By Jason Fleming, MD, FACEP

Practicing meditation is a skill that already comes naturally to emergency physicians. This is because we exist in a chaotic environment and constantly need to focus and refocus our attention. This is actually quite similar to the process of meditation. Practicing meditation can enhance our abilities to focus in the emergency department, making us calmer, more focused, and more effective. 

Many people think that meditation is sitting quietly and concentrating. We picture a monastic sage with a peaceful face under a tree. How can this fit in with the chaotic realities that we live every day?

The actual practice of mediation involves focusing the mind, and this often involves an object or a phrase. The object can be an actual object held in the hand, such as a pebble or a pen or a coin. A phrase typically has some meaning, which is often referred to as a mantra. The mantra can be in any language. We often find more meaning in a mantra that is in our native tongue.
  
For an object meditation, all that is needed is the object and a willing mind. A timer can be useful; try two minutes to start. The object can be held in the hand and focused on as you sit quietly - the shape, curves, edges can be intentionally felt with the fingers and appreciated. When the mind begins to interrupt this moment by naturally drifting to any of the myriad other things to think about ("distractions"), we bring it back to focus on the object of the meditation by intentionally noticing some new aspect of the object - the weight, the texture, the temperature in the hand. Once the chime on your timer signals the end of your object meditation, intentionally feel gratitude for this brief moment of peace. It matter less what or whom you "thank" than that you attach the feeling of gratitude to the process.

For a mantra meditation, the actions are the same except the meaningful phrase is substituted for the physical object. Many meditation practitioners use counting beads to keep track of how many times a mantra is repeated. The mantra can be repeated out loud, whispered, or simply repeated silently in the mind. Many practitioners have found value in the act of repeating the same mantra over and over. The mantra acts as the object of focus. When you notice that your mind has begun to wander, bring it back to focus on the mantra you have selected.

Some beginning meditators feel a sense of failure or "doing it wrong" when their mind wanders. On the contrary! This is the mind's natural tendency. The practice of meditation involves returning the mind to the calm-focus state, rather than feeling any pressure to keep the mind there without straying. The ability to stay in the calm-focused state will grow effortlessly from the practice of returning.

How can this practice help us in the emergency department? Developing our ability to return our minds to a calm-focus state allows us to switch tasks rapidly and effectively during the practice of emergency medicine and can lead both to decreasing the risk of mistakes and increasing our satisfaction at work.