December 16, 2011

Buddha Buzz: Mindfulness for Doctors, Meditation's Downfalls, and the Avian Flu

A sobering article out of the NY Times this week called “As Doctors Use More Devices, Potential for Distraction Grows.”

From the article:

Hospitals and doctors’ offices, hoping to curb medical error, have invested heavily to put computers, smartphones and other devices into the hands of medical staff for instant access to patient data, drug information and case studies.

But like many cures, this solution has come with an unintended side effect: doctors and nurses can be focused on the screen and not the patient, even during moments of critical care. And they are not always doing work; examples include a neurosurgeon making personal calls during an operation, a nurse checking airfares during surgery and a poll showing that half of technicians running bypass machines had admitted texting during a procedure.

This phenomenon has set off an intensifying discussion at hospitals and medical schools about a problem perhaps best described as “distracted doctoring.”

Apparently, this distracted doctoring phenomenon has gotten so bad that there was a recent malpractice suit, settled out of court, from a patient who was partially paralyzed after a surgery. The neurosurgeon who was operating on him—and presumably, paralyzed him—was using a headset to make personal phone calls to family and colleagues.

What?!

Seems to me like these doctors and nurses could benefit from some high-quality mindfulness meditation. Because is it just me, or is this ridiculous?

I’d like to post a little excerpt from the Anguttara-nikaya on operating room doors everywhere (text altered slightly from the original):

“This is what I have heard…‘Doctors, I consider no other single quality to be so much the cause of the arising of unwholesome qualities that have not arisen and the wasting away of wholesome qualities that have arisen as this: inattentiveness. When a doctor is inattentive, unwholesome qualities that have not arisen arise and wholesome qualities that have arisen waste away.’”

© Peter M. Fisher/Corbis

Speaking of meditation, I stumbled upon this Scientific American article while reading The Worst Horse. It’s written by John Horgan and called “Why I Don’t Dig Buddhism.” (And if you visit the site and happen to have the same question as I do, no, I don’t understand why it’s published on a blog that is supposed to include “critical views of science in the news,” either.)

Most of Horgan’s article is about his experience with Buddhism and why he decided in the end that he had “intellectual qualms” with it. His article has some real gems:

Buddhism, at least in its traditional forms, is functionally theistic, even if it doesn’t invoke a supreme deity. The doctrines of karma and reincarnation imply the existence of some sort of cosmic moral judge who, like Santa Claus, tallies up our naughtiness and niceness before rewarding us with nirvana or rebirth as a cockroach.

Hmmm. He goes on,

Research on meditation (which I reviewed in my 2003 book Rational Mysticism, and which is usually carried out by proponents, such as psychologist Richard Davidson) suggests how variable its effects can be. Meditation reportedly reduces stress, anxiety and depression, but it has been linked to increased negative emotions, too. Some studies indicate that meditation makes you hyper-sensitive to external stimuli; others reveal the opposite effect. Brain scans do not yield consistent results, either. For every report of heightened neural activity in the frontal cortex and decreased activity in the left parietal lobe, there exists a contrary result.

Now, Horgan doesn’t actually cite to link to any studies that say this, so I’m unsure if this has any truth. Judging by the validity of the rest of his article, I’d be surprised if he were right about this, but still, it’s worth asking. We’ve certainly heard quite a bit lately about the benefits of meditation—but are there any detriments?

Last, a news item about a Buddhist practice that truly may cause some harm: a recent Cambodian study is suggesting that the practice of animal release may place people at a greater risk of infection of the avian influenza H5N1 virus (the avian flu), as well as spread the disease. Check out the full article here

Photo credit:© Peter M. Fisher/Corbis

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astringfellow's picture

Sorry, but John Horgan's viewpoint is false and ill-researched to say the least. For one, brain scans have been, and still are showing significant results for practitioners of most forms of meditation. As for his self congratulatory analysis on Buddhism, this is also hogwash, I shouldn't need to go into any further detail about this.

However, what I am most surprised about is that. from reading some of the replies here, the average American is simply too attached to their own ego to be able to take true refuge. This is probably due to the terribly linear education system here. The end result is that most American minds are as partisan as their political leaders, and far too fond of externalizing their own internal dialogue to just trust, commit and be, or indeed to allow others. I am reminded of a time I listened to some students talk about Buddhism - it was incredibly circuitous and painful.

Not everything in the World should be looked at as though one is earning yet another academic badge to show others. Overachieving is not conducive to mindful practice.

