Himani Goyal, MD, on incorporating meditation, mindfulness in the OR

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Hi everyone. Welcome to another episode of season two of the "WIO/Healio Our View Video Blog," focusing on physician wellbeing. We have Dr. Himani Goyal with us today. Dr. Goyal, can you please introduce yourself?

 

Hi, my name's Himani Goyal. I am a cornea and cataract surgeon at NYU Langone Health. Been in practice for about 15 years now, which is crazy to believe, and for most of my career I have spent 50% of my time teaching residents.

 

Wonderful, can you tell us how you got passionate about meditation and mindfulness?

 

Yeah, you know, it's actually something that my husband introduced to me many, many years ago. He comes from a family that grows up with that as part of their lives. They are part of the Brahmin caste in India, and his parents actually incorporated it into his life very much. He didn't really get into it until he was an adult and well out of, you know, his schooling, but as he got into it, he really kind of brought me along and taught me about it. And I was a resident when I learned to about this organization called The Art of Living, and really, it was the first time that I learned what it was to be in the moment, to breathe, to meditate. And as a resident and going through the stress of being in such a demanding line of work and being in a whole different city, all of that, it was actually just so nice to have a way to ground myself and I wish that I had actually had those tools when I was younger. So, it's been something that just sort of was very inviting and really introduced at the right moment by the right people, I think. I was really open to it and since then I come and go in terms of how much I practice or how much it is a part of my life in any given phase of life, but it's always been nice to have that to go to and to be able to share that, even with my residents and my kids now too.

 

That's a great introduction. Well, I was wondering if there are any — maybe three pearls that you could give us for how maybe we can incorporate mindfulness meditation, maybe in the clinic or in the OR, or times of stress when you just need that quick pop of mindfulness.

 

Yeah, so I think one of the first things is just focusing on your breath, right? It's interesting that most of the time our emotions control how we breathe, but if you actually realize that breathing can actually help you control your emotions, so just kind of being aware of that and being able to flip that. It is very empowering and it's something that you wouldn't necessarily think of. It doesn't really come naturally to a lot of us. I've actually had one of my residents in the past tell me that, "Oh, I realize, you know, if I just focus on my breath, I can calm myself down." It was really cute to see that as a resident, he's realizing this while he's in a stressful situation, like in the OR. But most of the time it's the other way around, right? Like, our breath kind of changes. If we're nervous, it becomes short, and if we're relaxed, it's kind of calm and you know, deeper, so realizing that you can change your breath and then that actually changes your emotions and gives you more control. There are many resources. I think one of the books that I read more recently was called "Breath" by James Nestor. So, I would recommend reading it or even listening to it on Audible. It's really nice. So that's one thing. You asked for three, correct? So, you know, meditation and mindfulness, it's sometimes intimidating to think about it, especially in our line of work where we deal with trauma or timelines and everything is, you know, efficiency, efficiency, efficiency. And understanding what that is, to be able to clear your mind can sometimes be overwhelming and you know, it's just knowing that what mindfulness means is to be in the moment; to observe without judgment. So, it doesn't mean that your mind is completely clear, it doesn't mean that you're not having any thoughts. It just means that you're in a moment, you're observing what's happening and you're not judging yourself or others. So, maybe you didn't do the best at a surgery that you could've done better; Just be mindful of, like, hey, this is how things went, but don't be down on yourself for it. Or even when you're in an interaction with a patient, you know, a patient comes in, they didn't understand the instructions or didn't follow the instructions and instead of judging, just being mindful, like, okay, this is what happened. Let me observe what's happened and not judge and maybe that way I can be more effective in listening and absorbing what's happening here and can come up with a solution. So that's my note for mindfulness. And then meditation. It is difficult for a lot of us to do, and I would say one of the pearls for me in becoming better at meditation is knowing that it takes practice, and that repetition is key. So, like with anything else, practice makes perfect. You're not going to be able to clear your mind and be nonjudgmental, be able to control your breaths and control your emotions all at one time. It all comes in little bites, but first just being aware of this existence of all these things, and then just practicing it, right?

 

I love it. Meditation is like a muscle, right? It's a muscle that-

 

Yeah, your brain is a muscle! And breathing can help us be in the moment, which can help us be mindful and then mindfulness can then help us get into a meditative state on demand.

 

Himani, so many of the things you've said make such perfect sense when broken down into those separate elements. It's putting them all together. That's always the challenge, right? Especially in a tough situation, a challenging situation, when things are going south in the OR and how do you implement this. So, my question for you, Himani is, you mentioned at the start that you had a coach, your husband, who introduced you to this and then you found a path in your residency. For somebody who doesn't have a personal coach like you did and was fortunate enough to have a spouse, a partner, a good friend with that background, how does one get into it? What would you say? What would you recommend?

 

So, this day and age, we have all these apps, and I think first for each one of us, it starts with a little bit of an influence, right? So hopefully if someone's listening to this message, they are influenced a little bit just to kind of explore it. It needs to come from a desire to want to introduce something new into your life and have a little bit of a change if it's not a part of your life already. And I think that it's even easier now. You don't have to go and take a course like the Art of Living and give up a weekend, even though that is an amazing way to kind of immerse yourself. There are a few different apps that are free or even for pay. There's Smiling Minds, there's Headspace, I'm sure there's others that I'm not thinking of off the top of my head right now, but they come with just these bite-sized guided meditations or even guided breathing plans that are just maybe even a few minutes long. So, starting somewhere like that. Believe it or not, my kids are really into it. They're 7 and 8 [years old] now, but they've been meditating since they were toddlers, and it's really cute. It’s to the point where they can do their own little body scan and lead a little meditation. And so, as an adult you can definitely do that and start there.

 

That's wonderful. Himani, we're going to have to get your toddlers to come and coach us at the next WIO Symposium. Thank you so much for being with us today and sharing your pearls on breathing.

 

They would love that.

 

Thank you so much. You were wonderful, Himani. We really appreciated all the wonderful messages you communicated to us and to our audience.

 

Thanks for the opportunity.