoga Science has helped. My creativity has expanded, and this helps me consider complex problems and find solutions that might not have been seen previously. I think on my feet more quickly. There are times when I realize that an important question or action is about to be asked of me—because my mantra will spontaneously come into my mind. It happens right before the patient speaks to me or right before I’m asked to provide an answer or comment. It is in these moments that I feel my work is much larger than myself, and that the universe is actually guiding me to do the right thing in real time (meditation-in-action). Several times the mantra has appeared and saved me from voicing my first response to a patient, allowing me to discriminate my response. It really is amazing!
On most days, no matter how busy I am, I make a point of leaving the clinic during my lunch break just for a few minutes to walk around the parking lot and focus on my mantra. This centering practice calms me and prepares me for the afternoon. It is valuable self-care that prepares me to better serve all my patients.
In the morning, prior to my daily seated AMI Meditation, I mentally scan my body, noticing where the body is tight or tense. Now, I am aware when my body is beginning to tense during the day in the clinic, and am able to treat it quickly with Yoga Science practices such as shoulder rolls or massaging my face and neck. My regular practice of breathing techniques outside of the office has taught my body to remember what a relaxed state feels like. I can calm myself with just a few seconds of diaphragmatic, focused breathing. Now I notice when I begin taking shallow breaths while listening to a patient and I have learned to deepen my breathing in real time. These small shifts allow me to conserve energy, and not end my day in the complete exhaustion and anxiety I have felt before. Because I know that my clinic days are going to be very busy, I have begun to drive to work a few minutes earlier and practice three rounds of yogic breathing practices like alternate nostril breathing prior to entering the clinic. It prepares me for the work of the day. I never would have guessed that I’d be giving so much time to Yoga, but the practices have become as important to me as brushing my teeth.
Next, I think my practice of Yoga Science has helped me to be less reactive when experiencing the ordinary demands of a medical practice—the phone calls, the labs,
the computer issues. I can choose to serve the shreya (the action that will lead to the highest good). I can keep being annoyed that something with the computer doesn’t work right, or I can calmly call the help desk and work it out. I can be frustrated because someone did not do their job, or simply focus on creatively solving the challenge in front of me. I have begun to share some of my Yoga Science practice with patients, when it seems appropriate. I have even taught AMI’s one minute
meditation to patients suffering from anxiety, and have suggested stretching exercises to people with chronic neck or back pain. This isn’t easy to do in a short visit, so I’ve begun to think about how I can do group visits to teach this to my many patients who are suffering with anxiety, chronic pain, fear, obesity, hypertension and addiction. I used to be frustrated by patient requests and the demands of my job, but now I am realizing that my practice of medicine is my service to the world. My work is truly a calling, and it is holy work. I still get off track and annoyed; however, even more often I don’t get upset or angry. I just do what needs to be done. My shift in perspective, brought about by the practice of Yoga Science, has dramatically changed my experience and has helped me to reimagine my medical practice—right in this job I thought I had to leave.
Kristin Kaelber is a graduate of Case Western Reserve University School of Medicine, is Board Certified in Internal Medicine and Pediatrics in Cleveland, Ohio. She received her PhD in Developmental Neurosciences from Case Western and currently serves as a member of the AMI Department of Medical Education. Dr. Kaelber has been practicing Yoga Science as Holistic Mind/Body Medicine since 2015.