Education of Compassion

Update, March 2011

In 40 years of medicine, I have not been to nor heard of a medical school anywhere that teaches compassion. I’ve spoken at medical schools in 68 countries and keep in correspondence with medical students in 100 countries and there is a hunger for an education in compassion. Many have wondered: Can be taught? How can it be taught? Can it be measured? What are the common imagined attributes of compassion? Each culture finds its own words and descriptions for what compassion is. I was told in Peru 'compassion' has a pity part, so they use other words.

For thirty years I have encouraged, challenged, entreated medical schools to teach compassion, and offered that we would help. None had accepted until last year, in Lima, Peru, a medical school said, “we’ll try.” We set in motion a plan, not yet to create a course in compassion, but to study compassion for a year collectively with all the students who wanted to. I made a lot of suggestions for personal study and work/play groups. Why not take a real thoughtful look at compassion over the course of medical training? There are an infinite number of people to engage with, to talk of loving ourselves. At the end of a year we would get together and explore what we all found out about compassion. And after lots of efforts, to create a syllabus and self discovery course for medical students, to explore throughout their years of medical education.

In August of 2008 John Glick MD, Carl Hammerschlag MD, and I lectured at the school. There was lots of student and professor interest – it was exciting and it made us take a deep look at teaching compassion. We each wrote papers for the website.

Alas, Peru didn’t work out. It became apparent that there was no one at the school to spearhead the course and none of us could go live there. And this last year of planning left a very nice taste for the exploration of the teaching of compassion. Last year we initiated a similar exploration in three cities in Italy, “EduCare” (The Education of Care.) We were looking at the education of care in primary and secondary schools with three amazing Italian friends, Laura, Cristina, and Ginevra.

So now we regroup for other ways to explore the teaching of compassion, and we want to launch it at the American Medical Student Association Annual National Meeting on March 10th, 2011. Susan and I will keynote together there. She will present Gesundheit and I will invite students to join an exploration into compassion.

I suggest a two year study. I recommend that one student find 3 other students, ideally in their class, to form a study group, hugging group, theater group, etc. If other groups formed at our school you could cross-fertilize. Try meeting one day a week to explore each other and report findings. Four of the groups could meet once a month for a potluck or a slumber party.
What is compassion? Explore Everything!

There are only a few suggestions. You can make up you own. The core of my compassion, my love of people, comes from my mother. She gave me kinds of love that helped me discover loving people. Her compassion was sweet actions directed at others for the love of people, the delight of caring for others.

Here are things you could do over these next 2 years:

1. Keep a journal about your relationship to love and compassion. What is it? Ask everyday—How are you giving it? (Pay close attention. Be present.) How are you receiving it? (From everything, from strangers, from trees, etc.)
2. Do outrageous things for love, like clowning.
3. Actually see if you can produce the vibration of compassion for prolonged periods. What sustains it? (friends, having meaning, fun ...) What hurts it? (arrogance, apathy, tight underwear ...) Are there times you do not want to be compassionate?
4. Be observant of compassion in action around you, everywhere. Give details of its languages.
5. Become aware of compassionate projects around the world and plan on at least one elective at a project. Post these projects on this website and ideally how to contact them.
6. Explore the language of love and compassion. Read psychologists and poets, write essays on things you love. Add books you love to our book list.
7. How do you recognize love/compassion? Are there measurements?
8. Do we invite professors in on our exploration? Who?
9. How do you change performances of compassion in different situations?
10. At the small weekly meetings, find easy ways to present your findings to the group. Mention difficulties and ways they were overcome. Search for common languages to speak of these things. Keep notes. Bring questions for the group and preceptor. Find a preceptor from the staff at the medical school or hospital. Find someone who is really interested in the project maybe even will explore it with you. Within the first 6 months, relax the urge to pass judgement. Collect data and experiences and develop a passion for the project. Once a month, have 4 groups of 4 to get together for a potluck – to have fun, be affectionate, and explore inter-group similarities and differences in findings. It would be great to go clowning once a week or more often—to institutions like hospitals, orphanages, nursing homes and prisons, as well as streets, parks, shopping malls, buses. As you gain experience, try adding clowning (playfulness and engagement) to your personality. How do you find a preceptor? Think of who you know at school or hospital who can offer suggestions.
11. Encourage staff (doctors, nurses, friends, family) to ask for a 'compassion consult'. Sign up for one.
12. Have hug patrols. Create an Affection Room in the hospital, designed as a place to go either as a giver or receiver – operated by volunteers (grandparents and high school students, for example.)
13. Explore how you relate to other people on issues of class consciousness, race, age, sexual preference. Pay close attention. Decide to connect with people you don’t normally hang out with.
14. Explore this question: Should a medical student be evaluated for compassion and not graduate if they are not compassionate? How could this be evaluated? By whom? (patients, classmates, families of patients, staff?)
15. Should there be a way for students to give feedback, for example when an interaction with staff is perceived as rude or uncaring?

Tools That Help Me Be Compassionate

• Be a Twinkle in the eyes, a smile on the face and an excitement to meet.
• Engage eye contact
• Be fun and tender everywhere
• Turn off TV
• Develop all your interests
• Have a tender love for people
• Engage with the arts and nature
• Do volunteer work
• Practice organizing and following through.
• Offer Massage

Reading List

Books By Our Team:

Patch Adams, MD,
Gesundheit!
House Calls

Carl Hammerschlag, MD The Dancing Healers
The Theft of the Spirit

Bowen White, MD
Why Normal Isn’t Healthy

Other books of relevance

1. The Nature of Suffering, Eric Cassell, MD
2. The Illness Narratives, Arthur Kleinman, MD
3. Love and Survival, Dean Ornish, MD
4. Loneliness, John Caccioppo
5. The Doctor Stories, William Carlos Williams, MD
6. Love, Medicine, and Miracles, Bernie Siegel, MD
7. Caring, Nel Noddings,
8. Pathologies of Power, Paul Farmer, MD