Takeaways from “Attending: Medicine, Mindfulness and Humanity”  

Ernest Hemingway once famously said that books were a man’s best friend. For me, the context of where you encounter a book is important. So, while browsing in a book shop in Baltimore, a good friend handed me “Attending,” and I was intrigued. I later discovered that the importance of the book is found in the title, which the author addresses beautifully at the start: “Attending means showing up, being present, listening, and accompanying patients when it matters most.” These qualities are crucial for a great healthcare professional, and for every human being.

Epstein continues,“Attending is a moral imperative: by being attentive, doctors not only provide the best care, they also honor each patient’s humanity.” Ronald Epstein has infused so much knowledge, wisdom, and humanity into this book, and just in time, since medicine and the humane art of caring for another person is becoming overwhelmed by the technological scientific side: AI, algorithms, Big Data, robots (all necessary and important advances, nonetheless).  

Here are some words and ideas that caught my eye, and could be guiding lights for healthcare practitioners, young and older. They seem often  missing in 21st century medicine. 

1. Curiosity  

Excellent healthcare professionals must always be curious, think outside of the box, and delve deep into the person who is the patient. Epstein puts it beautifully, “Curiosity is part of the social capital of medicine. Just like young children, medical practitioners who are more curious feel a greater sense of vividness and vitality. They are more satisfied with their work, more engaged with their patients, and do a better job of treating their patients.” 

2. Intuition  

In the world of EBM, intuition has been relegated to the bottom of the pile with protocols and guidelines ruling the roost. But there’s an important place for intuition in caring for sick people. As always, the author hits the note perfectly, “Intuition is murky, visceral, impressionistic, and irrational, making it difficult to describe and study. However, intuition is vital for making sense of complex situations.” This could be connected to Aristotle’s phronesis (practical wisdom) since it’s critical in choosing which actions will serve a specific patient in a specific time. Algorithms do not deal with individual patients. 

3. Compassion for others and self

Epstein defines compassion as a “triad of noticing another’s suffering, resonating with their suffering in some way, and then acting on behalf of another person” [italics are the author’s]. Compassion is sometimes in short supply in healthcare, perhaps because of the system itself, but also if you resonate with another’s suffering then you can suffer too. It’s here where the author highlights the importance of being mindful since it “is observing, understanding, and regulating my own emotional reactions so I can reliably sustain presence in the face of a patient’s distress—and my own.” 

4. Mindful medicine 

For me, this book is about how to restore the soul to medicine or healthcare, and the author does this by (re)introducing mindfulness into medicine. There’s a chapter titled “Imagining a Mindful Health Care System,” that ends with: “I believe that now it is possible, with the right resolve, to have health care infused with and guided by mindful practice. A cord of three strands—individual, collective, and institutional—is not quickly broken.”  

This book is very accessible, extremely well-researched with highly informative notes, beautifully written, and straightforward even for the non-medical person, so I would recommend that everyone find a copy. I’m sure it will become a loyal friend for life. And notably, in the last section “Being a Mindful Patient”  Epstein suggests 10 questions to ask patients (like “What are you hoping for in this visit? What are you most afraid of?) that capture the intimacy, delicacy, and humanity at the heart of the patient-doctor relationship.

Finally, all healthcare professionals and patients need to be reminded of the authors last words,

“Doctors are human too and are usually appreciative if you’re an active partner in your care. Tell your doctor that you are motivated to do your part, to be mindfully attentive, curious, open, and present. That will inspire your doctor to be mindful and will lead to a more collaborative relationship and more effective care.”

It must never be forgotten that this collaborative relationship is the true essence of healthcare. Always.  

This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.