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In this episode, retired cardiologist Sarah Samaan delves into the world of meditation. We discuss the perception of meditation in health care, its benefits for physicians, and the scientific research supporting its effectiveness. Join us as we explore how meditation can enhance medical skills and offer practical advice on starting a meditation practice.

Sarah Samaan is a retired cardiologist.

She discusses the KevinMD article, “Meditation: the ancient practice with science-backed benefits.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Sarah Samaan. She is a retired cardiologist and a physician coach. Today we’re going to talk about “Meditation: the ancient practice with science-backed benefits.” Sarah, welcome back to the show.

Sarah Samaan: Thank you so much for having me. I’m excited to be back.

Kevin Pho: So Sarah has been on multiple times. Go to KevinMD.com/podcast to search for her prior episodes and hear her story. But today let’s jump straight into it. Tell us a little bit about that article.

Sarah Samaan: Yes. So I am a yoga practitioner, yoga teacher, and also a mindfulness coach. And what I learned as I explored ideas of mindfulness, and as I discovered the ways that I was sort of inadvertently using mindfulness in my medical practice for probably 20 years, was that not only was it something that I personally benefited from, but there’s actually a lot of research that is both based in brain anatomy, brain physiology, as well as behavioral science and physician burnout experience, that really supports the use of meditation for physicians.

Kevin Pho: And when you say mindfulness, what does that mean to you?

Sarah Samaan: Yes, that’s such a good question. So mindfulness is defined by Jon Kabat-Zinn, who is really one of the people that brought mindfulness to the medical profession back in the 1970s, as a way of living. It’s a way of being aware, and the awareness that arises through paying attention in the present moment without judgment.

So for physicians this is particularly beneficial, this ability to pay attention not only to the work that we’re doing but to our patients, to be in the present moment, to be with our patients, or with say the procedure that we’re doing or the study that we’re reading, to be present and without judgment. And in place of the word judgment I also like to use the word reactivity. So without reactivity, which can be especially important for physicians when we’re dealing with different types of situations.

Kevin Pho: So tell us some of the data and the science behind the benefits of meditation.

Sarah Samaan: Yeah, so a lot of people might think of meditation as being something kind of out there, something that’s not really in the realm of science. But there’s been literally thousands of studies done on meditation and mindfulness in the past few decades, and it’s a really legitimate area of scientific inquiry.

Most of the studies that have been done on meditation and mindfulness have been done in the past 10 years, so it’s really an area of growth. And so getting a handle on this can feel a little overwhelming, because there is so much data, and some of it’s good, some of it is not as well done as the type of research that we as physicians are comfortable in learning from and in accepting. But there are some very well done studies.

So first of all, and I think maybe the thing that’s perhaps most important to some of us as physicians, is that meditation can actually enhance your skills. And when I’m talking about meditation from my perspective, I’m talking predominantly about mindfulness meditation. So I’ll just say as an aside, there’s a number of different forms of meditation, but mindfulness meditation is a very, very secular form of meditation.

So the research that has looked at mindfulness meditation has shown, number one, that people who meditate are often more able to pay attention to a task, to focus attention. And that’s not surprising, because the process of mindfulness meditation is that returning back to the focus, to the area or idea that you’re trying to bring awareness to. So it’s that continually returning the awareness or returning the focus that kind of trains the brain. And so there’s actually EEG studies that show that while meditating there is evidence of sort of relaxed alertness. Now, I’m a cardiologist, not a neurologist, so I don’t want to overstep, but there are EEG findings that are signifiers of greater attention and perhaps even more internalized attention, where people are really focused and less distracted.

There’s also evidence of enhanced body awareness, which might also kind of bring your attention to where you might be holding stress, and that can be beneficial perhaps for somebody who is doing a procedure or a surgery, just being able to let some of that stress go and release some of that attention intentionally.

Also, mindfulness meditation, not surprisingly, can help you regulate your emotions, just simply by being aware and noticing. It can increase your capacity for memory, again this awareness, this returning to focus.

There’s also good evidence that people who meditate regularly have better sleep quality. But, and we can go into this in a little bit more detail, if you meditate at bedtime that might actually not be the right time to meditate, because of that focus. There’s different kinds of meditation, but from a mindfulness meditation standpoint, training your focus at bedtime might make it more difficult to get to sleep.

And then finally, there is good evidence, including studies published in well-respected cardiology journals, that have found improvement in cardiovascular health, including heart rate variability and blood pressure studies.

Kevin Pho: So when you use the term mindfulness meditation, what exactly would that look like?

Sarah Samaan: Yeah, so mindfulness meditation is a specific type of meditation that differs from something like Transcendental Meditation, or something that perhaps somebody might have experienced in a yoga class called Yoga Nidra, which is, the idea of Yoga Nidra is sort of to mimic sleep. So there’s many different forms. There’s sound bath meditation, there’s where you’re trying to clear the mind. But when we’re talking about mindfulness meditation, it’s a practice of awareness. So it’s a practice of training the mind to develop awareness, and also to develop a practice of equanimity, which might also be termed a practice of maintaining your composure, just being aware, being in the moment, and allowing yourself not to react.

Kevin Pho: Now, is this difficult to do? Does it require formal training? Can someone go online and learn how to do it? How would one learn how to do this?

