This transcript has been edited for clarity.
Kathryn Lafaber, M.D.: Greetings on behalf of Medscape Neurology. I am here today with Dr Indu Subramanian, Director of LA’s VA Southwest PADRECC. I am a neurologist in Saratoga Springs, NY. If you’ve seen us before, you know we’re both experts in movement interested in exploring the cutting edge of Western traditional medicine.
Meditation Medicine Fellowship
Last time I talked about integrative medicine and lifestyle medicine, and today I will talk about meditation medicine. Indu, you recently fellowship Please tell us how you got interested in this specialty and what we understand about this topic.
Indu Subramanian, M.D.: Kathryn, we’ve talked about the fact that the standard Western approach helps in many ways in the way we practice medicine, but that’s not all. I think we’ve been looking for something else.
I personally embarked on my own health journey and ended up relying on some mind-body practices that I was exposed to as a child. I received the training as part of my yoga certification at The Work. I have really found that it has transformed my body and helped me cope with the stress in my work and personal life as a working mother.
I work for VA and run the Center of Excellence. They are interested in holistic health as a concept and I think we are fortunate to have some of the most dynamic and amazing mindfulness teachers on the planet working in our VA.Some of this work works in meditation with patients, even depressed and anxious veterans really making a difference post-traumatic stress disorderThey were providing some sources Insight LA And mindfulness VA. I’ve done just about every mindfulness class a workspace for healthcare providers can offer.
I was eventually intrigued by this contemplative medicine fellowship. It was run through the New York Zen Center for Contemplative Care and had a very interesting application process. I needed an academic reference and a spiritual reference. No spiritual reference was ever written about me, but it was very interesting to think about who could play the role.In the end, I applied for a scholarship, got it, and moved to New York. I joined this one-year fellowship through the Zen Center.
Lafarber: Tell me more about the application process and fellowships. This is obviously in addition to normal clinical work.
Subramanian: I think it was really good that I chose 30 people. It was a relatively competitive application, and I was thrilled to receive the scholarship. We had to talk about a year-long project using meditative approaches, primarily in the Buddhist tradition. At the same time, it was also about considering how they could improve our own minds and health.
We talked about our own journeys we’ve taken through medicine and in my personal life, and then in my leadership role at VA with other doctors and health care providers. I had to talk about the feeling of using these practices to support the community of.
Also, the disease process that you and I both love is Parkinson’s disease, hence the sense that some of these mindfulness approaches can be used to help patients with chronic illnesses in this space. There is no perfect medicine or perfect exercise to cure the disease. Helping patients understand how they can help patients outside of traditional medicine when there is no solution was actually a big part of the process for me.
Integration into clinical practice
Lafarber: yes. Very interesting. Tell us a little bit about what this looks like in your clinical practice, and how this particular training you’ve had actually translates into your daily clinical practice.
Subramanian: Looking back, there were 29 or 30 other fellowships. Buddhism and many traditions have this concept. Sanga, the people you surround yourself with are an important part of your purpose and quest. For example, we were supposed to check in on the phone with someone else we were paired with each month to support each other. We also did his one day retreat which included meditation.
There were also some retreats where we met in person. I went to the New York Zen Center. Our graduation was actually in a pretty spiritual location in New Mexico. We really had this process of learning and doing very practical exercises regularly in our group. , and it was necessary to discuss it with groups and sometimes with small groups.
What is very interesting is that I am a Parkinson’s neurologist. I was the only neurologist in the entire cohort. There was a vast number of other specialties represented. It was very diverse, with her ICU workers on the front lines of palliative care during the COVID-19 pandemic, as a pulmonologist or critical care physician he worked in the ICU. Our cohort had several surgeons, various ages, several psychiatrists, and obstetricians and gynecologists. It was a real mix of people.
