Humanities CMAJ

CMAJ • APRIL 20, 2010 • 182(7)© 2010 Canadian Medical Association or its licensors

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The Mindful Medical Student: APsychiatrist’s Guide to Staying Who YouAre While Becoming Who You Want to Be

Jeremy Spiegel MDDartmouth College Press; 2009.

Sleep deprivation, competitiveclassmates, patronizing attend-ing physicians, challenging

patients, ethical dilemmas, stressfulexams — these are all commonaspects of the medical school experi-ence. In The Mindful Medical Student,psychiatrist Jeremy Spiegel does notattempt to make medical school anyless demanding. Rather, he focuses onassessing how the process can be morepersonally meaningful, so that itbecomes something to appreciaterather than something to be endured.

Of the book’s three sections — “Dis-covering who you are,” “Reinventingyourself” and “Blazing a path to yourdeeper self”— Spiegel is most success-ful in the first. The development ofgreater self-awareness, Spiegel argues,is fundamental to a healthy journeythrough medical training. The themes ofSpiegel’s book centre on the notion of amultifaceted identity. He describes a“true self” and a “false” (or performing)self and how, through conscious effort,a student can learn to nurture the formerand deconstruct the latter. Balancing thetheoretical discussions are vivid real-lifeanecdotes from medical students.

Spiegel takes a Freudian psycho-analysis-lite approach to commonexperiences, framing his discussion interms of transference, defences and theunconscious. One example is thehumorously entitled chapter “DreamInterpretation for First-Time Scalpel

Wielders.” Another chapter aboutarchetypes and synchronicities has amore Jungian slant.

Other chapters deal with more con-crete issues, such as managing your per-fectionist or obsessive–compulsive ten-dencies and learning how to formsupportive bonds with classmates.

Spiegel acknowledges that certaintraits that may have helped studentsget into medical school can becomemaladaptive under stressful circum-stances, and offers several pragmatictips on how to address these issues.These are typically simple mentalexercises that one can practise any-where at anytime, be it on the ward orin a call room. However, some sug-gestions will be a stretch for the aver-age students. For example, Spiegelsuggests creating masks and then role-playing the different personas one

encounters on the wards, such as “theabysmal anti-mentor,” “the somatiz-ing drama queen” and “the boundary-deficient love seeker.”

What sets The Mindful Medical Stu-dent apart from similarly themed booksis its emphasis on achieving clarity,reflective capacity and wholenessthrough the creation of a uniquely per-sonal narrative. Spiegel’s techniquesfacilitate the processing of experiencesso students take an active role inmoulding their own transformation andprotecting themselves against emo-tional shutdown and cynicism.

Spiegel draws on literary, philo-sophical and spiritual sources to com-bat what he refers to as “right brainatrophy” and “relationship anemia.”The goal is to move away from com-partmentalized identities and rigiddefenses, and to develop a more inte-grated and consistent personality, onethat is capable of treating self, patientsand colleagues with equal compassion.

The Mindful Medical Student is anenjoyable read with an entertainingconversational style. Despite its title,the book shares valuable insights thatmay be useful for all health careproviders in training. It is essentially amanual on how to maintain sanity inan often gruelling medical environ-ment and culture, makes a compellingargument that self-care is not a luxury.It gives students permission to stepback from their textbooks, to distin-guish the forest from the trees and toappreciate their special place in thatforest.

Denise Sum BAScClass of 2010Faculty of MedicineMcMaster UniversityHamilton, Ont.

Books

Finding meaning in medical school

DOI:10.1503/cm

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