Baime typically spends the first half of an eight-week course developing formal meditation-practice skills and then transitions to merging those skills with activity in the second half. “We have to be able to do what we are practicing as we go through our lives, or else we will always be running back to our offices and locking the doors,” he explains. “We have to bring mindfulness to life instead of using it as a way to retreat from it.”
Baime characterizes the first four weeks as the “boot camp” phase; but for many of the hard-driving professionals in the course, the second half is much harder.
“As physicians we have trained ourselves to multi-task,” says Mary Anne Layden, an assistant professor of clinical psychology in psychiatry and director of education at the Center for Cognitive Therapy, where she heads the sexual trauma and psychopathology program. “I find it hard to focus on the moment and not fling myself forward.”
“I did not realize the extent to which my brain gallops and the strength of the emotions that come up when I sit still,” says another member of the class.
One “homework” assignment is to stop and take 20 slow breaths, five or six times a day. A pediatrician and mother of three confesses this made her lightheaded. “I think I don’t breathe during the day,” she says.
Another participant in the class shared a similar experience. “Some of my breaths had barely any volume. I realized I barely breathe when I am rushing around the hospital, existing on adrenaline,” she confides.
Rather than thinking about these responses as “right” or “wrong,” Baime says they are all opportunities to “step out of what is hard and into what is meaningful.
“Your noticing is getting better,” he continues. “That is mindfulness. That is it. At its heart, mindfulness is an uncovering process of noticing what has always been there. And not all of it is pleasant.”
He tells the story of a student in another class, an oncologist who thought she had made a mistake with a patient. “The anxiety haunted her. ‘I made a mistake’ became ‘I made a huge mistake,’ and at some point it ran down her spinal cord and affected her whole body,” he says. “The result is a feedback loop that amplifies and feeds upon itself. Awareness disconnects the link between thoughts and emotions.”
Baime has firsthand knowledge of both emotional and physical catastrophes. In 2002, he was diagnosed with central serous retinopathy, an eye disease that causes visual impairment. The condition is usually temporary, and affects only one eye, but Baime’s was an exceptionally bad case. He lost vision in his right eye, but was able to function fairly well with the other one—until the day in 2006 when he woke up and couldn’t read the newspaper because the condition had spread to his left eye. “I couldn’t recognize people, so of course I couldn’t practice medicine,” he says. “I thought I would never see my children’s faces again.”
Out on disability, he entered a clinical trial in which his left eye was injected with avastin, a drug often used to treat macular degeneration. His vision came back, but only for three months. “It was heartbreaking,” he says. “I knew I had to give up my medical practice, which had been a central piece of my identity for 20 years. I truly loved my work and my patients.”
A physician in New York suggested photodynamic therapy—in which light is used to activate drugs targeted to diseased cells—as a last resort, and fortunately this worked. Today it’s the standard of care. But the sight in his left eye came with no guarantees. “My doctor predicted ‘three good years’ and then who knows?” Baime says. “That was seven years ago.”
It was 2008 by the time his vision improved enough for him to consider a return to medical practice (he is still blind in his right eye). By then, all of his old patients were long gone, and “the truth is, I didn’t feel like starting over,” he says. “When I knew that I had a limited window, I knew that mindfulness is what I wanted to do. I had to pay attention to what matters the most, and I wanted to leave something meaningful behind.”
Since then, Baime has devoted all of his time to mindfulness. His classes are always fully subscribed and often there’s a waiting list. He also supervises teachers, which is an intensive and time-consuming process (“They bring in recordings and we go over every class once a week,” he explains). He also gets involved in creating more programs to meet the growing demand—like a series of recordings for patients waiting for or receiving chemotherapy that is in the works—and developing remote learning opportunities through the Perelman School of Medicine for healthcare providers. With those activities, plus conducting workshops, seeing private clients, and speaking engagements, he confesses he is always tired. “During the weeks I teach, it’s all I can do to get through my email,” he says.
Not that he seems tired.
“I don’t know if his [meditation] practice has contributed to his calm demeanor, or if the ability to appear calm permits him to continue with practicing and teaching meditation,” muses the Cleveland Clinic’s Brian Mandell about his former colleague. “I am convinced, however, that he has somehow learned to sleep with his eyes open and a serene expression on his face.”
Especially in class, Baime models being “in the moment.” His voice is calm, almost hypnotic, yet his sensory antennae are on high alert. He is finely tuned to the effect that his words are having on his audience, and he makes eye contact with each student who asks a question. He responds carefully and thoughtfully—not with all the answers in every case, but with enough questions and encouragement to send the seeker toward discovering what works, or makes sense for him or her.
“We have taught well over 10,000 people, and more than 1,500 healthcare professionals, this course, and it never gets old,” Baime says unabashedly. “Every person is different, and every class is different. I have to pay careful attention to see what they need to take the next step. The only thing I can do is open the door.”