Mindfulness has become a buzzword in recent years. This has filtered through to the world of surgery where growing numbers advocate its use, with UCSF even having its own surgical mindfulness centre. But what exactly is mindfulness and is this a trend that merely highlights a behaviour already embedded in surgical performance?
Mindfulness can be defined as the practice of ‘purposely bringing one's attention to experiences occurring in the present moment without judgment’. Its origins stem from Buddhist traditions and its practise often involves meditation and breathing techniques. Practising mindfulness, it is argued, provides an alternative way to perceive and relate to stress and allows one to become more disciplined, more accepting, and less reactive. Mindfulness considers itself distinct from other tools we may use to reflect and recharge (such as exercise, television, holidays, or alcohol use). However, for many, there is overlap here.
Being mindful is defined as ‘the quality or state of being conscious or aware of something’. Operating fundamentally demands this very state of mind, as does taking a history or examining someone, or breaking bad news. During training and life, different experiences (real and simulated) allow an individual to learn how to maintain attention and focus, to deal with unexpected or stressful events, to react to people, and to process afterwards. The physical and psychological aspects of this development are intertwined. As such, suggesting that mindfulness is a new answer to improving this facet of surgical training is nonsense.
However, it certainly is useful as a way of highlighting and articulating this side of surgical learning. One person’s mindfulness may come with singing in a choir, another’s with a long walk, another’s by talking events through with a colleague. More likely, a combination of strategies will emerge. The new mindfulness, as defined by popular culture, is just one those strategies.
Moves to limit working hours have undoubtedly reduced operative training opportunities. On the plus side, this now leaves space to become more mindful and more resilient.
Consultant neurosurgeon and honorary clinical lecturer, Edinburgh