Coming into medical school, I knew I had a great deal to learn about sympathy, empathy, and overall compassion. However, lessons learned in the classroom, clinic, and at home showed me how far I needed (and still need) to go in order to attain the level compassion required of a physician.
I didn’t encounter significant adversity growing up: my family was loving, well-off, and I wanted for nothing. My exposure to poverty, addiction, and hopelessness was minimal. My Catholic faith, which has always served me well and on which I will continue to embrace for the rest of my life, spoke volumes about compassion and mercy, but I was too hardheaded to fully embrace the teaching. None of the pain of the world was concrete; it was abstract and far away.
After high school I joined the military and, for the next 14 years, lived in a world where compassion took on a new meaning. In one sense, compassion was a crutch; an emotion reserved for those who were too weak to get the job done or cope with adversity. I fully believed in phrases such as “nobody cares about your pain but you” and “pain is weakness leaving the body”. I also embraced the general concept that the enemy had no regard or compassion for your struggles: all that mattered was who shot who first. Even then I realized that these maxims were inappropriate for civilian life but apt for the corrosive environment that is combat. They enable service members to stay focused on the enemy and fight through adversity. They were necessary parts of military efficiency and mission accomplishment.
Paradoxically, the military also taught me the power of compassion. Showing empathy for civilians stuck in war zones was critical not only to humanizing them in our eyes but also enabling them to trust us (which, in turn, aided in mission accomplishment). Here were people who lived well-below our American poverty line with regards to access to food, water, shelter, health care, technology, and education. Even more importantly, many of these people lived in hopelessness, with neither physical security nor the ability to politically change their future. Sympathy was expressed with military families, particularly those who had a service member killed or wounded. Talk of mission accomplishment and big-picture strategic sacrifice did little to assuage their pain; this took allowing someone to cry on your shoulder.
Yet despite these vastly different life experiences, I came to medical school thinking that compassion, sympathy, and empathy were reserved for weaker individuals. I thought that my technical proficiency and ability to ‘cure people’ would be all the emotion I would need to invest in my patients. How wrong I was. What changed me?
1. Learning about the physiological potency of addiction, the unceasing assault of certain pathologies, and the impact of pain on activities of daily living.
2. Seeing patients deal with chronic conditions and desperately wanting to return to some sense of a normal life.
3. Becoming a father and witnessing the fragility and hope of new life.
4. Interacting with my classmates and opening my eyes to new perspectives and philosophies.
Now I know not only how vital compassion, sympathy, and empathy are to healing but that developing these skills is a life-long, rigorous, active pursuit. My life experience, faith, and family provided fertile soil for these traits, but my molding as a physician has truly planted the seeds that will eventually bear fruit. I encourage all who seek medicine as a profession to be open to learning, experiencing, and developing compassion. It is critical to your well-being, development, and most of the all the experience of your patient. It is not contrary or even peripheral to what physicians do, but rather key to mission accomplishment.