Breathe in, breathe out.
I tell Mr. M to do this again.
Deep breaths in. Deep breaths out.
I move my stethoscope side to side, listening to the sound of his lungs inhaling and exhaling air slowly.
I can also hear the clock ticking. Each second passes by, and a whole checklist of things to do runs through my mind: complete the physical, present the case, return with the attending.
But here, even just for a moment, I want to be still and keep listening.
We are ever-busy creatures. Forms to fill out, charts to type in, orders and prescriptions to check and re-check. Our calendars are etched hour by hour with our every movement. Hospitals and clinics to rotate through, textbooks to read, UWorld questions to complete. Exams and evaluations loom over our heads.
Do you ever catch yourself going through a robotic-like routine when completing a physical exam? Or auscultating the lungs, but quickly breezing through the actual act of listening?
Breathe in, I tell myself. Breathe out.
As the year winds down and 2018 turns into 2019, I’m taking a moment to pause. To reflect on the past several months. To rest and recharge.
With faith being a big part of my life, I try to read parts of Scripture each day; during exam weeks, I particularly read the Psalms with some of my friends. They’re like poems and songs on a wide range of subjects. During my readings, I see a particular word that repeatedly appears in the Psalms: Selah. Its meaning is still largely unknown, but many scholars say it is a musical direction signifying a rest. A pause.
Sometimes that’s just what we need. In the ever-busyness of life, particularly of the medical school life, we need a rest. A pause. For the medical students out there -- whether you’re a first-year student who’s just finished their first semester, or a fourth-year flying from one interview to the next -- I hope you take some time to pause and reflect. To take a moment and remember all the triumphs and trials of the year, and how at the end, perhaps you are a different person in December than you were back in January. Different for the better.
Finding these moments of Selah do not have to be just during holiday breaks. In daily clinical life, too, there are opportunities to pause.
One of my medical school mentors told me this when I was just a first-year student, and her words have stayed with me ever since then. Right before she enters a patient room, she not only “foams in” (uses hand sanitizer) per health protocol, but she also uses those few seconds to take a deep breath. She stands quietly, reminds herself of whom she is about to meet, and then knocks on the door. During rotations, I try to apply this kind of mindfulness exercise. It takes only a few, brief moments to help center my mind and my heart for what’s to come.
Aside from meditatively washing your hands, there are many other things you could do to take a mental pause during the day. When I’m on a quick lunch break, I usually try to put my phone in my bag or hide it away in my white coat pockets. We look at computer screens all day anyway, so stepping away from my phone for a bit helps my eyes rest and clear my mind. It can be tempting to scroll through social media really fast during a break, but I have come to learn to intentionally use these times to pause well. For example, during my inpatient psychiatry rotation, I sometimes took walks outside during my lunch breaks. At my pediatric outpatient site, there is a small garden in the back that I go to in the morning right before clinic begins. And at my medical school, we have a patio on the top floor where we can get a good view of the river. Sometimes all it takes to recalibrate, pause, and recharge fast is to go outside for a breath of fresh air.
Lastly, one of my friends taught me this: she writes down an encouraging quote on a small Post-It note, folds it and slides it into her white coat pocket. Whenever she has “downtime” (going to the bathroom, eating a snack, walking from one end of the hospital to the other), she pulls out that piece of paper and reads it. I have come to adapt that, too. Oftentimes, I will write down an encouraging verse or Psalm that one of my friends has passed along to me. Sometimes it’s just the word Selah. Even if it’s quickly just in-between patients, I reach for the paper. This is why I have come to love this word, and how it will be part of my anthem for the rest of medical school and beyond.
As the new year arrives and each day comes and goes, may you breathe in, breathe out, find your own Selah, and start again.
Anna Delamerced is a medical student at the Warren Alpert Medical School of Brown University. Born and raised in Cincinnati, Ohio, she enjoys exploring the crossroads of writing and medicine, and listening to patients tell their stories. Anna is also a 2018–2019 Doximity Author.
Image: fona2 / gettyimages