Compassion in the Medical Field

Introduction

Healthcare professionals are one of the most essential workers we can have in modern society from doctors to nurses to physician assistants. We will always have people who get ill in this world, it’s almost unavoidable, and it’s the duty of these healthcare professionals to tend to these ill people as best as they possibly can. These professionals have one of the only jobs that require them to care but an important question that can be asked is, “what is care?”. According to Oxford Learner’s Dictionaries, care is defined as “to feel that something is important and worth worrying about”(Oxford) which implies compassion as the same source defines compassion as “a strong feeling of sympathy for people or animals who are suffering and a desire to help them”. Since there is a connection between the concept of care and compassion, it would be safe to assume that they would both exist in the world of medicine but this is not the case. Plenty of patients feel as though they are not being represented well by their doctors and nurses and there is a demand for more compassionate/more caring doctors in the world. For example, a blog post by Practice Builders noted that 3 of the 11 key elements patients want to start seeing more from doctors are: communication, empathy, and respect. All 3 of these elements are elements of compassion because they all would only occur from someone who truly was worried about one’s ailments. Blogs can provide relevant and insightful information how society may view a topic, though informal, it aids in allowing us to understand the perspective of people around us easier. The idea of a lack of care and compassion in the medical field, leads to the question to what extent does compassionate support affect the level of satisfaction in patients. Compassion would increase the amount of satisfaction that a patient has from their treatment, this can be explored through various literature about medical ethics, studies and awards regarding medical compassion, and compassion being a necessary element of care being represented in modern forms of media. These 3 factors help display the impact that compassionate support can provide more satisfied patients.

Medical Ethics Literature 

Throughout history, there has been an increase in medical based literature and an increase in authors who discuss their pain or the evaluation of others. There is also a large amount of texts that provide argumentation for what is morally correct to occur in the medical field, with one of the prime focuses being what is true care that a doctor should hold. One of these includes a revolutionary feminist piece, The Yellow Wallpaper by Charlotte Gilman, which follows the story of a sick woman who was placed in a nursery by her husband to isolate herself until she isn’t ill anymore. However, due to the abandonment and isolation she slowly starts to go insane and hallucinates someone inside of her yellow wallpaper. For example, the story states “I kept still and watched the moonlight on that undulating wallpaper till I felt creepy. The faint figure behind seemed to shake the pattern, just as if she wanted to get out.”(Gilman). The figure the protagonist is viewing is supposed to represent her inner self and the emotions of wanting to get out of the wallpaper was supposed to represent the protagonist’s desire to leave the nursery. She is left in this nursery for her “care” but true care wouldn’t involve isolating a patient in an environment they don’t feel comfortable in because it lacks compassion and emotional interest in the patient. It’s easier to uncompassionately leave someone until they eventually get better but that does not make it true care and as a result the woman is losing her mind due to a lack of compassion which is evidently not satisfying her at all. Additionally, the story also stated, “Behind that outside pattern the dim shapes get clearer every day. It is always the same shape, only very numerous. And it is like a woman stooping down and creeping about behind that pattern. I don’t like it a bit. I wonder – I begin to think – I wish John would take me away from here!”(Gilman), highlighting the sheer depression that the protagonist is going through and further strengthens her desire to leave which also indicates that she is dissatisfied with her treatment of completely no compassion, noting the importance of compassionate support. It goes to show that if this was in the 1890s, and we still have issues to provide compassionate care then we still have a lot to learn.

Another medical ethics text is Feminist Ethics of Care by Jean Keller and Eva Feder Kitay, which discusses multiple ethical issues within the medical field. One of the most impactful quotes in the text was, “Care done without the right affect, such as love and empathy, is often not experienced as care at all. Similarly, when care is not offered through an intuitive and immediate response but mediated by reasoning, care can be experienced as insincere and calculated.”(Keller and Kitay). The quote is blunt and discusses an issue regarding a lack of compassion amongst caregivers, the quote emphasizes that when care is done calculated and insincere when without compassion. Being aware of these ethical principles would allow future healthcare workers to provide true and proper care for patients. As it is ethically immoral to refer to care without compassion as care. Similar to the story The Yellow Wallpaper where the protagonist received insincere care and then proceeded to feel as if she wasn’t receiving care at all even though she was technically being treated. Compassion is what makes receiving care feel so good, because there is a level of intimacy that creates comfort but without compassion it seems like the person is very uncomfortable with their medical treatment, which is also fortified through Gilman’s story.

