“Don’t be attached to the outcome” (Why is that one so hard to remember?) When my son turned a year old, my spouse and I eagerly attended a local talk by Myla and Jon Kabat-Zinn on the topic of mindful parenting. Their book, Everyday Blessings: The Inner Work of Mindful Parenting (Hyperion, New York, 1997) had just been published and, as enthusiastic young parents, we wanted to learn as much as possible from these parenting gurus. I was determined to come away with as many pearls of wisdom as possible, which the authors made very easy, since Jon ended his talk with, “Here are the 4 main things to remember about mindful parenting” I have repeated his words over and over to myself ever since, since mindfulness informs not only an approach to parenting, but also an approach to work and life in general.
- Show up
- Pay attention
- Be honest
- Don’t be attached to the outcome
Needless to say, the last principle seems to be the hardest one to remember. In fact, my spouse has yet to remember it even after 18 years of child-rearing (“What was the last thing Kabat-Zinn said again?”).
As a doctor, I try my best to follow the same guidelines. Even if rushed, or having lingering concerns about the patient who visited earlier in the day, when I go into an exam room (Show Up) I try to focus on the person in front of me (Pay Attention) as soon as I close the door. Being truthful about what is known and what is not known about the diseases we are treating, and the medications and procedures we recommend (Be Honest), is a top priority in “mindful doctoring,” but the most valuable principle is again the last one. Even when we’ve done our best we can still be wrong, and events may not turn out as we initially expected (Don’t Be Attached To The Outcome).
During my residency in Boston, one of my favorite attending physicians was a gastrointestinal specialist from Ireland. He taught us to consider all the major diagnostic possibilities when interviewing and examining a patient, and then to commit in writing to what we thought was the correct diagnosis, before looking at any labs, x-rays, or any other tests. And then, after considering all the data, we were to reassess our diagnosis. The benefit of the long hours we kept during residency training back then (and there were many disadvantages as well—but we’ve talked about the effects of sleep deprivation already!) was seeing patients on a daily/nightly basis to the end of their hospitalizations. Our hypotheses were tested, rejected, and honed. But the most important lesson some of us learned, was the importance of ignoring the ever present and pushy ego, questioning our assumptions, and following the patient’s agenda, not our own.