We don’t spend nearly as much time in nature—or even simply outdoors—as we should. During summer break, in a moment of child-like curiosity, I found joy in the simplicity of watching the stereotyped locomotion of a caterpillar across a rock, moving from flat line, pulling its backside forward to make an omega shape of its body, then extending its front end forward into flat line again, having successfully advanced itself a half-centimeter forward at a time. This tiny life moved onward against the backdrop of a gentle creek of cool water, runoff from a nearby mountain. During another part of summer break, I spent long-overdue time on an out-of-country family vacation. A black flag next to the oceanside signaled dangerous waters as the rhythmic smashing of ocean waves against the pebbly beach were both a source of wonder and fear.
Shinrin-yoku (literally translated from Japanese as forest bathing) involves “bathing in the forest atmosphere, or taking in the forest through our senses.”1 Taking a walk in a natural rather than an urban environment seems to offer affective benefits, such as decreased anxiety, rumination, and negative affect, and preservation of positive affect.2 Even just looking at photos of natural rather than urban landscapes seems to offer some positive emotional influence.3 A correlation has also been observed between municipalities with larger proportions of green space (e.g., grass, forests, or parks) and reduced suicide mortality in those municipalities compared to those with less green space.4 The posited mechanism for these various benefits is that the experience of nature activates the parasympathetic nervous system in ways that reduce stress and autonomic arousal.2 Getting a regular Nature Rx5 certainly seems like a prescription worth taking when our work lives as general internists and trainees have overflowing agendas to address.
In this issue of SGIM Forum, LeRoi Hicks, SGIM President, and Eric Bass, SGIM CEO, share important SGIM considerations regarding organizational priorities for the coming year, with special focus in the President’s column relating to the legality of abortion in each U.S. state and that impact on future SGIM meeting plans. Margot Cohen and colleagues write about their experiences of training residents as coaches of clerkship students during an Internal Medicine (IM) and IM-Pediatrics elective. Hussain Khawaja and co-authors describe a physician ambassador program to facilitate new faculty onboarding and retention. Medha Reddy, a third-year medical student, and her mentor offer five tips to overcoming vaccine hesitancy in minoritized populations. Stacie R. Schmidt summarizes the various ways that the healthcare industry contributes to yet can also mitigate its effects on climate change. Finally, Phillip M. Johansen, a fourth-year medical student, and co-authors offer a morning report case study and overview of the challenging diagnosis of psychogenic non-epileptic seizures. As an always impressive breadth of scope, our general internal medicine community spans advocacy, education, leadership, research, and the intersections and blurred boundaries beyond. I hope we can periodically return to our roots in nature as one of many possible ways to rejuvenate and reenergize our numerous important initiatives and daily work.