LOVE AND COMPASSION

One of my favourite lyrics is found in a song by the Lumineers. The song is called “Stubborn Love” and the line is, “the opposite of love is indifference.” A quick Google search traces this quote to a man called Elie Wiesel. Born in 1928, he is a novelist, political activist, and Holocaust survivor of Hungarian Jewish descent.

 

When I first heard the song, I really connected with this lyric. I reflected upon my own experiences of being in love and recognised that once I had moved on, I felt neither love nor hatred. I stopped caring. I was indifferent.

If one regards individual emotions as being on a spectrum then surely the opposite of love is complete lack of love. Hatred is a completely different emotion. At one end is extreme hatred and at the other is no hatred at all.

So does this mean that to completely heal, one must remove all feelings of hatred and all feelings of love? For hatred yes, but for love – no. Removing all feelings of love would lead to indifference and a compassion-less state. Such a state is unloving and unkind. As we discussed in my last blog, if compassion is the path to happiness, such states of indifference can never bring us true peace.

Even if emotions are indeed separate entities one cannot deny the effect of one emotion on another one. For example, when we’re excited it is easy to become irritated. When we are bored it’s easy to become sad. What’s more, the more excited we are the more likely we are to get irritated and the more bored we are the more likely we are to become sad. It’s as if the exaggeration of emotions leaves us vulnerable to the negative expression of the same energy.

Could this idea be applied to compassion? If compassion is the path to happiness then is it not a logical deduction that the suppression of compassionate feelings can lead to unhappiness? Does the trapped energy of compassion manifest itself as anger, frustration and helplessness – the symptoms of depression?

Could this be a reason why rates of depression among medical students are higher than in their age-matched peers? Could it be that medical students tend to naturally have higher levels of compassion than others and hence are more likely to have suppressed levels?

WHY WOULD WE SUPPRESS COMPASSION?

We spend our lives doing things that bring us immediate pleasure. Whether it’s alcohol, drugs, sex or food, we are driven by our desires. Our drives for these things are so strong that often they become addictions. How then is it possible that we suppress feelings of compassion if giving others compassion gives us an immediate buzz and is fundamental to long term happiness?

I think it is a sad reflection of the society in which we live. For example, I often pass homeless people on my way to the hospital. Every time I see them I feel compassion towards them, yet, only occasionally do I stop to talk or give them some money. The fact is, I feel embarrassed. I’m self-conscious. I fear the eyes of passers by. I don’t know how to handle the gratitude of the homeless person. Each time this happens, compassion is suppressed within me. And how do I feel later? Frustrated and angry.

In medical school I often find it difficult to express the compassion I feel for patients. Not only am I embarrassed by the eyes of onlookers, but I am also aware of my limitations as a medical student and my inability, whether competent or not, to treat them medically.

WHAT CAN WE DO?

I think we have to be brave. When we feel compassion and there aren’t any barriers [besides our own reservations] we should act. When we feel compassion but there are unavoidable barriers we should do what we can, and accept that we can only give us much compassion as we are able. I think there are plenty of situations in life where we can express compassion to offset the suppression encountered at other times.

And as I started by discussing love I’d like to finish with it too. I often wonder why we feel so strongly about certain individuals. Why do we feel compelled to give greater compassion towards them than to others in our lives? Is compassion part of falling in love? Is this why being in love brings us great happiness? Is this why it can bring us such anguish?

And what about those times when we have to let someone go or give them space? What do we do with our feelings of compassion? To be truly compassionate is to do what’s right for them, even if the most compassionate thing is to do nothing. But why doesn’t this make us feel happy? Why are we left with a such an unexpressed pool of compassion? Because we’re not perfect. We all have our own weaknesses but in having the strength to give compassion, despite our own pain, we can take great strength. And we must remember, there are many millions of other people in the world willing to accept our compassion. Just walk down the street. If you feel compassion, give compassion. It’s the act that expresses the emotion. It’s the act that cultivates feelings of happiness. Happiness may come from within, but we can’t get there alone.

 

 

 

 

 

?

 

 

 

 

 

 

 

 

 

 

 

Compassion isn’t abouts acts, it’s about intention. Sometimes the most compassionate thing to do is to do nothing.

 

Empathy: what is it anyway?

What does it take to be empathetic? Can we ever truly put ourselves into someone else’s shoes if we’ve never had the same experience? Of course we can’t. I have no idea what it must be like to live with chronic pain nor can I imagine the horror of experiencing my own cognitive decline in a progressively degenerative condition. The truth is, we’re never going to understand what the vast majority of patients are really going through. Suffering might be a universal experience but each person’s suffering is a completely subjective one.