Lastly, another key ethics text that demonstrates the importance of compassionate support in patient satisfaction is Pain Scale by Eula Biss. This story is a narration through the daughter of a doctor who talks about the pain scale, a scale many physicians use as a method to determine how much in pain someone is, and breaks it down into a way that each number on the scale can have its own independent representation of pain (Figure 2). There are plenty of significant statements that the narrator made, one of them, regarding compassion was “Where does pain worth measuring begin? With poison ivy? With a hangnail? With a stubbed toe? A sore throat? A needle prick? A razor cut?”(Biss). Pain and illness is subjective thus having multiple interpretations so using calculated care for it would prove to me insufficient in properly assessing the emotions of a patient. Since we cannot determine when it is worth starting to calculate damage on the body, it would be more effective to assess damage based on how the person feels about the issue. Even if one doesn’t believe that a paper cut is worth measuring, it doesn’t change the fact that the patient still is uncomfortable with the paper cut and should receive attention and proper care, not because they need it to survive but because it’s the duty of a caregiver to satisfy all needs of a patient. Biss delved into this topic further when she wrote, “A better scale, my father thinks, might rate what patients would be willing to do to relieve their pain.”(Biss) which shows that true compassionate care to satisfy a patient is what the patient wants to fix, not necessarily what they need to fix. Fixing each of a patient’s issues ultimately leads to satisfied patients but a caregiver can’t get to that point without compassionately and truly caring for the issues of their patient as that’s the only way to reach every single issue. Biss agrees with this belief as she writes several reasons why the pain scale does not sufficiently address patient issues and all it does is add a calculated apathetic measurement to how someone feels which further leads to apathetic and calculated care. 

Studies and Awards on Compassion

A study was conducted by Fallon Chipidza, Rachel  Wallwork, and Theodore Stern and it was focusing on the importance of compassionate communication between patients and their doctors. Compassionate communication is crucial as shown from previous sources, like Gilman’s story, because it helps bring people closer together allowing for not only easier but effective care. This was shown through 2 cases studies evaluated, it is about a man named Mr. A and a woman named Ms. B who both have similar drug/alcohol abuse troubles and faced two different doctors regarding two different illnesses. Mr. A developed Hepatitis C and needed treatment therefore, a medical team had an intervention with him about his drug abuse where they discussed various treatment plans that included a abstinence from drugs. After the discussion, Mr. A stated, “prior to this assessment he had never had a “decent” conversation about addiction treatment.”(Chipidza, Wallwork, and Stern), showing that he is extremely satisfied with the outcome of the discussion. The medical team had empathized with their patient with compassion and it led to the most satisfied the patient has been in his entire life, compassion is powerful. The second case study was on Ms. B who had a malignant tumor developing on her stomach and needed to go under surgery to help fix it, however, the procedure was dangerous and she was told she may not survive. From this heartbreaking, cold, and apathetic news, Ms. B “began to shake her head from side to side and cry.”(Chipidza, Wallwork, and Stern) which shows her blatant sadness that she feels from the news. Later in the research study it was also stated, “the doctor in the case of Ms. B could have made an effort to demonstrate regard for the patient and to display a desire to know the patient. The surgeon could have started off by asking Ms. B open-ended questions about her understanding of her disease, as well as of her fears and expectations regarding her health. This questioning would have allowed the surgeon to create a patient-centered interaction by recognizing and addressing Ms. B’s thoughts, concerns, and values.’’(Chipidza, Wallwork, and Stern). By showing more compassion, it’s safe to conclude that there would have been a more positive and more satisfying reaction from the patient. By simply trying to engage and showing interest in the patient’s wellbeing, it will lead to more results like Mr. A who also had severe illnesses but left his treatment discussion happy and satisfied. When comparing these two case studies, it’s evident that by being compassionate your patients will be more satisfied and being compassionate isn’t that work intensive; it only takes a few questions about the emotions of a patient. It also displays the importance of compassion through understanding, similar to Keller and Kitay’s reference to empathy, because everyone goes through their own various issues and it’s important to empathize with them and show compassion as it will allow you to satisfy your patients to a grand level.

