Take a Deep Breath

By: Deepak Chandra, MD

August 24, 2017

This post is a part of our Life as a Fellow blog post series. This series includes "fellow life lessons" from current trainees in leadership with CHEST.

The “code blue” pager goes off; I rush to the patient’s room. A chaotic yet well-practiced drama of chest compressions, intubation, orders being called out, and medication pushes unfold in front of me. With each epinephrine push the patient gets, my adrenaline rises as we race against time to revive the patient. Then I take a deep breath, focusing on the air moving in through my nostrils and I slowly breathe out. Time seems to slow down, the mental fog lifts, and my focus field narrows to the patient and my options become much clearer. I know this sounds straight out of a Matrix movie, but I have experienced this in real life.

I have practiced yoga and meditation for as long as I can remember, which was a daily habit inculcated in me and by my parents who were regulars themselves. Unfortunately meditation fell out of my daily routine sometime during medical school—until I started my busy pulmonary-critical care fellowship when the need resurfaced out of necessity.

There are several different forms of meditation as a YouTube search would reveal, but the simplest form involves visualizing a deep breath moving in and out. Our neo-cortex is said to have evolved faster than our primitive brain could learn to control it. This is probably why many experts liken the brain to a monkey and meditation as a means to “leash it.” There is no scientific basis for this reasoning but that it works and I believe it. 

Meditation is an integral part of training for elite armed forces around the world as well as for professional athletes and top business executives. Medical professionals and in particular intensive care physicians, face tremendous stress innate to the job, made worse by patient, hospital management, and insurance company expectations and requirements. Yet we receive no formal training in treating our own minds, which likely accounts for the 45% burnout rates reported in adult critical care physicians.¹ This can cost us our careers, endanger patient safety, and affect our family life. This is where I feel meditation can be a game changer.

I am still on a very basic level of meditation. My goal is to do an hour of meditation each morning and the evening. Hoping not to infringe on any copyright for deep breathing, I will describe my method. Seat yourself in a comfortable position in a quiet dark place, close your eyes, keep your head slightly tilted upwards and take slow deep breaths, trying to visualize the breath going in and out. Initially you will need to force yourself to stay in place but slowly you can increase the time. Guided meditation may help novices and is available in the form of online videos, apps available on the Apple App Store or Google Play, or meditation classes given by trained instructors.

Believe me, this is the biggest life-changing intervention you can do in your busy and stressful life, with nothing more than some air borrowed from nature! Take a deep breath.

Deepak Chandra is a second-year pulmonary-critical care fellow at the University of Nebraska Medical Center, Omaha. He attended medical school in Kerala, India, and completed his internal medicine residency from University of Arkansas in Little Rock. His interests are critical care ultrasound and developing innovation in medical education.

1.Shanafelt T, Boone S, Tan L, et al. Burnout and satisfaction with work life balance among us physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-1385.