However, in spite of this, I believe that whatever the cause of suffering might be, the subjectivity of pain and distress can, ultimately, only be expressed through a limited set of emotions, ones that have evolved over millennia and ones that we all share; the likes of sadness, fear, grief and guilt. Therefore, I would argue that it doesn’t actually matter whether we can or cannot put ourselves in someone else’s shoes. All that matters is that we can appreciate the features of what makes each one of us human.

If we have all experienced the same basic emotions, albeit to varying degrees, why is that some struggle to show empathy while for others it comes almost naturally? Is it down to our individual personalities? Is it dependent on our lifetime exposure to suffering or perhaps our lifetime experience of it? I suspect, like so much of medicine, it’s a combination of many factors.

For me, my own personal experiences of mental ill health have given me a rich taste of a wide range of human emotions. Periods of depression have given me an appreciation of sadness and guilt while anxiety and panic attacks have given me insight into the extremes of fear. Even relationship break-ups have enabled me to get a taster of living with loss and loneliness. I feel very lucky to have had the opportunity to experience all of these different emotions and even more lucky to have been able to gain such an insight in the process.

If I’m being completely honest, sometimes I do feel like my anxieties are a huge burden, limiting my potential and risking my success. However, I know deep down that I am blessed to have experienced first-hand the delights of the human mind. I can sense distress and unease much more quickly than many of my colleagues and the often subtle signs of emotional hardship leap out at me like an old friend. My experiences will make me a better doctor and I would prefer to battle uphill with a clear appreciation of how others feel than to sail through medical school lacking in emotional depth and most of all, empathy. Therefore, I think we should all embrace our own struggles with mental health as they really can be used for good. You may not pass medical school with empathy alone but in my opinion, you will never truly succeed in medicine without it!

There was a time when I thought that the quote below was the perfect discription of the human experience. However, I hope you agree that this should never be the case as happiness and sadness are equally as relatable. As medics we have a unique opportunity to help those who suffer to feel less alone and it is through empathy that we can achieve this. Let’s use our own suffering for good.

“Laugh and the world laughs with you; weep and you weep alone” Ella Wheeler Wilcox

“Laugh and the world laughs with you; weep and the world picks you up!” anxious_medic

We’re not gatecrashers!

Have you ever been dragged along to one of those parties where you don’t know anyone there? If you have, then you are also likely to have experienced that uneasy moment when your friend, and only ally, either goes to the toilet or moves away to talk to someone else. Suddenly you become very conscious that you’re standing alone while everyone around you is relaxed and chatting enthusiastically to one another. If you’re anything like me, you enter a bizarre state of hyper-awareness, as if a spot light is following your every move. Then the weird behaviours begin… Here are my usual two:

• I repeatedly check my phone, as if I’m expecting hundreds of urgent text messages (…unfortunately I’m not quite that popular..!)
• I begin knocking back my drink at a socially unacceptable rate!

It’s awkward. You feel awkward, others feel awkward for you, and you feel more awkward knowing that they’re feeling awkward. Yuck. Hardly surprising that we try to avoid such parties is it?

So what has this got to do with medicine?

For or me, entering the wards used to feel like turning up to one of these parties. From the first moment I stepped inside I would feel a sense of awkwardness. I felt like a phony, a gatecrasher at someone else’s event. Unfortunately, this wasn’t the kind of party that I could stand in the corner and down my drink. I had to mingle! What’s more, as far as I was concerned, everyone at this party was older, wiser, had more expertise and many of them seemed to respect each other more than they respected me. Many were tired, some were stressed and most looked like they would have preferred to be somewhere else. The dreaded spot light was overhead and I even had to advertise my gatecrasher status with a sign around my neck saying, “I’m a medical student”. How awful. With these kind of thoughts it’s no wonder I felt anxious being on the ward.

However, I began to realise that it wasn’t the hospital that made me feel this way, but rather the hospital was the perfect medium through which my underlying anxieties were expressed. The idea that the hospital was an unwelcoming, scary place was simply wrong. It was a belief based purely on my own insecurities. The truth is, I felt inadequate. I was intimidated by being in an environment where I felt like I knew, comparatively, very little.I felt self-conscious and under scrutiny, surrounded by people who I admired greatly, people I felt inferior to.

You can’t gatecrash a party that you have an invitation for!

We’re expected to be in the hospital and more often than not, we’re wanted there too. The vast majority of healthcare professionals actually like us being around – really! They enjoy teaching us and respect us for having the courage to actively seek learning opportunities. We shouldn’t feel intimidated by the knowledge of doctors. They were all where we are now and with time we will know just as much as them. We should never feel inferior, no matter who we’re talking to. We’re all human beings and as such, demand equal respect. It’s no more important for us to be polite to consultants as it is for them to be polite to us. We’re in the hospital to learn and we’re expected to have gaps in our knowledge so we shouldn’t feel stupid. The fact that we have made it this far shows that we know enough at this stage and we have a life time of learning ahead of us.

