Great discussion today led by Mark Michalski on compassion in emergency care. Mark is a staff specialist in emergency at RBWH and, as he was introduced by Vic Brazil, a bit of a moral compass for the rest of us.

This has been a bit of a theme in local circles – an article from the MJA has been circulating and provoking a bit of discussion. The article is called “More than the sum of our parts” by Tanya Hall and gives an account of the experience of being a patient undergoing diagnosis and treatment for breast cancer. Of course, the patient is in this case a medical practitioner.

Now that I think about it, what does it say about our profession that we only take note when one of our own pops up to say that this isn’t good enough, despite the fact people who aren’t doctors are going through this every day - even every few minutes?

Mark helped us developed a better concept of compassion – something like:

Having a deep awareness of the suffering of another coupled with the wish to relieve it

There was a little discussion on the big element missing from that definition – the showing part of showing compassion. In other words, having compassion and demonstrating it are not necessarily the same thing.

Mark mentioned a Stanford insitution - The Center for Compassion and Altruism Research and Education (CCARE) - founded by a neurosurgeon James Doty. CCARE supports research and education programs in compassion and I for one am developing a long list of individuals for whom an 8 week program is probably worthwhile.

We also talked about how it may be hard for us to demand compassion from our doctors, any more than we can mandate love from our parents or children, but we can certainly demand professionalism, including the professional behaviors that overlap with demonstrating compassion.

FInally the conversation segued around to the importance of understanding the needs of our patients beyond simple diagnosis and management (the sum of our parts, indeed). Determining the individual’s reason for presenting, and addressing that reason, while helping your patient move through this adverse situation that is so much more than a simple diagnosis is surely the best emergency care we can provide?

So to go full circle I recommend taking a peak at another MJA article, just heading to the presses and available open access. The article titled “Patient Designs” reintroduces the concept of patient-centred care with the help of a quote from Don Berwick, former president of the US-based Institute for Healthcare Improvement. Check out his speech on why he is scared to be a patient below.

The experience (to the extent the informed, individual patient desires it) of transparency, individualization, recognition, respect, dignity, and choice in all matters, without exception, related to one’s person, circumstances, and relationships in health care.