How to Master Mindfulness with Dr. Roxanne Sukol

Podcast Transcript

Nada Youssef:   Hi. Thank you for joining us. I'm your host Nada Youssef and you're listening to Health Essentials Podcast by Cleveland Clinic. Today we're broadcasting from Cleveland Clinic main campus here in Cleveland, Ohio and we're here with Dr. Roxanne Sukol. Dr. Sukol is a staff physician in the Executive Health Program here at Cleveland Clinic and today we're talking about mindfulness. See how I did that? And please remember this is for informational purposes only, and it's not intended to replace your own physician's advice. And before we jump into topic, I want to say thank you so much for being here today.

Roxanne Sukol: You're welcome.

Nada Youssef:   And for taking the time. But I want to ask you some questions, kind of just personal questions to get to know you on a personal level if that's okay?

Roxanne Sukol: Yeah.

Nada Youssef:   All right. Who or what inspires you to be a better person?

Roxanne Sukol: I think I would have to say my family and my patients.

Nada Youssef:   Excellent. Good answer.

Roxanne Sukol: My patients have taught me so much about what works and what's important and how to frame things in a way that is meaningful and respectful and supportive and kind and I would say the same about my family.

Nada Youssef:   I love that. I'm sure it's reciprocal. I'm sure they also feel the same way about you. And if you can not work for a year, what would you be doing?

Roxanne Sukol: I would finish my book.

Nada Youssef:   Oh, okay.

Roxanne Sukol: That's what I would be doing.

Nada Youssef:   What's your book about?

Roxanne Sukol: My book is about changing the way we talk about food. I have a lot of interests in wellness in general but I'm particularly interested in what we eat.

Nada Youssef:   Excellent. I love that.

Roxanne Sukol: And which things we eat that are really food that nourish us and which things we eat that aren't really food. I would have to say they don't nourish us but they do entertain us and there is benefit to entertainment but it's not food.

Nada Youssef:   Sure. Sure. What is that book called?

Roxanne Sukol: I don't have the title yet.

Nada Youssef:   You don't have the title yet. Okay. I'll be staying tuned. I'm very excited for that. And well, my next question is what book as influenced you the most or movie?

Roxanne Sukol: I am an inveterate fiction reader and one book that I come back to all the time and that I share with my patients a lot and I recommend to people is a book called Let the Great World Spin by Colum McCann. He lives in New York City. I think he's an Irish immigrant. And I actually read that book three times. It's the only book I've ever read three times. I'm not usually a re-reader. There's so much out there and there's so little time so I'm always onto the next thing.

But when I finished that book for the first time, I thought, "There is some deeper truth in here that I did not connect to but I know it's there," so I read it again. And when I finished it, I turned it over and read it a third time. And then I knew what it was. And what it is is that in this book all the good and all the bad and all the things that happen to the characters, and some are pretty terrible and some are pretty wonderful, everything is totally connected. And that is life.

Everything in life is completely connected. People meet and fall in love at funerals. They get out of jail in this book and they have a car accident on the way home. Everything is connected. And if we can remember that, I think it helps us to ride the waves a little bit better in life and to know that things aren't all bad or all good but they're all connected. And that we deserve to celebrate and we deserve to feel as good as we can possibly feel when the good things happen.

Nada Youssef:   Yes, yes. And there's good and bad always happening and there's always a balance and to also look at the positive, not just the negative because a lot of people dwell on that as well. That's very good. I'm going to add that to my list. Thank you. All right, so let's start off with mindfulness. Now what is mindfulness? Is it to clear your mind? Is it to focus on just one thing? Can you tell me the definition?

Roxanne Sukol: Mindfulness is being present in the current moment and however you do that is mindfulness. We spend a lot of time anticipating concerns that most of which never even happen and that causes anxiety. We spend a lot of time ruminating about what I should have done, what I should have said, I had the opportunity, I blew it. That's all looking at the past. But if we spend all our time thinking about what might happen or what did happen, then we literally miss our life.