The DAISY award is an award specialized for nurses and normally given to nurses for exemplary work in their field also giving these great nurses recognition for their services. In one case, a nurse was awarded the DAISY award in 2022 for her outstanding treatment of patients during the COVID-19 pandemic. She was given this award as she was evidently compassionate and tended to every single need that her patients needed. In one specific case, the nurse would always reassure the ICU patient that he would be fine soon, but more importantly, her compassion trickled down to the wife of her patient and she would constantly reassure the wife too. Even the wife stated, “everytime I went home and went to sleep I knew that he was in safe hands”(Daisy Foundation) thus displaying her satisfaction she had regarding the treatment of her husband. The satisfaction also is within the patient who was also more than glad with the treatment he had received, going to show that compassion can create a whole new world of hope in illness causing the patients to be more satisfied. The nurse came off as humble and made her extraordinary efforts seem like it was easy to do, and if it didn’t take much for her to accomplish the ultimate patient satisfaction then it can be done by everyone.

In the process of handling illness with people, a common forgotten aspect of being treated is the discharge process. The discharge process can be one of the worst parts of treatment for patients as they have to face responsibility and independence over their sickness and often rebel against doctor’s orders. However, a study was conducted by Shoshana Hahn-Goldberg to determine whether or not compassionate support during the discharge process leads to more satisfied discharged patients. According to the conclusion of the research, “Patients who had high caregiver participation reported slightly higher satisfaction scores (average of 8.2 versus 7.0 on a scale of 0 to 10) and were 40% more likely to have a discussion in hospital on whether they would have the help they needed at home after discharge.”(Hahn-Goldberg). The conclusion dictates that a higher caregiver participation, more concentrated and careful care, leads to more satisfied discharged patients who carry out their instructions properly. To add, they were 40% more likely to communicate with their healthcare provider in the hospital, showing a level of satisfaction with their physicians, nurses, etc allowing them to develop a level of trust. The data from the experiment helps fortify the belief that compassion is one of the driving forces to proper care in the medical field.

Modern Media

Modern media, in this context, would be involving more commonly used forms of media that most people use informally, such as art or music, and  using these forms of media will help share the voices of the world in a more digestible manner. Firstly, a famous Latin-American film known as Gun Hill Road which is about a man who was released from prison and comes home to his son transitioning into a woman. In this film, the father performs numerous actions in order to convert his new daughter to conforming to her previous gender she was born with which as stated by the father is done out of “care”. However, obviously the daughter didn’t view this as help or care but simply neglect and bigotry from her father which led to more conflict as the film progresses. The movie helps to show a message that is often overlooked but similar to what Keller and Kitay referred to with care being only possible using compassion with it. Being that compassion was missing from her father, she didn’t receive it as her father trying to help but rather someone trying to obstruct her from being her true self. In a specific scene, the father cuts the daughter’s hair because he didn’t approve of the girlish style she had and during this scene he stated “I’m doing this because I love you”(Gun Hill Road), which proves that he did in fact do all of the actions that he did through care. But where he went wrong is that he failed to try and talk it out with his daughter, also failing to empathize and try to understand his daughter plays a role in the lack of compassion being delivered. It is evident that the father is clearly uncompassionate about the care he provides for his daughter and is only taking any form of action since that is how he feels. The result of this was his only child crying for days on end and constantly degrading herself by complaining about how “ugly” she looks while her mother does her hair, highlighting the immense amount of depression she faced because of her father’s “care”. Therefore, the film helps solidify the idea that uncompassionate care will lead to dissatisfied recipients such as the daughter in the film Gun Hill Road and this belief would trickle down to the medical field as the professionals inside of the career field all are required to care for more people similar to the daughter in the film.

