 It is easy for me to nurture others, something that I find natural and comforting. I recently got a cat for this reason. It adds to the collective at home of fish, dog, kids, turtle. There is something settling in me when I care for others, which is why being a physician was a natural calling. The cat has brought welcome slow down, a moment to pause in the mindfulness of purring and rest. To marvel at another creature’s ability to sleep all day, and watch the shadows playfully at night. It reminds me of the speed I have been going to get where I am. I remember in college at UC Berkeley walking around the beautiful northern California campus so lost in thought about where I was going next or what I needed to study that I would be unconsciously walking faster and faster. Suddenly, I would realize my center of gravity was far out in front of my feet. My backpack was so heavy that it hurt my low back to walk this way. As always, with pain, I paid attention. As a small moment of mindfulness, I would practice “walking over my feet”. I would catch myself busily rushing forward and consciously bring my center of gravity back over my hips. Head suspended, chin slightly tucked, shoulders back, core present over the pelvis, feet moving ahead but always, settling, under. Moving together, as a unit. It is funny how much this small physical attention would change my mind and my space. Life has moved a lot faster since that time. Berkeley was busy but medical school was like trying to take a small sip out of a fire hydrant of information. Residency was doing and practicing, gaining clinical sea legs but moving so quickly through the fatigue that working became a rote muscle memory. Walking over my feet at 3 AM sometimes meant running to labor and delivery to catch a baby. In surgery, as a resident, I learned my job was to anticipate the surgeon’s next move at all times. That is the best way to get involved and gain experience and confidence. It trains your brain always to think steps ahead, as a physician must. You must sit back from the playing field and understand all of the possible paths from this point so you can anticipate and outsmart fate when it is possible. I remember the nights in the hospital when I had a patient that was already a head of me. The process of dying had set in, and very much like the process of labor, when it was gaining momentum there was nothing you could do to stop it. You would try ordering tests or antibiotics or fluids and medications but sometimes there was nothing you could do but at one point realize, I am walking ahead of my feet. If I sit back and see what is happening here, I know it’s time to tell the family what we are facing. Rooted in the realization I would tell the family the cross roads at which we had arrived. Moments of mindfulness like walking over your feet do not require a week long meditation retreat or even in depth study. The simple act of paying attention changes everything. Getting out of our heads and into our bodies can teach us profoundly, where to soften, where to strengthen. I want to share my journey of how I moved toward direct primary care and opening my own clinic. Here is where it starts. Right here, walking presently and mindfully, over my own two feet.
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 When I was 7 years old my mom and dad taught me my first version of meditation. It was walking meditation, which worked for me because I was always in motion as kids are.
Over the years I was exposed to many types and traditions of meditation. During a difficult time in my 20s when I reconsidered everything, as young people do, I felt confused and lost about how and if to meditation. I went to teacher in my massage school at the time. He was a deep and introspective gentleman and I asked him how I should approach the problem of not being able to meditate any more. He said, “hold the Brieanna that does not meditate in the palm of your hand as if you are watching her. And love her”. Meditation returned to my life through medical school but it had a new name in the 1990s, mindfulness based stress reduction. Jon Kabat Zinn’s work in the field was bringing a scientific evidence basis to effectively bringing oneself into the present moment with mind exercises or mindfulness techniques, many of which are forms of meditation. I read several of Jon’s books including my favorite, Wherever You Go, There You Are. Suddenly I found myself in Pueblo, Colorado, rotating at the state mental health hospital with a brilliant psychiatrist Elizabeth Stuyt M.D. on the dual diagnosis unit for people with drug addiction and mental illness. Along with all of the therapy and medications and social work that supported people during their court mandated 90 day stay, Dr. Stuyt would assign books to her patients from the center library. The books varied, but a series was on yet another approach to mindfulness, the Heartmath Solution. Heartmath writes a series of books and as a medical student Transforming Stress was the one to which I gravitated. At the end of each chapter was a mindfulness exercise and instructions on how to slow your body down, specifically your heart rate variability to improve our “fight or flight response”. At my next cardiology rotation they were just implementing the Heartmath Solution for patients with heart disease to lower stress because of the great research behind stress reduction that was mounting. In the last few years, I came across a Time magazine article on mindfulness and started using the app Headspace. It is the latest mindfulness tool that fits into my tool box. As Andy Puddicombe says, meditation is a tool to exercise the muscle of mindfulness. It is not stopping thoughts or getting rid of emotions. It is stepping back and seeing the thoughts clearly with a relax focused mind. Allow thoughts to come and go without all of the fuss. On average our minds are lost in thought 47% of the time. We reinforce the story line when are are “on the roller coaster” of the mind. Our minds are wired for going, doing, looking out of the dangerous and negative. So why, as a Primary Care Physician and Osteopath, is mindfulness so important to me? I am by no means an expert in mindfulness nor would I speak to myself being particularly “good” at it if there is such an achievement in this realm. As a clinician, I have seen it radically transform people’s health. Be it mental health, eating habits, quitting smoking or dealing with chronic pain, there is a place for mindfulness at the treatment table. Over the next few weeks I’ll be writing series of articles with reference to the importance of mindfulness and stress reduction in our daily lives. My goal is not to become dogmatic or religious. My point is to help you learn a few tips for dealing with the day in and out process of your own brain. The brain is powerful, wonderful and to be respected. But the mind is a monkey. It jumps around and around and fear, negativity and doubt are some of its favorite chapters to play repetitively. The mind is also very good at amplifying negative feelings, causing us to be sucked in to the roller coaster and ride ride ride the wave of intensity of pain, anxiety, discomfort or boredom that our mind is feeding us. Mindfulness is not just getting off the roller coaster. It is seeing it, being aware of it and being the space that surrounds the busy, active bee of the mind. Or as my daughter puts it, it is finding the “life watcher” inside of you. As the fall leaves change and fall, be aware of them crunching under your feet. Stop looking at your phone. Feel the crisp in the air. Thinking about that project? Back to the crunching under your feet. Bring the air back into your nose, feel the temperature, smell the scents, hear the world around. That is how one walks mindfully. And even seven year olds can do it. I’d like to invite you to join me on October 19th from 5-8pm for an Open House and Evening of Community networking to celebrate the opening of my new practice, Direct Osteopatic Primary Care. I want to share the new space and clinic model of direct primary care with everyone in our community network of partners and referral resources. The Open House will be held on Wednesday, October 19th from 5 to 8pm at Direct Osteopathic Primary Care’s new office at 16 Lakeside Lane, Lakeside, CO 80212. Join us if you can for beer, wine and hors d'oeuvres. Families and children are welcome. If you are unable to make the event, please click here to download my updated contact information so that we can stay in touch.
Visit Direct Osteopathic Primary Care’s website at mydenverDO.com or download this 2-page PDF brochure to learn more about the services I offer and the direct primary care model. Remember referrals to me for:
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February 2019
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