Our whole life is right now, right here. This conversation. And if we don't remember that this is where we are right now, then we miss out I think. That's mindfulness. There are lots of ways to accomplish it but that's it at it's core. It's about being present in the present moment.

Nada Youssef:   And your thoughts, everything you talk about, not what's coming up that makes you anxious or something, that made you depressed but literally just living right now with what's happening. That's excellent. It seems like a quality that maybe every human already possesses rather than something that we can [inaudible 00:05:41] correct?

Roxanne Sukol: I think we all possess the capability but I'm not sure that ... I think we all could benefit from being brought back to the concept from time to time. Because we do spend a lot of time thinking about planning for the future or worrying and I think that to the extent that we can spend more time in the present I think we'll all benefit from it.

Nada Youssef:   Sure. Great. Let's talk about some of the proven techniques to help us tap into mindfulness. Meditation obviously being one. Can you talk about the different techniques that we could do?

Roxanne Sukol: Yeah, there are lots of different kinds of meditation. There is mindfulness meditation, there's breathing meditations, there are guided meditations, there are lots of apps that give people an opportunity to be guided. Not everybody meditates sitting still in a chair. One time I had a very high strung patient who I felt really would benefit from a meditative kind of experience but they said, "I can never do that. That's not me." And I knew that was true.

But later they said to me that everyday they go to a pool and they swim half a mile and they said that their spouse called it counting the tiles. Not swimming. Like, "Did you go count the tiles yet?" And I thought, "That's your meditation." That's what takes their brain off the rails and makes time melt away essentially. There are lots of different ways to be mindful.

Nada Youssef:   Something like sports as long as you're ... Because you're only worried about your next step or what you're doing right now, that could be meditative. How about something like yoga?

Roxanne Sukol: Well, for sure yoga. Let me just talk about sports for one second.

Nada Youssef:   Yes.

Roxanne Sukol: I think that that's definitely a mindful activity because you have to stay in the present in order to accomplish your goals, but I don't know that it's meditative exactly. I think repetitive activity that you do on your own could be meditative but not ... But it's a little bit different than mindful. A lot of crossover and overlap but not exactly the same. Yoga is a way of being mindful in different positions.

I completed the yoga teacher training course here last year at Cleveland Clinic so I am a certified yoga teacher. And what I learned in that course is that yoga is not about the positions. Yoga is about the breath. I have heard yoga teachers say that many many times over the years but I never really understood what it meant until I spent enough time doing it that it finally came to me. Each position is a vessel for the breath and one of the major benefits of yoga is learning how to calm your mind in the setting of mild discomfort.

You find a position, you lean into it to a place where you're just a little uncomfortable. No sharp shooting pain, no damage, just a little bit of an edge to the discomfort, and then you keep breathing. You keep, some people say you keep sending oxygen to the place. I don't know that that's exactly physiologically true but you definitely are continuing to calm your nervous system.

There are two sides to your nervous system. I explain this to patients just like this. The gas and the brakes. You need both to drive safely. But we live in a society that has everybody pressing their gas pedal all the way to the ground all the time even though you know you don't get your best mileage with your engine racing.

Okay, so the question is, how do you improve the tone in your brake pedal to make it a more worthy partner for your gas pedal? And the answer is, stimulate that vagus nerve. What is that? It's the biggest brake pedal nerve in your body. Spelled V-A-G-U-S. No relation to Vegas. And all you have to do to stimulate that nerve is to take a deep breath, literally. This is why upset 13 year old scream at their friend, "Take a deep breath dude," or we sigh when we get into hot water. It's embedded in our language. These are examples of taking a deep breath after the fact. You're all ready a little ratcheted up.

