Compassion and empathy can solve so many of the pains that arrive in the office


There she was — compassion. It had been so long since I had caught sight of her, I wasn’t sure at first if I recognized her. Had she had changed so much over the years or had I? She was peeking around the corner checking in to see how I was doing. I am surprised she still visits me, after the way I treated her all those years ago. If I let myself, I can easily remember that time. Those had been rough days when it wasn’t safe to have her around anymore. I wasn’t alone, so many others in my class were doing the same thing. Each in their own way turned inward and put up walls and barriers to protect themselves. My compassion had been placed in a safe room deep inside while I went about the business of learning medicine. I could not have her hanging out with me in medical school; it would have destroyed her completely, and likely me as well. Like others, I built my defenses so that she and I would remain safe in the process. I build walls and barriers out of biting wit and edgy sarcasm. I weaponized my intellectual capacity to deliver maximum harm with minimal effort.

I am surprised that compassion still peeks around the corner at me.

Compassion is watching me take care or a five-year-old who has a very sore throat and doesn’t want me to have a look at it. Her father is in favor of just holding her still and forcing her mouth open, but that is the standard answer of a staff sergeant in the infantry. Do what needs to be done, regardless of how unpleasant it might be, and move on. You do not gripe. You do not complain. You get the job done.

Somewhere inside, a small voice tells me‚ “Just wait and see.” And I do. I meet her eyes, fleeting at first, and we talk for a bit about how yucky it is to have such a sore throat. I am the one talking, and she is nodding her head yes and no in answer to my questions. With my eyes, I ask the sergeant to stand down. She did not catch that look, thankfully, it might have upset the whole process. After some time, her body visibly relaxes, and so I take a chance, I turn on my light, and I make an exaggerated yawn. It moves around the room, first her mom, then her dad, and then true to form it stops with her as she gives me a big five-year-old yawn that delivers the most beautiful view of her throat I could have possibly wanted. It smells like strep; it looks like strep, there is fever, there are lymph nodes, an upset tummy, and no cough. I forgo the strep screen, opting instead to treat her with the cherry flavored amoxicillin. Mom and dad chat with me about other things that we can do to help her feel a little bit better, maybe some Tylenol, maybe some Advil and maybe a few popsicles as I see this little smile appear on her face.

Back in my office, writing my notes, I wonder aloud in my head why I made that choice? What prompted me to do something so radically different than my usual method of business? It took a bit longer, it put me behind schedule ever so slightly, but I felt good about it. The usual angst of being behind did not seem to penetrate this good feeling. It would take many sightings over the next four years in the small army clinic in Utah before I really understood my compassion had returned. It had not changed much during the time I had kept her away, but she changed tremendously during the time we collaborated at Dugway. The more I allowed her to be with me, the better my medicine got. The longer I allowed her to simply linger in the silence without asking a question or probing for an answer, the more the story would spill out, the underlying sadness and grief that each of us carries. While most of my practice consisted of treating chronic diseases and acute illnesses, I became less a doctor and more medicine man during that time. I began to notice that compassion and empathy can solve so many of the pains that arrive in my office. A kind ear and a heart that did not judge — these provided more solace and comfort than all the tablets and all the pills I ever wrote out.

She is with me now, almost always. I find her harder to hear when I am tired or stressed, and there are certainly patients who come to the clinic that create enough noise in my system that her small voice is sometimes unheard. But I can feel when she is gone, something that is very generous goes missing, I somehow feel less completely myself, and that sensation is a calling card for me to bring compassion back into the room.

Gil C. Grimes is a physician and can be reached at Doc Grimes.

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