Sarah Samaan: Yeah, that’s a great question. And I do myself have extensive training in mindfulness. Not only am I a mindfulness coach, but I’m a certified mindfulness meditation teacher. But you don’t have to do that. You don’t have to have special training. That can help just to deepen the practice, but it can be as simple as a five-minute practice with an app.

And there’s actually research looking at health care workers who practice mindfulness meditation with an app for five minutes, finding a reduction in burnout, for example. There was a study in the journal Military Medicine that was just published this month that found that health care workers in the military who just periodically dropped in on a meditation reduced their levels of burnout, felt more positive, and felt more connected to their patients, and they experienced significant benefits. So it doesn’t have to be something where you go to a center and learn. You don’t even need to do yoga to do mindfulness. There’s a number of apps that you can just download and start using.

Kevin Pho: So a common thing that I’m sure that you hear from other physicians is that, I’m too busy to meditate, I have to see all these patients in a clinic or go to the hospital, I come home exhausted, I have to do all my charts, spend time with my family and take care of my kids, I don’t have time to meditate. So take us through a success story about how busy physicians can incorporate meditation into their lives.

Sarah Samaan: Yeah, that’s such a great question, because I completely relate to that. I’ll give you my own success story, because I think this really made me a believer.

So back in the 90s, I ride horses, and I had a bad accident, and I realized at that point that I didn’t have that mind-body connection that I really needed in order to connect with my horse and to understand what I was doing with my body with riding. Each leg and each arm are different, your core is different, everything works differently. So I started trying to figure out how to make something better, and I found yoga.

And back then there weren’t a lot of yoga studios back in the ’90s, but the ones that were in existence, at least in my community, were staffed by really excellent practitioners. And so I started doing yoga, and I really thought of it more as a physical practice or kind of a training practice. But I began to realize a few months in that as I was getting ready to walk into a patient room to deal with a difficult situation, or I was getting ready to work through say a complex procedure, that I was taking a pause before walking in the door and taking a few deep breaths.

And as simple as that sounds, and as really non-exciting as that sounds, it really shocked me. Because like a lot of us, I’m somebody who runs from one place to another and barely finds time to eat or just go through the basics of life. But this really brought that awareness to me in a very real and very meaningful and very actionable way. And that was really the beginning of my exploration of mindfulness.

Kevin Pho: You said earlier that before going to sleep isn’t the best time to meditate. When can one best incorporate meditation during the day?

Sarah Samaan: Yeah, so I don’t want to discourage people if the only time they have is right before going to bed. But because meditation is a practice of focus, doing it for five minutes in the morning, maybe while you’re waiting for your coffee to brew, something really simple like that can make a difference. Or maybe at lunchtime, if you have a few minutes, if you’re doing your charts and you just have five minutes, you can go close the door and just sit quietly and listen to a mindfulness meditation on your phone. That can be a great way to reset.

And it is hard, I mean, your mind will wander, and even if you’ve been doing it for years your mind will probably wander. We’ve all got so many distractions. But I think that’s one reason why it’s so important right now to learn these techniques and develop mindfulness, because our attention is being pulled ever more in different directions, and it’s so easy to just allow your phone to pull you in one way or allow your inbox to pull you in another direction. And just being able to know that you can step back and take a pause, even if it’s brief, is something that can really sustain you.

Kevin Pho: You mentioned that there are some meditation apps on your phone. What is that experience like? So if someone downloads an app, what exactly do they have to look forward to?

Sarah Samaan: Yeah, so there are a number of great apps. I love Waking Up, that’s an excellent app, but there’s also Headspace and Calm and Insight Timer, and a lot of these are free or they’ll have free options.

But basically you just open up the app, you download it on your phone or your iPad, or you can access it often from your computer, and usually there’s a search bar, or there’s a meditation of the day. Waking Up has a 30-day kind of introduction to mindfulness meditation program. And some of these meditations may be 10 minutes, that might seem like too long, so often you can put into the app exactly what you’re looking for, so you can say I want a five-minute mindfulness meditation and something will pop up. Something like Insight Timer is a great way to get started because it is free, and there’s probably thousands of meditation teachers on that app, so it may not be as well curated, but if you wanted to just try something out, you can find any length of meditation as you would like with that app.

Kevin Pho: We’re talking to Sarah Samaan. She’s a retired cardiologist and a physician coach. Today’s KevinMD article is “Meditation: the ancient practice with science-backed benefits.” Sarah, let’s end with your take-home messages to the KevinMD audience.

Sarah Samaan: Great. Well, I’d like to really encourage physicians to explore mindfulness meditation. Mindfulness is often pushed on us by hospital systems or corporations, and I think that has created a lot of pushback from physicians, feeling as if this is heavy-handed and imposed by organizations. Don’t let that dissuade you. I think that we have to separate the things that we’re being told to do from the things that we choose to do ourselves that we know are beneficial. But don’t let that negative impression lead you away from trying mindfulness.

Mindfulness is a way to train yourself to be present in the moment, to be nonreactive, and it’s something that you can use and explore in your work as a physician, with your family, and with your relationship to yourself. So I really want to encourage people to explore this tool.

Kevin Pho: Sarah, thank you so much again for coming back on the show and sharing your time and insight.

Sarah Samaan: Thank you so much for having me.