I'm proposing learning how to improve the tone in your baseline vagal tone, vagus, so that the next time somebody does something that ordinarily would send you flying right off the cliff, instead, ideally, after you've been practicing for a while you could be like, "I wonder why that presses my buttons," instead of just going off. That I think is one of the many benefits of yoga is that you're taking these deep breaths and that calms your nervous system, it strengthens your vagus nerve and it makes it a more worthy partner for your gas pedal. Gas pedal is called fight or flight, runs on adrenaline, I'm sure you've heard of that.

Nada Youssef:   Yes.

Roxanne Sukol: You know what the brake pedal is called?

Nada Youssef:   No.

Roxanne Sukol: You're not alone. Most people don't know. Rest and digest.

Nada Youssef:   Wow. I had no idea that even existed. Rest and digest.

Roxanne Sukol: Right. This is why we get butterflies in our stomach or we say expressions like, "Trust your gut." I'm very much a word person and I love when words give me insight into how human beings think. And I think these are all examples of that. And so I want to take advantage of those connections and share them with patients. It has just enough of a connection to something they already know that it gives them a comfortable bridge to this place that I'm taking them and then they can take it home and experiment for themselves.

Nada Youssef:   Now is there a certain spot in our body where this vagus nerve lives?

Roxanne Sukol: It runs from the brainstem to the diaphragm.

Nada Youssef:   Oh, okay. The brain, interesting.

Roxanne Sukol: Right.

Nada Youssef:   Okay, so instead of just say I'm driving and someone cuts me off and I see myself getting heated up, I would just breath and think about-

Roxanne Sukol: Just a couple of deep breaths.

Nada Youssef:   Think about what's happening instead of react without thinking.

Roxanne Sukol: Right. Just take a couple deep breaths. That's all. You know I started meditating, I want to say four years ago. I don't remember exactly when. I took a course and they talked about meditation at the course. It wasn't a meditation course. But they were talking about mindfulness and I got interested. They showed a little YouTube video called 10% Happier by a celebrity named Dan Harris who was a newscaster and Dan Harris was living a little too exciting of a life and needed to calm down but that wasn't in his personality exactly. He actually had a panic attack on national TV.

Nada Youssef:   Oh yes, I've watched this.

Roxanne Sukol: And it precipitated this interest. Like he was like, "Okay, I've got to do something about this." It was a pretty terrifying experience. He's done a lot. He wrote a book, he has an app and he has this short little YouTube video which explains how mindfulness works, 10% Happier, and I watched it at this course and I decided I was going to start to try to meditate.

I have a friend who's a member of the Bar and she teaches this meditation at the law school so I thought that would be a good one to try. And it's only one minute. It's called One Minute Meditation. You breath in for five seconds, breath out for five seconds. That's your warmup. And then you do it five more times. And that's it.

Nada Youssef:   Nice.

Roxanne Sukol: Yeah, so I decided I would start doing it. Six months later one of my colleagues says to me, "You're meditating aren't you?" And I didn't even notice any difference, at all. I still hadn't felt the difference. It took a full year before I noticed the difference and now it's been a few years after that and I really feel the difference. I think that I can be more reflective now instead of more reactive. It's subtle. It's not like ... Your personality doesn't change.

But you just get a little bit more steady in your ... You get a little more grounded in your stature. It's just not as easy to knock over your dominoes basically. They get a little more sturdy in their spots. And I think that helps everyone around you. I think that's good for all your relationships. With your friends, with your co-workers, with your kids, with your spouse, with everyone. It just really helps.

Nada Youssef:   Yeah, and it's just like you said. It sounds like it's literally controlling your reactions and thinking about it and being mindful before reacting. And I can see why someone can see that in you more than you see it in yourself because we don't see ourselves reacting, we only see other people so that makes a lot of sense.

Speaking of family and children, I take my kids quite a bit hiking in nature because I find that that's the only time they are the most present. They're not asking for snacks. They're not asking for TV. They're literally just walking. Would you call that meditative? Would you call that just mindful hiking? Or both?

