Compassion Fatigue

Katrina…Darfur….Haiti…Tsunamis…Jerry’s Kids…Homeless families…Oppressed women and minorities….

The list is endless and seems to be ever expanding. We are constantly exposed to images and stories of our fellow man who is suffering, and we feel a visceral tug that makes us uncomfortable or sad, energized or determined. As health care providers many of us struggle with the feelings of compassion for the ill and the realities of what we can and should do. With the internet and 24/7 instant global news, how easy is it to become overwhelmed by the suffering, and instead choose to withdraw and shut down.

I heard a new phrase several times this week - “compassion fatigue.” The first was in response to a young woman I saw in Milot with a recurrent fungating, locally invasive phyloides tumor of the breast. It had been excised multiple times, only to recur. She was in the tent, her dressings changed by family and volunteers. At age 23, she was otherwise in perfect health. In the States, she could undergo a wide resection and reconstruction, but the capacity was not available in Haiti. I spoke to several CRUDEM administrators who had arranged transfers of similar patients to several large academic institutions in the US. I filled out a report, took pictures, and made contact. Everyone was sympathetic but the story was the same – we are tired of dealing with the quake victims and others from out of the country that will require a huge outlay of resources, with no ability to pay, even a small amount. Although you could convince administrators and practitioners to give of themselves early in the disaster (and they did), the emotional bank was dry. I had to examine my own motivations as to whether I was doing the right thing even offering the hope of a resection. The jury is still out – I am using some personal connections with other institutions and caregivers that weren’t as involved initially who perhaps still have some emotional reserve.

Compassion fatigue also came up during sermons over the recent Jewish holidays. While we examine our own behaviors and their impact on others, we must also be sensitive to the emotional suffering of our fellow man, even if they have hurt us. Beyond that, in most religions, making amends includes charitable acts as a component of repentance. But with world suffering seemingly enveloping us, how do we feel, and yet not be overwhelmed? And when others are not compassionate toward us, is it because of their unwillingness, or their inability?

I know that as both a surgeon and a parent, I often struggled to let down the clinical barriers when dealing with my family’s illnesses. I remember one of my children showing me a cut and saying, “OK Dad, there’s blood, does it count?” Over the last year, with both my professional transitions and new experiences, I’ve also learned that there are endless opportunities to be compassionate. If you can’t do it all the time, it’s OK, as there are others whose bank is more full than yours. Appreciate the moment, and the satisfaction of relating to another’s suffering and trying to relieve it. Concentrate first on those around you that you love, so that they can be energized and supported. Then do what you can for the world.

And if you feel fatigue, take it as a sign that you’ve truly given of yourself. Rest, recharge, and refill. There’s plenty more to do, and the magnitude and variety of the list gives you endless opportunities.