Compassion is Complicated

Paul - Durham
Entered on October 5, 2008

Compassion is Complicated

I used to believe that compassion required an open heart – an emotional connection that implied a certain vulnerability. But after working for fifteen years as an ER doctor, I believe compassion is more complicated than that.

One morning, several years ago, a mother rushed into the ER where I worked. She carried a floppy, blue, infant. Our most skillful nurses tried, but failed, to establish an intravenous line – one of the essential steps in a resuscitation. When this happens, the life-saving intervention is to hold the chubby little leg in your left hand, and with your right hand, jam a needle the size of a finishing nail down through the skin and muscle and into the bone itself. The IV fluid runs into the marrow, and from there, into the bloodstream. If you can wiggle the needle, it’s not in the bone. It should feel solid – like a nail driven into wood.

So, that’s what I did. I felt a crunchy little “pop” as the needle broke through the cortex, and into the marrow. It was quick, brutal, and effective.

But when I stepped outside the ER to talk with the mother, whose face had drained of color, I had to soften the edge that I’d brought forward to resuscitate her child. I had to unclench my shoulders, my face, and my voice. Without that extra step, the harshness I had summoned to skewer her infant’s flesh would’ve wounded a woman who was already burdened with the visceral knowledge that her child might not survive. She had after all, carried the lifeless baby in her own two arms.

This effort of opening and closing one’s emotional aperture is exhausting work, but I believe it is essential. If we remain habitually detached, we lose connection with the people around us. If we stay detached long enough, we’ll lose connection with ourselves.

Working in the ER, if I remained fully open to the steady stream of pain and suffering that flows through our doors, I would be paralyzed; unable to do the necessary work of spiking a needle into an infant’s leg.

So, yes, compassion is sometimes an emotion. But I believe that it is also a discipline, a habit that is acquired through practice. I believe that it involves judgment, and the humility to know when to pack our own emotions away, for the good of another.