Roxanne Sukol: I think both. I mean they're breathing deeply, they're much more attentive to what is right in front of them, they're less distracted. There's evidence, there are data to suggest that just spending time in nature is good for our nervous systems in many different kinds of ways.

Nada Youssef:   Excellent. That's great. What is the difference between mindfulness and meditation? I know earlier when my first question about techniques, you mentioned mindfulness meditation versus guided meditation or meditation. What is the difference between mindfulness and meditation or is it the same thing?

Roxanne Sukol: Well, I kind of made that up. What I said. But I think mindfulness is being in the present moment. And there are many many ways to accomplish that. Meditation is focusing on your breath. And you can do meditation many different ways. But a guided meditation for example where you feel your toes and you relax your toes and you feel your feet and your ankles and you just go up and up and up. That's a guided meditation. You're not exactly focusing on your breath but in the process of attending to one thing at a time your breath becomes slower and deeper and so it becomes that kind of an experience.

Meditation itself is about returning to the breath and one of the things I've learned in the last few years that I didn't know before was that it's not, the goal is not to clear your mind of all thought. First of all that's a physiologic impossibility. Our minds are always moving and we have, I read something like 10,000 thoughts a day, or maybe it was an hour, I don't know. It's a lot. A lot more than you would even imagine. The goal is not to clear your mind of all thought. The goal is to return to the breath. And it even looks like that action of returning to the breath is the beneficial aspect of meditation. That's what trains your vagus nerve to be stronger.

One thing I've discovered in recent years is that the things that distract me now give me insight into what's bothering me or give me insight into possible solutions to things that are bothering me. Or like I didn't even realize that was bothering me but that's all I keep thinking about. I keep finding myself thinking about it so I just return to the breath. And there are lots of ways to attend to your breath.

You could feel the air that goes in and out of your nose and if you do it for a little while and concentrate, you will notice that the air that you breath in is cooler than the air you breath out. That's kind of cool. It could be feeling the air fill your lungs, it could be feeling your belly go in and out. There's not one way that's the right way to do it. It's just doing it. And finding something that you feel like you can focus on. And when you discover that you're mind is a million miles away, you just go back to the breath. It's inevitable and it's part of the activity and it's even part of the solution.

Nada Youssef:   And it's kind of funny, even the terminology of returning to the breath. We've already been breathing, we just didn't notice it right? And that's Alan Watts, the philosopher that we were talking about earlier talks about that quite a bit. That we're always breathing. Whether we think about it, whether we're intentionally doing it or not, it's still always happening and it's just almost awareness or the thought that it's happening is almost meditative on its own, which is excellent.

Let's talk about some of the benefits of meditation. Obviously to calm ourselves. Is it also to ... Does it help us become more aware of our thoughts? Does it help us sleep better? Or is that not very meditative itself to talk about? What are the benefits coming after doing it?

Roxanne Sukol: First of all I don't think we have begun to understand all the benefits of meditation. I do think we're starting to see some of them, but I think that this is the tip of the proverbial iceberg. I think when people are less reactive in general, they become capable of more, a greater ability to connect to other people and to connect with the world in general. I think it makes you kinder to yourself and I think, I don't know, I feel like the greatest thing I can do for a patient is to teach them to be kinder to themself.

They self-medicate less with food, they find a little more energy to go for a walk in the middle of the day, or to say, "Okay, I'm going to start getting on my rowing machine for five minutes a day. No I will never be an Olympic rower, I will never be able to row for half an hour every single day, but if I could just row for five minutes a few times a week that's a big improvement." And if I can get them to a point where they feel like that's a constructive use of their time that all in my mind falls under the heading of being kinder to yourself. That's a really important aspect of this to me.

