Medical training has been and perhaps will always be hierarchical. In the large academic centres where we train, medical students and junior residents are frequently dispatched by superiors to fight off consultations, dodge admissions, and turf patients. To fight these battles with fellow residents, nurses, and staff, medical culture instructs (and requires) a personal and emotional distance from our coworkers. Why? So we can ultimately “win” these fights. So profound is this disconnection that when a senior colleague has a friendly chat with a nurse or off-duty resident, I am often caught by surprise.
As a medical trainee, one’s body of knowledge and repertoire of skills grow by observation, practice, and repetition. When the context of this learning happens in such a potentially dehumanizing environment, when interactions with peers can go so wrong, how can we expect anything better when trying to be mindful with patients?
Unless “mindfulness meditation training”1 can meaningfully address this issue, it would seem to offer little in the humanization of medicine.
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