Do I Have Your Attention?

February 13, 2017
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One night several years ago, I was the sole physician seeing patients at a busy urgent care clinic in East Baltimore. That night was particularly busy, and as each patient’s needs expanded beyond the time I had allotted to see them, I got further behind.

I walked into an exam room and saw a young, healthy man. I breathed a sigh of relief, thinking that I might start to catch up, as I assumed it would be a pretty quick encounter. He told me that he had a spot on his lip that he wanted me to check out. I looked carefully, did not see any spot and told him so. He was unsatisfied and concerned, so I looked more carefully. I mentioned to him that his lips were dry and suggested some moisturizer. Still, the man seemed unsatisfied, and the encounter ended with both of us a little frustrated.

At night’s end, our medical assistant asked me, “Hey, what was wrong with that guy’s lip?” “Nothing,” I told her, “But why do you ask?” She answered, “Oh, nothing? Really? Because, in my culture, if a guy has a spot on his lip, it means he’s an alcoholic.”

Walking out of clinic that night, I was disappointed with myself for dismissing the patient’s concern. Of course there must be a reason why a healthy young man would come to the doctor for a seemingly small issue. If I’d been less rushed and more aware, there was one simple question I could have asked: “Is there anything in particular that you’re worried about?” But I didn’t, and I may have missed an opportunity to talk to him about his alcohol use.

Mindfulness is defined as a mode of awareness, a “metacognitive” skill that involves attentional control, emotional regulation, self-awareness, and a nonjudgmental and curious orientation toward one’s experiences. Mindfulness has been popularized in the form of mindfulness-based stress reduction programs, which have been shown to improve quality of life for patients with numerous medical problems, especially chronic conditions.

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Johns Hopkins Medicine

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