Over the past 10 years, cardiologist Jonathan Fisher has turned anxiety and grief into a pledge to embrace the moment – to practice mindfulness in every aspect of his life. But it all started with a simple Google search:
“How can I be happy again?”
That was 2010, shortly after his sister Andrea died from a brain tumor. The youngest child of seven, Fisher considered Andrea his best friend and the person who had lifted him up more than any other. He had struggled with anxiety as a child, his mind racing in uncomfortable situations and always predicting the worst possible outcome. His anxiety intensified as he studied to be a doctor, and the fear he felt congealed into deep depression. Andrea, also a physician who had struggled with the stress, pushed him to seek counseling while he was completing his medical residency, and it helped.
But the stigma associated with doctors and depression caused a different kind of stress. The majority of state medical licensing boards delve into a doctor’s mental health, even asking about past diagnoses and treatment. Studies have shown that doctors, fearing such disclosures could jeopardize their license to practice, do not seek help for depression. Fisher felt he couldn’t talk to the people who most understood what he was going through; he had to keep his struggle largely to himself.
“Counseling, therapy and coaching is beneficial and helps improve the performance of physicians, and yet there is a tremendous stigma, which is one of the main causes of burnout among our physicians,” Fisher said.
Even as he faced the loss of his closest confidante, Fisher tried to help Andrea through her illness by taking her to radiation treatments and on errands such as getting her hair done. It never felt like enough.
“I recognized that I wasn’t the brother that I wanted to be for her in those moments,” he said. “My own fear of her death and my own stress was preventing me from being as fully there as I wanted to be.”
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That Google search after Andrea’s death pointed him to a book called “The How of Happiness,” which recommended meditation as one of the key skills needed to be a happy, fulfilled person. As Fisher delved into the details of meditation, he discovered mindfulness and the mounting scientific evidence that it could not only help him but also his heart patients.
As medical director of the Cardio-Pulmonary-Oncology Rehabilitation and Wellness Program at the Novant Health Heart & Vascular Institute – Huntersville, he said he was ecstatic when the American Heart Association in 2017 released a statement supporting the benefits of mindfulness meditation for heart health.
“There are many ways to appreciate the benefits of mindfulness practice in the heart,” Fisher said, “but to put the connection simply, we start off by talking about a happy heart, and a happy heart is relaxed, it's supported by sleep and nutrition, hydration and exercise, which helps lower blood pressure and cholesterol, and control blood sugar, weight and stress.”
Stress is an important piece of the puzzle, especially during a pandemic, when chronic low-level stress can elevate blood pressure. If that comes up during a visit with a patient, Fisher will offer to teach some basic techniques for managing stress, and do a guided, one-minute mindfulness meditation. In the past month, one of Fisher’s 80-year-old patients said it was the most incredible experience she’s had in a doctor’s office.
Fisher is working with Dr. Russell Greenfield, director of integrative medicine at Novant Health, to launch a program that teaches mindfulness meditation to cancer patients. The five-week virtual experience will include 15 patients and begin this spring. Greenfield gives Fisher a great deal of credit for exploring mindfulness as a way to heal himself, his patients and his colleagues.
“He shares it openly and readily with his patients, he shares it openly and readily with people through his work on the internet, through his videos, through his work with the staff,” Greenfield said. “It's all too rare to find people who actually live what they speak. I think part of why Jonathan's work is so helpful and so effective is that it's genuine.”
In a recent ranking of the most stressful jobs in the U.S., nearly half touched the health care field. That stress has only increased since the pandemic. Fisher serves on the steering committee of Novant Health’s COVID-19 Caregiver Burnout Prevention and Recovery Task Force and facilitates workshops through the Novant Health Leadership Development Program.
Then there’s the colleague who recently stopped him in the hallway to say she was having a hard time staying grounded as she worked to keep COVID patients alive. He helped on the spot with this: “OK, deep breath, feel your feet on the floor, let’s be present here and take that sense of presence with you as you move on.”
You don’t have be a patient or a colleague to hear Fisher’s message about mindfulness and self-care, either. He’s coordinating events to end physician burnout via LinkedIn.
If you ask Fisher what he’d like people to do to keep their hearts healthy, he’ll answer without hesitating: “Love themselves. If we start with the idea of, ‘Can we be kind to ourselves?’ it catches so many of the behaviors that will keep our hearts healthy and strong.”
Practically speaking, that means you’ll drink enough water; eat more fruits and vegetables and fewer processed, high-fat foods; and get your exercise and adequate sleep.
And you can always try Fisher’s Google search yourself, more than 10 years later: “How can I be happy again?” You’ll find a grab bag of advice from endless life hack sites.
They all include mindfulness tips.