Roy Lilley, in his  25th March newsletter at nhsManagers.net wrote, “I’ve been thinking about it. Ruminating, cogitating and turning it over in my mind.  I’m not sure I should be saying this but I have a bit of a problem with ‘compassion’.  It’s too slick, too easy, too glib.” – Robin Youngson responds: 

Lilley starts badly. Few would agree with the definition of compassion he offers:

Definition; Sympathetic, pity and concern for the sufferings or misfortunes of others.

Compassion is not pity. True compassion has non-judgment at its heart but pity is a form of moral superiority. The person being pitied is belittled – poor you!

Even Lilley has misgivings with the definition he offers.

That’s not good enough for me.  Compassion should have a depth to it… Strictly speaking it means ‘suffer with’, from the Latin ‘Cum Passus‘.

He goes on,

Compassion doesn’t do it for me.  How can a young nurse with little experience of life ‘Cum Passus‘, suffer-with, a terrified, dementing  90year old.  How can a childless person ‘Cum Passus‘ a family bereft at the death of their child.  Few of us can ‘Cum Passus‘ with an amputee or understand the life of a refugee or a rough sleeper.

I can only think that Lilley has never found himself, or a loved one, in a situation of deep suffering and vulnerability as the result of serious illness or injury. Then he would know that the young and open-hearted nurse might be the one to offer the most exquisite compassion and loving kindness. Life experience helps us to empathise with a person’s situation but it’s not needed to recognise suffering and to feel motivated to do something about it. It’s the caring that counts.

How often do you hear; ‘I know how you feel’.  You can’t know how ‘I’ feel.  You might know how you felt when something pivotal happened in your life but that’s all.  You might be able to say; ‘I can’t imagine how you must be feeling; all I can say is when my Mum died, I felt terrible and I expect you do too‘.  That’s empathy.  It is not compassion but it is sensible and meaningful.

Empathy has several components: an ability to sense what someone is feeling and to name that feeling; the ability to listen carefully, comprehend a situation, and paraphrase your understanding; and the capacity to convey all these with touch, tone, facial expression and body language. The person who says, “I know how you feel” may be lacking in empathy. The person who takes the patient’s story and makes it their own – ‘autobiographical empathy’ – is not expressing empathy either. Empathy is a good start but it’s not enough. Torturers use empathy to increase the suffering of their victims. Empathy is not a moral virtue, it’s a skill. Compassion, on the other hand, is a motive: the humane quality of understanding suffering and wanting to do something about it.

We can wish for the safety and happiness for other people but that’s not compassionate.  We can do everything we can to avoid pain, fear and sorrow but that’s not compassion.  It’s professional.

What ghastly vision of “professional” includes the treatment of pain, fear and sorrow without recognising the suffering of the patient and being motivated to lessen it – other than to act like a robot? When the patient is in pain, fear and vulnerability, the coldness of a detached professional is like a knife to the heart. Yes, we want our health professionals to be knowledgeable and technically competent but we also crave kindness,  compassion and love. When medicine runs out of treatment, there’s nothing else left. Love can save a life.

We simply cannot share the dark inner recesses of other people’s lives.  To pretend we can, in the name of ‘compassion’ means the word has been hijacked and professionalised, sloganized, polished and devalued.  We cannot share someone else’s sorrow or fear but we can share our own, with them.

I wish that Lilley could sit with us in a "Reawakening Purpose" workshop and hear the extraordinary stories told by so many health professional – young and old. Time after time we hear stories that bring tears to our eyes. They tell of the extraordinary capacity of caring health professionals to leap into the chasm and be with their patients in the darkest places. It’s a capacity to be vulnerable, to step beyond any sense of knowing what to do, and to witness pain, despair and suffering without having to ‘fix’ it. From these precious moments of deep connection arise a mysterious force of healing. This is the nature of compassion. There is no pretense.

Compassion is a fad-word; it trips easily off the tongue.  It’s neat and smooth and not right. 

Yes, when politicians and health leaders glibly talk about compassion, it can become a fad-word. But let’s not devalue the deepest expression of caring in our healthcare system – compassion is what called most health professionals to join their profession.