Nada Youssef:   Yeah. I love that because I mean when you meditation you're alone and a lot of people now, just like we mentioned earlier, there's so much going on. People are busy. I don't time to sit down by myself and just think about my thoughts. It teaches you to love yourself and to love being alone and to be okay so I think that's very important. And just like you metnioend earlier, people when they think about meditation, some people don't even try and they'll say, "I can never clear my mind of too many thoughts." And it seems to be the biggest misconception about meditation. Now we are noticing our thoughts come and go and trying not to fixate on them, correct? Just kind of releasing your thoughts.

Roxanne Sukol: Let them go.

Nada Youssef:   Okay. Can you explain what meditation is and I think we've talked about it quite a bit but if you don't mind, how to do it. Just kind of step by step, just a few seconds, and if you are listening to this and you're driving, please be careful or don't do it. But your voice is very soothing so I think this would be a nice little sample.

Roxanne Sukol: Well I'll tell you when I first started doing my one minute meditations and I did them for a couple of years before I decided to move onto the next step, when I first started I would do it when I first pulled into the parking garage at work. I like that spot because I would drop my keys in my lap, turn off the car, drop the keys, and meditate for one minute and then I'd go inside. I liked that because I wasn't at home, I wasn't at work, I wasn't driving. It was like liminal time you know. You're not late. One minute.

Nada Youssef:   Right. And it's before the end of your day. It's calming everything down before starting your day.

Roxanne Sukol: Right. Right. It was a great way to start the day. I just dropped my keys in my lap and it was exactly what I said before. Breathe in for five seconds. I would lower my lids. Not always closed but decrease the visual stimulation. Lower your lids and then breathe in for five seconds, breathe out for five seconds. That's your warm-up. And then do it five more times. And that's the whole thing.

Nada Youssef:   And when your brain is racing and you're thinking, "Well, I have meeting coming up. Oh my god, my daughter failed her test." You're literally-

Roxanne Sukol: Back to the breath.

Nada Youssef:   Let it go and go back to your breath, thinking nothing.

Roxanne Sukol: Just back to the breath. Right. Anytime things keep coming up over and over again, you know that that's something concerning. That you're probably going to give some more attention to later. But not right now because right now we're returning to the breath. And anything that keeps coming up, you don't have to write it down, later you'll remember. It'll come back to you at some point and you'll deal with it at that time. But this is like one minute off the rails. That's what I like to call it.

Nada Youssef:   Breathe in and out as practice or just in the beginning of warmup and then five more times and go back to the breath every time your thoughts take you away to any anxious or [crosstalk 00:23:17] thoughts. Any thoughts. Okay.

Roxanne Sukol: It could be ... For a long time I was distracted by things I had to do that day and then at some point my vagus nerve got stronger and gave me a break from always thinking about, "What do I have to do. What do I have to do." And then for a long time I found myself thinking about meditation. Like, feeling the cold keys or, "I wonder how many breaths that was? Am I half done now?" And I call that meda, like meda distraction. I'm thinking about thinking about meditation. Like that's not it either. But in the last few months I feel like ... I'm sure this continues over a life. That you just continue to find yourself going through phases.

But it's taken me a number of years now to really be comfortable about returning to the breath. Before, up until I think pretty recently, and maybe the last six months, whenever I would discover I was distracted that would be like a demotion. Like a demerit. Oh, you blew it, back to the breath with you.

Nada Youssef:   You have to be kind to yourself.

Roxanne Sukol: That's right. But now, it's much more fluid. Like, "Oh, I was away. Now I'm back. I was away. Now I'm back." And that's taken a long time. You just have to trust the process. What happened to me in the process is that there used to be, I used to have a car with a little digital readout so I would be very aware of the time. I'd open my eyes in what I thought was a minute and then I would move on. But then once in a great while two minutes would have gone by and I would be like, "Where was I? I didn't even notice." And then once, six minutes went by.

Nada Youssef:   Wow. Were you in a trans state at that point would you say?

