Appeared in The Catholic Virginian February 21, 2000

 Health Care: The Gospel of Compassion

I recently heard a talk given by Daniel Callahan of the Hastings Institute (Bio-Ethics Center) on the subject of "Care vs. Cure". In this week’s TIDINGS, I want to reflect on the connection that must exist between care and cure in our health care ministry. The basic component of that connection is compassion – a compassion that must greet and accompany the sick throughout the experience of their illness.

Originally, hospitals were founded primarily as centers of hospitality. Hospitals existed to care for the sick, to give comfort to those who were ill; to give meaning to suffering and to bring healing when healing was possible.

Today, all the emphasis is being placed on cure – even of those who are incurable. Many times life is extended beyond reason. Physicians have a sense of failure if death comes even from the most natural causes. The attitude today is "cure at all costs", no matter what hardship is placed on the patient or others and despite the major hardship of exorbitant expenditures. This cure mentality is actually driving up medical costs while, at the same time, 40 million of our citizens – a good percentage being children – are without any medical insurance coverage.

The one-sided emphasis on cure has tended, in a culture that already denies death, to make the practice of medicine more and more impersonal. All of us have surely had the experience of being treated as a social security number eligible for Medicare or Medicaid coverage rather than as a real person with real feelings, fears and apprehensions – and with little or no say about the prescribed treatment. I have heard too many stories of those who feel rushed in and out of a doctor’s office. People mention how a doctor’s visit to a hospital room takes place in a matter of seconds, with little if any conversation. One is lucky to receive a grunt or a nod which is optimistically interpreted to mean everything is fine.

I’m not blaming or faulting doctors. They certainly are under tremendous pressure to get patients well as quickly as possible – but with the results of leaving the patient perplexed, worried or confused. Today, HMO’s and PPO’s stipulate who your doctor will be, to which hospital you must go and how quickly you must be discharged. You can be discharged even if – while maybe medically ready – psychologically you could not safely go home, if there is no home to go to where someone is available
to give kindly care.

Care and cure should not be seen as an "either or", but as a "both and". Unfortunately, emphasis in today’s medical culture is cure at the expense of care. It is a known fact that much illness has psychosomatic causes or complications which are seldom addressed in today’s hurry-up society. Pills to go to sleep and pills to wake up take the place of healthy life-style. Go to any drugstore, and you find several rows of antacids on display as the magic cure for heartburn. I must admit that I have found
Rolaids or Maalox or other such magic drugs a great help on occasion.

It is not my intention to fault the medical profession or the health care provider. So much of the behavior I mention is economically driven – mostly by a third party. I am on a crusade for medical practice to become less impersonal and more compassionate. Compassion comes from the Latin words "cum" and "passio" which together literally mean, "suffering through with". I do not want the physician to feel my pain, but at least to know that I am in pain and want to get out of pain. I remember
hobbling into the waiting room of an orthopedic doctor’s office with a torn cartilage in my right knee. I knew, by the looks of everyone waiting there, that this was a room of compassionate people. They understood what my situation was all about.

Would that we could all have that same feeling from everyone around us – when we enter a hospital or go into a nursing home for the elderly, or when we ring the doorbell of a rectory or a parish office complex, a chancery office or even a business office.

Compassion does not require so much of our time as it demands our attention to the other. We must be present to the one hurting; we must affirm the other by recognizing the dignity and humanity of the other. We must make the other feel important and worthwhile. Compassion does not automatically lead to cure, but it does bring comfort and inner peace in accepting one’s illness – whether or not a cure is on the way. The greatest example of compassion was Jesus himself who was acutely aware of
the needs of others – perhaps even before their own self-awareness of those needs. Jesus reached out with love and kindness and even sympathy, but never in a condescending way.

Empathy is a word synonymous with compassion. One empathizes with the other when one resonates with the anguish inside another human being and identifies with it. Empathy goes beyond "feeling sorry for" or having pity on the other. Pity is only slightly warmer than indifference. Empathy goes beyond pity – which one can offer another without any real personal involvement or cost – to respect. Respect is the first step on the road to justice; empathy or compassion is the first step on the road to love.

Care or cure, both should go together in all that we do in the health care apostolate. Compassion should be the driving and motivating force for both. Health care ministers must be those who practice the Gospel of compassion. As we applaud and thank all those in the healing ministry, let us practice compassion on them because of the unreal expectations of others, the excessive demands upon them to be miracle workers. In whatever role, whether as the provider or the recipient of good help or kindly care, let us always give meaning to life itself and give reason to hope in the presence and care of a loving God.