We also make more of a difference on the wards than we give ourselves credit for. We allow staff to improve their teaching skills and we can help with tasks such as venepuncture and catheterisation. Perhaps more importantly, patients like us being around too! While doctors and nurses are busy, we can actually spend time with patients and brighten up their days. Many feel delighted that they are able to help with our learning and this can give them a sense of purpose when they may otherwise feel like burdens.

So, we may feel like outsiders but that’s all it is, a feeling, brought about by our own fears of inadequacy and of inconveniencing others. The fact is, we’re wanted, we play an important role and we have as much right to be there as anyone else. The hospital is our theatre and the stage is ours to share, so lets start enjoying it!

Is medicine actually stressful?

Brace yourselves. I’m about to say something controversial. Medicine isn’t stressful. I know this for a fact. Actually nothing is stressful. Erase stressful from your vocabulary.

“But you’re an anxious medic?” “Yes I am”

“And you’re often stressed?” “Yes I am”

“Because medicine is stressful?” “NO”

I can understand that this sounds a bit ridiculous at first glance. However, I want to argue that there is simple proof that makes what I am saying correct. Do you know of a medical student who appears completely relaxed about the course and stresses very little or at all? Of course you do, we all do. Oh how we despise these people! Surely they don’t care. They can’t. If they cared about their future they’d worry about failure. If they cared about medicine they would worry about making the wrong decision. Yep, either they don’t care about the course or they don’t care about people. In fact, maybe they’re just completely arrogant. Actually, yeah, that’s it, they’re big headed. Thank goodness I’m not like them… I’d prefer to be stressed and care than to be calm and cruel…..! However, the very fact that there are medics who barely seem to worry proves that it is not medicine itself that is stressful. I would actually go as far as to say that this pattern is seen in every degree and in any career. Some seem to float effortlessly through life while others flounder, even if these individuals are exposed to the same challenges.

“But, anxious_medic, look at the statistics!”

It is true, stress levels in medical students have been found to be on average higher than in other people. The key word is potential. Medicine has the potential to be stress provoking. And my God, potentially, medicine is an extremely stress provoking place! There are stressors flying at you from every angle. If stressors were water we’d be in full scuba gear in most clinical situations…

“Well thanks anxious_medic, now I can’t even blame the course. It really is my fault. I’m doomed.”

No. This is fantastic news! Being able to accept that we are completely responsible for our own anxieties is the most important step in overcoming them! Imagine this: if we have total responsibility for our own anxiety, we have the ability to be in complete control of it. We don’t have to worry about what happens in the hospital, or anywhere else for that matter, because we can handle it! So yes, I am an anxious medic. I know I am yet to overcome my own anxieties. However, I fully accept that the problem lies within myself, and it is only by addressing this, that I will be able to face the unpredictability of medicine with confidence and resilience.

Accept and own your anxieties but relentlessly reject any thoughts that there is nothing that can be done about it!

Pah! Medics can’t be anxious!

Hi everyone, thank you so much for taking the time to read this. I’ll start by explaining a bit about myself and what inspired me to begin writing this blog.

I’m a medical student in the UK, currently in the midst of clinical medicine. Like most medics, so far in my life I have excelled academically. In fact, I have yet to fail an exam. I come from a relatively comfortable background and I have a strong support network with a great family and caring friends. I have enough money, I live in a safe environment and have been fortunate enough to travel to many different parts of the world. I enjoy running and keeping fit, have a passion for live music and attend as many concerts/gigs as I can. I am ambitious, driven and am determined to make a big difference. Just your typical medic really.

However, time for a confession. I lack confidence. I worry. I stress. I dread. I’m scared I’ll fail, I’m scared I’ll get kicked out, I’m scared I’ll hurt a patient, I’m scared I’ll let myself down, I’m sometimes even scared I’ll succeed! Does any of the above sound familiar? Oh wait, hang on – we’re medical students – we aren’t meant to show weakness. We must be confident, resilient individuals who can handle pressure and thrive in moments of uncertainty. That’s rubbish!

I am determined that my anxieties will not stop me. In fact, I aim to use them positively to help others who feel the same, and to use my experiences, good and bad, to become a more empathetic doctor. I hope that you will join me on this journey and we can prove together than anxiety is merely another hurdle that we can all overcome.

My blogs will reflect upon my own experiences of medicine and life, in a positive/humorous way, and I sincerely hope that they can be of some therapeutic benefit – even if it’s just a case of “thank God I’m not as bad as him!”.