Compassion: The Essence of Good Medicine

Compassion: The Essence of Good Medicine
The more rushed and robotic health care becomes, the more we need to make compassion a priority. (Drazen Zigic/Shutterstock)
Peter Weiss
5/5/2022
Updated:
5/5/2022
We all get way too many emails and texts that make us want to turn off our devices. I don’t need to know about the latest discount for a new laser machine, or a text letting me know that I won a free iPhone—if I just respond.
I also get a lot of old-fashioned mail, from insurance companies denying a patient’s prescription for one reason or another, to a company telling me they can provide a service to prevent me from getting unsolicited offers! With all of this, I wasn’t expecting a handwritten letter from a long time patient, N.L.
I actually stopped, looked at the envelope, gently opened it, and started reading. Something about it spoke to me and said, “slow down and read.”
“My Dear Dr. Weiss,” she began and started by explaining why she didn’t come in for her annual exam this past year. Many patients did not, due to the fear of COVID 19. I just acknowledge them and  say, “no worries, you’re here now.”
N.L. went on to say she really missed our annual “visits.” I loved how she called her annual exam “our visits.” N.L. is my age, has no children, and every year, we discussed what book we really enjoyed that past year. Both of us are avid readers. She said she really liked my recommendation of “The Lost Shtetl,” by Max Gross. She wanted to give me “one final recommendation,” the book “Yiddish for Pirates” by Barry Garwin. 
I had to stop and reread that last line, “one final recommendation.” I knew what was coming next. She went on to say she had stage 4 terminal glioblastoma (a very aggressive deadly brain cancer) and wouldn’t be seeing me again. 
N.L. wrote she loved being my patient for “forever number of years” and was so ever grateful for her care. I had been seeing her for some 35 years, and we really did talk about books each of those years. I had her read “The Martian” by Andy Weir, years before the movie came out. She didn’t enjoy it as much as I did, but she read it. The letter hit me hard. I have lost patients over the years and have built up a long and strong bond with so many. N.L. was one of the really good ones.
Compassion is very much the buzzword today when speaking about health care. What is it really? The journal Clinical Ethics had an editorial titled “Compassion in healthcare” in their 2013 specially themed edition of the same title. 
The editorial makes that point that “Compassion and empathy involve attunement—the delicate but precise art of ‘reading’ another person’s emotions and responding sensitively and appropriately.” There are few times we need this kind of attunement as distinctly as when facing a potentially life-threatening situation where another human being’s help is critical to resolving it. 
Compassion is the key to providing the best health care possible. Being a physician is about being the patient’s champion. Compassion is where “care” begins.
A research review published in the journal The Patient in 2017 looked at nine studies that tried to measure compassion among health care providers.  The authors came to the conclusion that there is an “unmet need for a psychometrically validated instrument that comprehensively measures the construct of compassion in healthcare settings.'’
In other words, there is wide concern about the lack of compassion in health care systems today. What we measure, matters, as the saying goes. Scientists that they are, they want a way to measure it. We need more compassion but I don’t think any of us need studies to realize that. 
I tried reaching out to N.L., but received no response. I recently wrote a letter to her, thanking her for being my patient and allowing me to “care.”
I told my wife about N.L. and she reminded me of another story I had told her many years ago about the first patient I lost. 
It was 1979 and I was in my third year at the University of Michigan Medical School, doing a surgical rotation at the Veterans Administration hospital in Ann Arbor. I was only a medical student, but I considered C.L. my patient. 
He and his wife owned a bakery in Toledo, Ohio, only 50 miles down the road. C.L. had severe diabetes as well as significant heart disease. My job was to “debride” his diabetic necrotic toes every day. I had to cut off the dead tissue right at his bedside. In those days, there were just wards with curtains, no private rooms like today. 
He had already lost several toes and on that day, with me there, his big toe fell off. He just laughed. C.L. told me about the struggles and joys of his life. Two days after his toe misadventure, his wife brought me in a birthday cake she baked. I never knew how they found out that it was my birthday (I was 22 on that date). 
A few days later he coded and we were unable to resuscitate him. I say “we,” but I just stood in the back and watched the doctors and nurses do everything they could. 
His death shook me, but I knew there would be many more over the years to come. I had to finish my rounds with the team after that, all very somber, hardly an unnecessary word spoken.
Compassion isn’t just for physicians, it’s for all of us. We must find time to stop and read those letters. Compassion is a two-way street. I am always in awe of the patients who have serious medical issues and yet sincerely ask me how I’m feeling and how my family is. 
“A kind gesture can reach a wound that only compassion can heal.” – Steve Maraboli
Dr Peter Weiss is a nationally known physician and healthcare thought leader who has advised CEO’s, and political leaders on current and future healthcare trends affecting our country. He was a national health care advisor for senator John McCain's 2008 presidential campaign and was an Assistant Clinical Professor of OB/GYN at UCLA School of Medicine for thirty years. Dr Weiss is the co-founder of the Rodeo Drive Women's Health Center and remains in private practice. He also spends part of his time writing and lecturing on healthcare in America.
Related Topics