Conclusion

Compassion can bridge a great gap between the patient and their healthcare worker. Something about the concept of compassion simply leads to such great satisfactory conclusions for the physicians, patient family, and the patient itself. From case studies to experiments to famous literature on medical ethics, it’s safe to say that compassion has a positive control over the medical environment. Figure 3 is a representation of what the medical field should be like as the name of the lake is called “Medicine Lake” meant to be medicinal. The medical field will be more peaceful and sustainable through compassion as it allows both patients and doctors to interact happily and wholly. And it’s arguably safer to say that patient satisfaction as a result from compassionate support would increase. Thus, compassionate support has a great effect on the level of patient satisfaction and as physicians it is their job to make sure they are accurately caring for their patients.

Works Cited 

•  Chipidza, Fallon E., et al. “Impact of the doctor-patient relationship.” The Primary Care Companion For CNS Disorders, 2015, https://doi.org/10.4088/pcc.15f01840. 
•  Hahn-Goldberg, Shoshana, et al. “‘we are doing it together’; the integral role of caregivers in a patients’ transition home from the medicine unit.” PLOS ONE, vol. 13, no. 5, 2018, https://doi.org/10.1371/journal.pone.0197831. 
•  “E.W. Sparrow honors Compassionate ICU Nurse with DAISY Award.” Contify Life Science News, 20 Dec. 2022, p. NA. Gale OneFile: Health and Medicine, link.gale.com/apps/doc/A730720400/HRCA?u=nysl_ca_dmvacces&sid=bookmark-HRCA&xid=769e6351. Accessed 5 Oct. 2023. 
• “Nominate a Nurse.” DAISY Foundation, DAISY Foundation , Jan. 2000, www.daisyfoundation.org/daisy-award/thank-your-nurse-nomination?gad_source=1&gclid=CjwKCAiA9dGqBhAqEiwAmRpTC8gJw1AEK6YfAyfJcHHJPgOxloRINX91j40tHXgZABGxFDbpeT6JyxoCHeAQAvD_BwE#main-content. 
•  Biss , Eula. Pain Scale . Harper’s Magazine , 2018. 
•  Keller, Jean, and Eva Feder Kittay. “Feminist ethics of care.” The Routledge Companion to Feminist Philosophy, 2017, pp. 540–555, https://doi.org/10.4324/9781315758152-44. 
•   Gilman, C. P. (n.d.). The yellow wallpaper. Full Text – The Yellow Wallpaper – Owl Eyes. https://www.owleyes.org/text/yellow-wallpaper/read/yellow-wallpaper#root-422327-1 
•  “11 Things Patients Want from Their Doctors.” Healthcare Marketing Agency, Practice builders , 1 Feb. 2019, www.practicebuilders.com/blog/11-things-patients-want-from-their-doctors/.
• “Oxford Learner’s Dictionaries | Find Definitions, Translations, And …” Oxford Learner’s Dictionaries , Oxford Dictionary , Jan. 2020, www.oxfordlearnersdictionaries.com/us/. 
• Green, R. E. (Director). (2011). Gun Hill Road. Motion Film Group.
• “Medicine Lake, Jasper 1990” by Gord McKenna is licensed under CC BY-NC-ND 2.0. The tranquility of the lake correlates to how the medical field should be, calm and peaceful.
• “Pain Rating Scale” by Pinkpollyanna is licensed under CC BY-NC-ND 2.0.
• “Modern Interpertaion of The Yellow Wallpaper”, 12/16/2021, Cove Editions, https://editions.covecollective.org/content/modern-interpertaion-yellow-wallpaper