Filmed during Mind & Life Institute’s “Mind and Life XXV: Contemplative Practice and Health: Laboratory Findings and Real World Challenges” on October 20, 2012.

Session One – The Real World

Distress as the Sixth Vital Sign: Bridging the Gap Between Clinic and Laboratory
SPEAKER: Jimmie Holland

Traditional medicine has focused over the centuries on the treatment of disease, not the treatment of the patient. This was noted in 1927 by Peabody in the JAMA who wrote that medical students were taught the newest science but they were not taught “the care of the patient”. The same could be written today. In 2012, however, we now have evidence-based interventions, treatment guidelines and a science of psychosocial care which addresses treatment of the whole patient with cancer. The Institute of Medicine in 2008 reported a new standard for quality cancer care: the psychosocial domain must be integrated into routine care.
This presentation will review the major barrier and approaches to integrating the psychosocial into routine care. The barrier was the discomfort of both oncologists and patients with the words “psychiatric,” “psychological” and “psychosocial,” related to the stigma attached to all mental issues. The word “distress” was chosen, which sounds normal and is non stigmatizing. The evolution of the Distress Thermometer and its designation as the Sixth Vital Sign will be traced along with its use at an international level in cancer and potentially other chronic diseases.

MODERATOR: Anne Harrington

INTERPRETER: Thupten Jinpa

His Holiness the 14th Dalai Lama
David Spiegel
Lis Nielsen


Jimmie Holland, MD

Memorial Sloan-Kettering Cancer Center

Anne Harrington, PhD

Harvard University

Thupten Jinpa, PhD

Compassion Institute

Board Chair

Mind & Life Connections