Depersonalization of the patient and the loss of compassion

A common complaint about modern medicine is the depersonalization of the patient and the loss of compassion.

So let’s take a look at compassion.

Compassion is derived from the Latin “cum” (together with) and “patior” (suffer). From the perspective of clinicians, compassion is defined by two concurrent emotions: (1) a feeling of deep sympathy and sorrow for another who is stricken by medical misfortune accompanied by (2) a strong desire to relieve that suffering.

So why are clinicians trained to keep all their sympathies in check? The explanation most often offered is that clinicians’ emotions can get in the way of making difficult decisions or performing procedures that are gruesome or cause patient pain.

My awareness that clinicians’ emotions can interfere with their ability to provide care that optimizes the benefits of modern medicine is the main reason I have not socialized with my colleagues who are also my physicians. More than I want their friendship, I want them to be able to make dificult choices in my care.

But complete detachment is not the answer. DISpassionate care is incompatible with COMpassionate care. What’s a clinician to do?

I suspect that when Dr. Frances Peabody said, “The secret of the care of the patient is in caring for the patient,” he intended the implied ending “while maintaining a proper balance of objectivity and sympathy.”

Sympathy with patients may heighten clinicians’ senses, helping them pick up clues from the history provided by patients or from their physical examination of patients.

Clinicians’ desire to save lives may energize them when they have gone without sleep and help them focus when they have gone without food.

Clinicians’ desire to relieve suffering may help them find equanimity when caring for angry or mean patients. It may push them to search the literature and obtain curbside consults from colleagues when usual remedies don’t offer patients relief.

Clinicians’ hopefulness may help them guide patients through Plan “B” or “C” or however many it takes, when Plan “A” doesn’t fix patients’ problem.

When clinicians are grateful for and happy about patients’ recoveries, these patients feel their healthcare team cares about them as well as cares for them.

Wendy S. Harpham is an internal medicine physician who blogs at Dr. Wendy Harpham on Health Survivorship and is the author of Only 10 Seconds to Care: Help and Hope for Busy Clinicians.

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