One of the things that was really interesting was looking at the current healthcare environment and seeing that we were all sharing a very universal healthcare experience that we are not very comfortable doing right now. By looking for something different, something a little more meaningful, understanding the discomfort we had, and working with some mentors and some teachers to see if there is anything , tried to track it down in quite a few ways. what we can do meaningfully.
As a cohort, we’ve been close all year long and really supported each other. Even today, I find myself thinking about various classmates and sending them poems, songs, prayers, or anything else that resonates with me that I might have read that reminds me of them. Sometimes I talk about what happened in my clinic and ask for advice on how to deal with it.
One of the huge pieces was actually this cohort of fellow healthcare workers. And this concept of meditative medicine, where we try to be in the moment, the present, to see and reflect on our thoughts, has been very therapeutic.
Lafarber: As I mentioned earlier, we are exercise specialists and see many Parkinson’s patients. You said that Parkinson’s disease has many symptoms that are difficult to cure with medicine, and that many people are suffering from it. depressionsleep problems, or anxiety, some of these meditative approaches can really help.
How do you approach patients in your practice? Especially those who may not have heard of such an approach or may be receptive to alternative approaches. Can you give me some practical tips? .
Moments of minfulness and just being there
Subramanian: The concept is that there is a 20 minute meditation where you can sit on a cushion and reflect on your thoughts and be in the moment. There are several ways to bring reflection into your daily life.
One thing that really resonates with me is just taking moments and taking simple moments. For example, just one minute of his pause during the day to have his thoughts and go out into nature. I work in VA and have some beautiful rose bushes that smell beautifully. It’s like being out in the sun, riding the wind, feeling the sun on your face. I think a lot of these things can be tried to incorporate, even for simple moments.
I am taking some trainees outside. Originally, it was a place where they would present their cases outside under the guise of social distancing. It was. Nature has regained its presence, its joy and its gratitude. These are the simple things we can do. We try to teach our patients things they can easily incorporate into their lives.
One of the causes of burnout syndrome is the desire to do everything for the patient. I see their suffering and want to improve their housing situation, food shortages or homelessness. It is so daunting to work through all these issues and I suffer with my patients and take on their suffering. One of the lessons I have learned through this fellowship is the ability to testify. I learned how to be and be with someone in those moments of suffering, even where that person is in a palliative care hospice setting and may be dying.
I felt the need to do something to adjust my meds, help my family in this way, or say something to comfort people. I took my time learning how I could be there. Sometimes being able to be with someone who can talk to you about their problems, listening to them and seeing them through that shared human experience is actually very therapeutic. I think that’s part of the drug I never thought I could give my patients or myself in any situation.
means
Lafarber: Amazing. Thanks for laying this out. It seems like this was a really positive experience for me personally and it might be helpful for others too. If someone wants to learn more about Meditation Medicine, where should they go? do you
Subramanian: I think there are many spiritual teachers that I have loved over the years. I think Jeff Cornfield is someone who really speaks to me. Sharon Salzberg is also a great teacher. She was a visiting teacher in our fellowship.
The fellowship itself is an experience. It’s a year-round deep dive.They will accept applications for next year’s cohort
It’s not for everyone, but I do believe that some principles can be learned from reading. You can check their website. There are also some videos that cover some of these topics, as well as resources on his website.i definitely recommend people to watch it
You can look for a meditation center or find a colleague who is interested in this and ask them what are the first steps in exploring this in your neighborhood. Or on college campuses, I’m sure there are many stop-in meditation groups. There are also frequent free outdoor classes. US cities for yoga and meditation.
We recommend testing the water a bit. You may stop by or read a book in the space. There are also podcasts and apps if you’re into 5 minute meditations.It’s probably about sleep. app to calm down When, ten percent happy Another app that I think is accessible. Please, try it.
Lafarber: Thanks for that wealth of information. I hope you can find moments of peace and contemplation in your medical and personal lives. I would like to close. Thank you for speaking with us today.
Subramanian: Thank you Katrin.
