Finding Resilience in the Community

 By Fred Marshall, M.D.

As the rate of COVID infection begins to wane in our community, the trauma of our prolonged isolation from one another weighs heavily on my heart. I think about my patients and their families. So many of the people I care for are elderly, many living in nursing homes or assisted living facilities from which their family members were barred for nearly a year. The toll that social isolation has taken is profound, and I fear that the consequences of this on all of us may be enduring. As I ponder these things, I am aware that mindfulness can be nurtured in isolation, but that, for me at least, it feels more fruitful to cultivate it in community.

We just completed a 4-day online workshop, Enhancing Quality of Care, Quality of Caring, and Resilience (April 28-May 1, 2021) together with 27 participating clinicians and educators spanning 11 different time zones around the world. As often happens, I found myself a bit anxious about how things would go in an online forum rather than a physical, residential retreat where we could all gather together in-person. 

A great deal of care was taken to try to incorporate ways of building connection between participants, including large-group meetings, affinity groups (smaller) meetings, and break-out sessions (mostly dyads, but sometimes trios or quartets). Participants were able to introduce themselves to the group prior to the work-shop by uploading a brief self-introduction video clip, and could review others’ contributions prior to our first online session together as a group.

During our first session, after some welcoming introductions, once the whole group gathered online we split into small groups of 4-5 participants to talk with one another about three questions:

1. “Beyond resilience, beyond success or failure, what needs and desires have brought you here?”
2. “What do you already know about yourself that has helped you to move toward those needs and desires?”
3. “What would you like to happen over the next few days to further your journey?”

After each discussion, we were able to share within the larger group.

Over the following days, we moved in and out of large and small group sessions like this, mixing didactic content (prerecorded and reviewed by participants prior to our on-line synchronous gatherings) with formal and informal experiences together. We explored elements of mindfulness, including attention, intention, and attitude of mind. Importantly, we grounded these experiences as much as possible with attention to our sensory awareness, emotions, and thoughts, cultivating a safe space to explore things like how we face uncertainty in medicine, how we can respond with compassion and clarity in the face of our own grief and that of others, and how we can respond mindfully when things go wrong. Using shared narratives, appreciative dialogues, and drawing attention to the interpersonal aspects of mindful communication with another human being, we gradually blossomed into a community of learners bound by our common humanity.

We cared for one another.

I emerge from the workshop re-energized and also wary of the many ways in which I can slip back into attitudes of mind that are not helpful to me as an individual, as a father, as a partner, or as a physician. I do know, though, that building community with others — my patients and their families, my colleagues and students, my friends and family, is a central element of my ability to thrive in the world.

Emma Strujo | 5/13/2021