Roxanne Sukol: I don't think so. I think I was just in the groove. Just returning to the breaths you know and I just lost my awareness of what was going on. That was like an eye opener. Like, wow, something's happening. Something is changing here. And I mean it was a pretty long time before that happened but then it happened. And they say you're supposed to meditate for 20 minutes. I don't know who they are but I've heard that 20 minutes a day is best and I even had a patient last week tell me 20 minutes twice a day, which is not on my radar.

But I think I've been meditating now 10 or 15 minutes pretty regularly for a couple, few years now, but it happened organically. I started with one minute. And I didn't push myself to do more. I just, when more came, I just let it be.

Nada Youssef:   Your body started literally becoming more relaxed and it's important to know that this also takes practice just like everything else. Just like you said in the beginning, you're thinking about is meditation over, is it a minute yet, and then the next thing you know six minutes go by and you didn't even notice it. Practice makes, not perfect, but it helps you with meditation as well. Because a lot of people try meditation and say, "It just didn't work for me," but just keep going.

Roxanne Sukol: Yeah, maybe a different type of meditation, maybe a different voice.

Nada Youssef:   Sure.

Roxanne Sukol: Maybe a guided meditation. There are so many different ones. Here's what I would say about practice makes progress. Practice doesn't make perfect. Practice makes progress. Perfection is the enemy of progress. Okay.

Nada Youssef:   Because there's no such thing as perfect.

Roxanne Sukol: That's right. We're human beings. We're dynamic creatures. You don't get to set our anxiety point every morning. It just is what it is. I always ask patients questions about stress management. I want to know how much stress they feel like they're under. Give me a number on a scale of one to ten. One is everything is totally relaxed, ten is you don't even know what you're doing here anymore. But I'm not really asking for the number. I'm not really asking how much stress do you have because everybody has a lot of stress basically.

What I'm really asking is are you riding the waves or are they beating you up? And I can see that in people's faces by how they struggle to answer the question in general. And then we talk about some people like high waves or we talk about ways basically to make your raft bigger so that they don't beat you up so much. And I think this is one strategy that people can use to calm their nervous systems. To help them achieve that.

Nada Youssef:   Yeah. And you're talking to so many people and how many years have you been in the practice as a physician?

Roxanne Sukol: I graduated from Case Western Medical School class of '95.

Nada Youssef:   '95, okay, so it's been a really long time. Do you think people are mores stressed nowadays or do you think people are catching onto mindfulness and meditation? Or it seems like a new thing almost, mindfulness.

Roxanne Sukol: I think we are more stressed.

Nada Youssef:   More stressed.

Roxanne Sukol: I think we are. And I think that the reason that we're catching onto meditation and mindfulness is because we realize that this adrenaline rush can't be all there is. It can't.

Nada Youssef:   And that's what people are striving for is adrenaline rush and it's very temporary. I know you talked about writing a book about food, so I want to talk about mindful eating. I want to talk about what that means, what that is. That's probably one thing that I lack at times because I'm a very fast eater. What is mindful eating, what is it and how to practice it.

Roxanne Sukol: I don't think I'm an expert at this, and I think I'm learning just as much as everyone else. I think there is a couple things going on. One is that in our society we have a lot of bad habits around food. Like eating in our car. Like drive thru. There's research showing that families that eat dinner together, that there are benefits to just eating dinner together. Just spending time together without any screens on, etc.

I think it's about appreciating your food so gratitude, which is an aspect of mindfulness. It's about tasting your food. It's about it being real food. Color and nourishing. It's about appreciating how the food got to your plate. I don't think it has to ... You don't have to sit down and do a 10 minute meditation with everyone holding hands before we eat. But some acknowledgement of the fact that someone in your family spent some time preparing it. And tasting it.

Nada Youssef:   Tasting, smelling.

Roxanne Sukol: We eat quickly. We don't taste it.

Nada Youssef:   And it takes our body like what, 20 minutes to even realize we're full, our brains, what I've heard at least.

Roxanne Sukol: I've heard that too.

