Compassion and healthcare

BRIDGEPORT—When Dominic Vachon’s brother was dying of cancer, it gave him a profoundly personal insight into healthcare and the importance of empathy and compassion.

His brother died in 1983 after four years that Vachon said “gripped my life” and led him on a lifelong professional journey, exploring empathy in the health professions and the emerging science of compassion through which he came to an understanding of the “compassionate mindset.”

Today Vachon is the director of the Ruth M. Hillenbrand Center for Compassionate Care in Medicine in the College of Science at the University of Notre Dame, and as a psychologist he has been training physician residents in the areas of patient-physician communication and professionalism.

Vachon recently joined Jean Watson, Ph.D., a distinguished professor and dean emerita at the University of Colorado Denver, College of Nursing Anschutz Medical Center, and Michael W. Higgins, Ph.D., author, columnist and distinguished professor of Catholic thought at Sacred Heart University, for a discussion about compassion in healthcare titled, “A Dialogue on Compassion: The Lived Experience.” The lecture was sponsored by the College of Nursing at the Center for Healthcare Education at Sacred Heart University.

“Science is catching up with what we have known for thousands of years—we are built for compassion,” Vachon said. “It is in our DNA. It is built into our biology and built into our evolutionary journey, our psychology and spirituality.”

Watson, founder and director of the Watson Caring Science Institute, said a compassionate mindset brings together the intellect and the heart.

She said there is a danger of getting caught up in the medical system whereby “A person gets reduced to a patient, and then the patient gets reduced to body physical and body physical gets reduced to machine or technology. When we reduce another person down to the body physical or machine, you are reducing them to the moral status of an object, which takes away their humanity, and we can justify doing something to them as an object that we could never justify doing to them as a wholly functioning person like ourselves.”

She added that the face-to-face connection is the only way we can sustain our humanity in the digital, virtual world, and there is a fundamental need for caregivers to connect human-to-human and heart-to-heart. The source of compassion, she said, is in the heart.

Higgins cited the work of Henri Nouwen, priest, psychologist and author of some 40 books, who after almost 20 years of teaching at institutions such as Yale Divinity School, Harvard and the University of Notre Dame, joined the L’Arche Daybreak community in Ontario, where he worked with people who had developmental disabilities.

He was inspired by his friendship with humanitarian Jean Vanier, who founded L’Arche, which has established communities in almost 40 countries. Vanier had a profound influence on Nouwen, who spent the last ten years of his life at the community in Ontario.

Higgins said that in many ways they were the most fertile years of Nouwen’s life, “working with the most disabled, the most broken, the most wounded, the ones least capable of communicating.”

The lives of Nouwen and Vanier illuminate the fundamental elements of compassion, Higgins said—the need for imagination, trust and tenderness.

“Nouwen spent a good deal of his life living out compassion,” he said. He learned this from his studies in phenomenological psychology and his reading of Scripture, which taught him to move beyond case studies.

“It’s not just looking at the individual patient or client as a case study,” Higgins said. “He looked at the patient as a living, human document. And to enter fully into that living, human document, you have to have the imagination, the capacity to become part of their universe.”

The profound understanding that Vanier achieved through his creation of L’Arche was that “It is not that we teach the vulnerable. The vulnerable teach us what it is to be human. What it is to love. What it is to trust. These are quintessential human qualities.”

“To be deeply human, we must be able to trust,” Higgins said. “And the heart of compassion is tenderness.”

Vachon said the science of compassion studies the relationship of biology, neuroscience, physiology and psychology to compassion.

From a scientific point of view, compassion has four components: noticing another’s suffering, empathically feeling the other person’s pain, wishing or desiring to see the relief of that suffering, and responding to help ease or alleviate that suffering.

“Scientists have confirmed that compassion is not a sentimental process, it is a motivational process,” he said. “When you are in compassion mindset, your attention becomes more focused and your emotions become more regulated in a positive way.”

He told the healthcare professionals in the audience, “Whatever your knowledge is, whatever your training is, you must be focusing it on the person right in front of you …. I can have the best nurse in the world, the best doctor in world, but if that best clinician is not into my problem, it means nothing.”

Healthcare professionals must ask themselves four questions to enter the compassion mindset: “Do I view this patient as a fellow human being who is suffering? Is this suffering a primary concern to me over my self-interest? Can I view this patient as deserving some type of help? Do I have the ability to cope with the patient emotionally?”

Science has shown that professionals who are rooted in compassion provide much better care.

He said, “When we are smart, but not compassionate, our smarts are wasted.”