Cultivating Attention as a Surgical Resident: Sabbath as Resistance
Thomas “Clark” Howell, MD, MSHS, General Surgery Resident, Duke University Hospital
We are in the midst of an attention crisis. Every second is an opportunity for transaction, influence, and advertisement – creating an attention economy. This economy is a consequence of our consumerism and the transformation of the digital age. Our inattention is also caused by our obsession with efficiency, busyness, and productivity. According to psychologists, the result of our inattention and overbusyness is a new-found illness: “hurry sickness.”
Our rising inattention is not isolated to our personal lives, but also exists within medicine. Because of pressures and incentives, we as healthcare providers are obsessed with efficiency in medicine. Being efficient is considered a virtue. As a surgical resident, I am evaluated on and celebrated for my efficiency. As an industrial engineer, I am employed to write linear programs and apply stochastic models to optimize for this efficiency. But being efficient does not reward attending to the soul of patients. Our busyness does not create space for attending to suffering. How then can we cultivate this kind of attention so we can practice unhurried medicine?
What psychologists call “hurry sickness” can be treated by the Sabbath. The Sabbath is a practice revering the holiness of time. The Sabbath can also be translated as “to delight”, it is a reminder to delight in the first holy thing God created: time. The Sabbath is a weekly day of rest and worship, but it is even more than that. The Sabbath is a way of being which permeates the week and attends to the soul. It is a way to say “enough”. When we create this space through the Sabbath, we cultivate attention. Just as I have learned to attend to the acute abdomen as a surgical resident, so too can I learn to attend to souls. The Sabbath—this way of being, this “delight”—enables me to do this.
The Sabbath is resistance because it actively resists the lie that we are limitless. Resistance takes work. What precedes the Sabbath is the day of preparation. We cannot simply stop; we must get ready to stop. Out of this preparation and practice, we create a rhythm of rest and worship. We must “unhurry” our souls in order to attend to the souls of patients. The Sabbath allows us to practice slow medicine instead of hurried and efficient medicine. The Sabbath is the key to unlocking this type of presence and cultivating attention.
What does it mean to keep the Sabbath when I cannot keep the Sabbath as intended in the ten commandments? Herein I intend to explore the Sabbath as a surgical resident and how this cultivates the virtue of attention.
Our rising inattention is not isolated to our personal lives, but also exists within medicine. Because of pressures and incentives, we as healthcare providers are obsessed with efficiency in medicine. Being efficient is considered a virtue. As a surgical resident, I am evaluated on and celebrated for my efficiency. As an industrial engineer, I am employed to write linear programs and apply stochastic models to optimize for this efficiency. But being efficient does not reward attending to the soul of patients. Our busyness does not create space for attending to suffering. How then can we cultivate this kind of attention so we can practice unhurried medicine?
What psychologists call “hurry sickness” can be treated by the Sabbath. The Sabbath is a practice revering the holiness of time. The Sabbath can also be translated as “to delight”, it is a reminder to delight in the first holy thing God created: time. The Sabbath is a weekly day of rest and worship, but it is even more than that. The Sabbath is a way of being which permeates the week and attends to the soul. It is a way to say “enough”. When we create this space through the Sabbath, we cultivate attention. Just as I have learned to attend to the acute abdomen as a surgical resident, so too can I learn to attend to souls. The Sabbath—this way of being, this “delight”—enables me to do this.
The Sabbath is resistance because it actively resists the lie that we are limitless. Resistance takes work. What precedes the Sabbath is the day of preparation. We cannot simply stop; we must get ready to stop. Out of this preparation and practice, we create a rhythm of rest and worship. We must “unhurry” our souls in order to attend to the souls of patients. The Sabbath allows us to practice slow medicine instead of hurried and efficient medicine. The Sabbath is the key to unlocking this type of presence and cultivating attention.
What does it mean to keep the Sabbath when I cannot keep the Sabbath as intended in the ten commandments? Herein I intend to explore the Sabbath as a surgical resident and how this cultivates the virtue of attention.