Nada Youssef:   Maybe mindful eating would make me eat less.

Roxanne Sukol: Yeah. Yeah.

Nada Youssef:   Great. Meditation apps, do you recommend them? Because I find myself sometimes listening to some guided meditation with my kids on YouTube but are there meditation apps that you know of that are successful?

Roxanne Sukol: Yeah. I think anyway you can get someone to meditate is beneficial. Some of the ones that I've tried just for fun are 10% Happier I mentioned. Headspace, I really like the voice of the narrator in Headspace. Insight Timer is a nice one. Insight Timer is fun because you can set what type of meditation you want to do. You can set what time you want it to go off. And it gives you this very pleasant little ding when it's done. You could set ... Let's say you had seven minutes before you had to be somewhere, you could set it for seven or six minutes and then you don't have to be concerned about whether you exceeded your time, you don't have to peek out of one eye to see what time it is, you know it will let you know.

Nada Youssef:   It'll stop.

Roxanne Sukol: Yeah. That's a fun one.

Nada Youssef:   Yeah, and Cleveland Clinic has its own ... Is it some kind of meditation app or stress free app?

Roxanne Sukol: This is an app called Stress Free Now and it was developed to teach people about mindfulness and meditation. It has a number of meditations associated with it and I'm pretty sure you can download those just for fun to use any time. But the program itself guides you over the course of a few weeks through a lot of different aspects of meditation and mindfulness to teach you more about the topic.

Nada Youssef:   Okay, great. We've learned so much about the benefits of meditation, mindfulness, adopting mindfulness in everything we do. This was my last question but I feel like we did already kind of talk about this about I was going to ask you if there are any books, audiobooks, online resources that you recommend to our viewers so I want to repeat the book that you mentioned earlier because it sounds really really interesting, Let the Great World Spin. You also mentioned 10% Happier by Dan Harris. Is there anything else that you would ... Any kind of resources to help our audience become more mindful and to learn more about what it is?

Roxanne Sukol: I'm particularly fond of that writing of a Buddhist Monk named Thich Naht Hang. It's spelled T-H-I-C-H. Naht I think is N-A-H-T, and Hahn might be H-A-H-N. If you Google that they will know who you mean. He's written a number of books. I've read a few of them. They all are really meaningful to me. They are all about being in the moment. One particular book is made up of short observational chapters, very short, one or two pagers, and the one that just pops into my mind right now is appreciating a flower. Just one blossom. It's such a good time of year to remember that every single blossom is such a miracle. They're so gorgeous and they're all unique and we just drive by them without even thinking about them. They could be at our front door and we just go flying out the door. It's the simplest message to me and that's all he's saying is just take a moment and smell the roses.

Nada Youssef:   That's excellent. Have you ever read The Power of Now?

Roxanne Sukol: No.

Nada Youssef:   It's a similar book that reminds me of what you're describing and basically the same thing. Sometimes we just need to stop, look around, notice what's happening around us and notice the miracle that we're living in. And thank you so much for being here today. It's been a pleasure.

Roxanne Sukol: Thank you.

Nada Youssef:   Thank you.

Roxanne Sukol: I really enjoyed it.

Nada Youssef:   Thank you so much. And thanks again to all of our listeners who joined us today. We hope you enjoyed this podcast. If you would like to read more about mindfulness from Dr. Sukol and other Cleveland Clinic experts go to our Health Essentials site. It's health.clevelandclinic.org and just simply search for mindfulness or to check out the Stress Free Now App by Cleveland Clinic you can go to clevelandclinic.org/mobileapps. And to listen to more of our Health Essentials Podcasts from our Cleveland Clinic experts make sure you go to clevelandclinic.org/hepodcasts or you can subscribe on iTunes and make sure you're still following us on social media for all the health news, tips and information on Facebook, Twitter, SnapChat and Instagram at clevelandclinc, just one word. Thank you. I'll see you again next time.