For a brilliant riposte by someone who looked at Horgan with clarity:
http://mumonno.blogspot.com/2011/12/john-horgans-back.html

Dominic Gomez's picture

A similar predicament was faced by Shakyamuni's disciples after his death. An elite group of monks too attached to provisional teachings had little to offer others except their "academic badges". Ergo mahayana (more comprehensive vehicle).

sharmila2's picture

While multi-tasking is undoubtedly stressful to the brain and ultimately inefficient (and in a deeper context, impossible since the mind can only really do one thing at a time, it is the frequent vacillation between objects that causes the tension) it affects a lot more industries than just medicine. Ironically, doing surgery (even brain surgery) is a lot less about intense focus and much more auto-pilot than you would think - a lifetime of training enables it to be done fairly routinely without too much supra-tentorial thought, much like driving. Obviously none of us know the specifics of that particular case, and im not advocating chatting on the phone during surgery, but it probably has less of an impact than you would imagine. (yes, Im a surgeon and no, i have never done this - i dont even play music in my OR).
The second point - yes, meditation absolutely has significant side effects when done intensely that manifest especially in the "real world" rather than the protected setting of a retreat. During the stages that mark the progress of insight in the Theravada tradition (the other traditions have their own versions, this is the one I'm intimately familiar with) the majority of them accentuate the negative afflictive emotions and cause one's judgement to be severely impaired in a more exaggerated way than our usual state of ignorance. These side effects unfortunately persist after the retreat, when all the "highs" are gone, and can lead people to behave quite terribly and make very ill-advised decisions due to their distorted reality. They often also create a much greater experience of suffering - increased awareness is certainly no picnic, and while this is a necessary step toward liberation, can be quite devastating at the time. Despite being a longtime Buddhist who considers the religion/practice to be the center of my existence, I have to admit there is some truth in Horgan's statements, albeit a very incomplete view.

wtompepper's picture

Horgan makes an important point in his essay, and I can see exactly why it is on the "Cross Check" blog. the popularity of pseudo-scientific claims about meditation seems to increase daily, although the scientific evidence for the claims goes nowhere.

It is easy enough to say that Horgan's version of Buddhism is all wrong, that he doesn't understand "real" Buddhism. Unfortunately, the Buddhism he talks about is the most common understanding of Buddhism in America. People really DO believe that karma is a magical force like Santa, and they really DO believe the goal of Buddhism is some mystical meditative "high." His version of Buddhism may not be supported by the Pali Canon, or by the great Mahayana thinkers, but it is very, very common. Ask a Buddhist at a retreat, and they'll instantly tell you they believe in anatman, but talk to them for a while about what that means, and you'll most often find that to them it means that we don't have to engage in the world, just retreat from it into the imaginative plenitude of meditative bliss--then, be nice! Anatman, to most American Buddhists, means my body is not a self, but they absolutely believe in a world-transcending permanent consciousness that can achieve true bliss. Usually, when they don't get that "buzz" from meditating, they give up on Buddhism altogether.

I wish I could disagree with Horgan, but he is talking about how Buddhism is actually encountered in America, not how it SHOULD be encountered. And unfortunately he seems to me to be pretty accurate in his description. Instead of yelling at him and quibbling with his depiction, maybe we should take his essay as a wake-up call.

Danny's picture

Although I'm only a novice, a student of Buddhadharma for just over a year or so, I believe you are spot on in this analysis, Tom. As I've heard you say many times here on Tricycle as well other blogs, Buddhist anti intellectualism is rampant...not that people are "limited in their understanding so much as being insistent on limitING their understanding". i also find it interesting how you sort of put Horgan in his place without lifting a finger.
Thank you for helping keep me on my toes!

wtompepper's picture

Thanks moloney. This is the reason I think it is important to keep people arguing strenuously over how to best understand Buddhism. If we're all too worried about being nice, people wind up with the bad version of Buddhism Horgan found, and it does them no good so they give up. In my experience, Buddhism takes a lot of thought, but it really can reduce suffering in the world.

fishman.ellen's picture

'"Research on meditation (which I reviewed in my 2003 book Rational Mysticism, and which is usually carried out by proponents, such as psychologist Richard Davidson) suggests how variable its effects can be."'

As we come to experience practice, I would say Horgan has an interesting construct- variability in how practice is implemented by each person. Practice is a tool that comes with many teachings and is used by many people who have capacities at different levels, so to suggest that outcomes would be a singualr effect is not plausible.

As to the detriments, again simplicity is relegating practice to a one size fits all. A quote from Ken McLeod-Advanced meditation practices can cause energy imbalances that lead to serious physical and emotional problems. Ken McLeod, a veteran of two three-year retreats, explains what to do if this happens to you.
http://bdtest1.squarespace.com/web-archive/2011/11/9/what-to-do-when-ene...

allcalm's picture

Actually doctors and nurses are doing a lot of work to bring mindfulness practices into their workplace:
http://www.impactednurse.com/?s=Mindfulness&searchsubmit=

As a nurse with 26 years experience working in one of the most stressful, information and interruption dense environments that there is, I think it is all to easy just to call this isolated incident 'rediculous' and think a simple posting of mindfulness is the solution.