What Does it Mean to be a Doctor who OMs? Part 1
by Pooja L. Nov 18, 2013
I keep thinking of that Jack Johnson song, the one where he sings: "Why don't the newscasters cry when they read about people who die?"
Medical training teaches doctors how to make quick decisions. It's needed. We need to know how to take a patient who presents to the ER and quickly recognize the constellation of symptoms, then make a diagnosis, triage, and figure out what type of care this person needs. Is it emergency surgery? A stat MRI? How can we make sure that this person is safe and gets just what treatment he or she needs. In the outpatient setting we are taught how to figure out the puzzle—it's often a mystery to figure out what could be causing the constellation of symptoms that a patient presents with.
This process of learning requires absorbing a huge amount of textbook knowledge, metabolizing it, and then being able to apply it in a clinical setting. Unfortunately, through all this, it seems that the process of "feeling" gets discounted. Or, at least, the importance of feeling is not spoken about. The culture of medicine is evidence-based: we need facts and data. This is what we are taught. And the idea of feelings, hunches, or using our sensations as a guide is, well, frowned upon. Mostly because, in a lot of ways it cannot be proven or replicated in a way that facts, numbers and charts can be.
So what happens when you are a physician and you start to OM? Well at Rutgers, where we do neuroscience research on orgasm, we have found that the parts of the brain that are activated in OM are those that have us feel visceral sensation. Orgasm activates our limbic system. And moreover, it activates the insula—which is important for feeling pain and pleasure—and it activates the secondary somatosensory cortex which sends projections to the limbic system (1). We also know, based out the research out of University of Toronto, that Mindfulness meditation states activate the "experiential part" of the brain, and meditators spend more time in the present moment, where they are in touch with the five senses. This is in contrast to people who do not have a practice, who spend more time in the "narrative brain" (the frontal cortex), which equates to thinking about the future or the past (2)
So that means, as a physician who OMs—you have more attention to put on your patients. Whether it's while you are in a hectic ER, where you are able to fully focus and feel your patients. Your patient might be telling you one thing ("I have a pounding headache.") and you might be able to feel another thing ("Wow, he seems really sad about something."). I recently had this experience where a woman was telling me about her relationship and recent breakup with her partner of many years. I got the urge to ask her, "Do you feel disconnected from your genitals?" She broke down crying, and said that she was recently diagnosed with uterine cancer and had a hysterectomy. She felt trauma and numbness from this, and felt tremendous shame talking about it. I don't know what motivated me to ask this question—certainly nothing she had mentioned in the conversation lead me towards it and I don't think she would have voluntarily offered the information. Because of OM, I have the skill to use my attention, see how people carry their bodies, how they respond to my questions, and what their bodies look and feel like, whether its taking a interview of a patient's past medical history, or listening to their lungs.
To me, it makes sense. Our medical world has become full of technology—MRIs, virtual CT scans, robotic surgeries, but the history and lineage of medicine as a profession goes back the the physical exam, which involves direct human contact with the doctor. This is the way that medicine is practiced in much of the world. We have this new technology with OM that gives us a keener ability to feel ourselves and the people around us. I believe this is an asset to physicians and patients a-like. It's the technology of human connection, and being able to feel. And, it's a tremendous asset for the medical world.
All this has me question what it means to be a physician in this culture of evidence-based medicine. Yes, evidence and research are very important, and as I think more about the lineage of medical care I realize there is an art to it. Centuries ago, physicians did not have fancy machines and technology to take pictures and make diagnoses. They had to use their hands—palpate the abdomen, test the reflexes, examine the pupils. This is what a physician’s practice was all based upon. Now, we learn all of these skills in medical school, and then, over-time, use them less and less frequently in favor of newer technology that is thought to be faster (kind of like how we all learn our multiplication and division tables in grade school, but universally whip out a calculator to do math). But, we are finding that there are some cases where this type of technology just doesn’t have the answers, and that coming back to the basics of using physical senses is far more valuable. In light of this, I think OM is a valuable tool.
In Part 2 of this series, to come out on Friday, we'll talk about the personal side of being a physician who OMs.
1. Komisaruk BR, Whipple B, Crawford A, Grimes S, Liu WC, Kalnin A, et al. Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves. . Brain Res. 2004;1024:77-88.
2. Farb NA, Segal ZV, Anderson AK. Mindfulness meditation training alters cortical representations of interoceptive attention. Soc Cogn Affect Neurosci. 2013;8(1):15-26.