by Elton John
I have some good news. The single biggest change that could most radically improve our health-care systems is free. It can't be patented by any corporation. It doesn't eat into anybody's budget.
What we need most is compassion.
I know that might sound, at first, airy-fairy or wishy-washy, but I mean it quite literally. I know it's true because compassion saved my life, and there is now significant scientific evidence that it can save millions more.
When I was in rehab, after hitting the rock bottom of my drug addiction, they taught me that "your secrets make you sick." All the years of shame — for being gay — had caught up with me. By showing me love and compassion, they taught me — slowly, carefully — how to show it to myself. If I hadn't confronted that stigma, I don't think I would have survived to write this.
Last year, I met a young Ugandan woman who was living in Britain, whom I'll call Waangari. When she was 16, she was raped by her brother-in-law. She knew it would devastate her sister, so she never told a soul: instead, she just sank into shame.
She later married a man who took her to Britain, where he began to beat her up all the time. Alone and knowing no one, she fled to a refuge and was told at a medical checkup that she was both pregnant and HIV-positive. When she went for treatment, the nurse in the antenatal ward looked at her notes and told Waangari that she could not bathe on hospital property "because of your condition."
She tried to argue, but the nurse called a meeting and told all the nursing staff on the ward that Waangari had to be kept in a separate single room away from the rest of the patients, and confined only to showers. She started having flashbacks to the shame of being raped and infected with HIV in the first place — and it was so unbearable that she stopped going to her checkups, or for treatment.
By denying Waangari compassion — indeed, by showing her contempt — that health-care provider risked causing a chain reaction. Waangari could have gotten sick; her baby could have gotten sick; and either of them could have later passed on the HIV virus to others, who could have passed it on to others, and so on. The potential human, financial, and medical cost of the nurse's contempt is incalculable, yet scenarios like this are playing out every day, all over the world.
Waangari got lucky. A few months later, her general practitioner apologized when she heard this story and arranged for an obstetrician to meet her at the hospital bus stop and hold her hand as they walked onto the ward. Waangari was so moved by this act of compassion that after her child was born, she started to train as a nurse. Today, she is showing compassion and love every day to her own patients.
The virus of kindness infected Waangari; it is now radiating out from her, and it is beating the HIV virus. I have heard stories just like hers at projects funded by my foundation in Russia, Ukraine, South Africa, and Washington, DC. Too often, doctors have looked into the eyes of these people and seen not a human being with feelings and needs like their own, but only a deadly virus. By doing this, they have made the virus ever more deadly.
We will only end AIDS if we end these stigmas —toward people with HIV, toward gay people, toward drug users. Many will not come forward to be tested and treated if the cost is being sneered at and shamed. For people who already feel a great deal of shame — because of their sexuality, drug use, or sex work — even a cold glance can be enough to trigger an internal spiral of shame that will drive them out the door and out of the reach of medical intervention.
This insight goes much further than AIDS. As Dr. Tom Shakespeare, a British sociologist who has studied this topic, highlights, hospitals in the British National Health Service that showed lower levels of compassion to patients led to higher death rates across the board. Yet he explains that one medical consultant had shrugged, "I find the ward round goes much faster if you don't talk to the patients."
Compassion saved my life when I was sick. It saved Waangari 's life, and it led her to save the lives of others. I have seen compassionate doctors and nurses saving thousands of people across the world. They know medicine is not offered to machines. It is not like the petrol we pump into our cars. It is offered to human beings — with dreams, despairs, and desires. It costs nothing to remember this, but it means everything.