“Human presence is a creative and turbulent sacrament, a visible sign of invisible grace”. John O'Donohue

Friday, 9 November 2012

Time for compassion

 Health care is not a usual topic for me on this blog. Partly because there are many better informed and more erudite commentators on the subject than I am. Also because I tend to try and steer clear of any criticisms, working as I do in partnership with the health care system. 

But compassion seems like a legitimate topic for Ceibhfhion to tackle.

The last time I visited  my GP was not a happy experience. I won't relive the details but the basics are: she made some very judgmental comments. I  got angry. When I'm feeling vulnerable I typically respond to my  anger by getting upset and emotional. She showed no signs of compassion or care and, sticking to the allotted 10 minute appointment slot, coldly let me  leave her surgery in floods of snotty, hiccupy tears without so much as the offer of a Kleenex!

I was not looking forward to the follow-up appointment on Monday. I thought of requesting another doctor. Not an option unless I wanted to wait a fortnight. And then I thought the right thing would be to discuss my feelings about  the last appointment with her. Perhaps not. In the end, I decided that the best way would be to go, ignore anything she said and just get it over with.

What actually happened, I didn't plan. Perhaps as a result of my own recent deeper exploration of mindfulness.  I went in to meet this other person, a woman, just like me, with fears and anxieties just like me, with a life and a family and good days and bad days. Just. Like. Me.

I realised that whilst I believed I was angry because of her lack of compassion for me, my anger was partly a product of my own lack of compassion for her. She got me on a bad day - snot and all. And I clearly got her on a day when her capacity for dealing with the snot-and-all had worn a little thin. It happens.

Okay, so in that scenario  she's the carer and I am the patient and perhaps it is her job to be compassionate. True, but my point is not about whether she acted appropriately but whether I reacted appropriately. I discovered that my capacity for compassion - for myself and for this other person - may well have completely transformed my earlier experience and perhaps every subsequent experience I have with her.

In my work with cancer patients I have the luxury of spending up to an hour with each person I see. And in that time I guarantee that I will learn more about that person, possibly even in the first ten minutes, than most of his/her doctors will ever know, because they do not have the luxury of time. When an appointment is restricted to ten minutes ( the standard In Scotland due to 48 hour waiting time targets) and it's important, in that time to try and get to to a diagnosis, it sort of follows that one of the first things to suffer is the bedside manner. My dog is given more time, and shown more kindness and compassion when we take her to the vet. Certainly, we pay for the privilege, but we do actually also pay for the NHS too, if not at the point of care.

It may not be that the doctor is lacking in compassion, only in the time to create an environment in which compassion is at the heart of the interaction. Fearful of misdiagnosing, or missing crucial information, and mindful of a full waiting room, then perhaps it is understandable why the ten minutes is not generally spent exchanging pleasantries.

And why I found myself out in the street when I hadn't had time to blow my nose.

"When we come into contact with the other person, our thoughts and actions should express our mind of compassion, even if that person says and does things that are not easy to accept. We practice in this way until we see clearly that our love is not contingent upon the other person being lovable. " Thich Nhat Hanh

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