Foreword to Medicine and Compassion
by Harvey Fineberg, M.D., PhD., and Donald Fineberg, M.D.
Harvey Fineberg is President of the Institute of Medicine of the National Academy of Sciences. His brother Donald is a psychiatrist in Santa Fe, New Mexico.
“A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.”
--The first principle of the Code of Medical Ethics of the American Medical Association
Every doctor knows what it takes to become technically competent: learn more about scientific advances and the latest, successful drugs and procedures. How many physicians, however, have any sense of how to become more compassionate? Are some simply more inclined than others to be compassionate? Is it how we are born? Can you develop compassion in the same sense that you acquire other knowledge and skills that make up the craft of medicine?
The thesis of this exceptional book answers clearly: the conscientious physician can learn compassion. It can be done. A remarkable American physician, David Shlim, has done it. More importantly, he and his co-author, the Tibetan lama Chokyi Nyima Rinpoche, describe how you can as well. Their approach to compassion in medicine emerged from their twenty-year relationship and derives from the philosophy of Tibetan Buddhism. It would be a mistake, however, to think that only an adherent of Buddhism could gain from reading, reflecting, and acting on this book’s ideas. Beyond a statement of philosophy, this work provides practical guidance to anyone who seeks to become more compassionate.
Michelangelo was said to sculpt by liberating the figure within the marble. In similar fashion, Chokyi Nyima Rinpoche teaches here that compassion lies within each of us and emerges after removing the stumbling blocks of greed, anger and ignorance. This requires effort and the mastery of technique, but compassion itself is not a technique. Compassion arises together with being a complete, understanding, and open person. In contemporary psychological terms, a focused intention to develop compassion takes advantage of the principles of cognitive consonance. Equipped with the knowledge of how to tap into your compassion, and acting on this understanding, you bring this feeling into your work and into your life. Your personal growth and professional depth go hand in hand.
The same qualities of mind that foster compassion—tolerating uncertainty, moment-to-moment awareness, openness to new information—can also engender better clinical decision-making. Compassion promotes competence. Compassionate physicians stay better focused on the true needs of their patients while taking full advantage of expert knowledge in treating them. In this way, compassion directly expresses “patient-centered” care, a key constituent of high quality in health care. Indeed, this concept was identified as a major dimension of quality in a report by the Institute of Medicine entitled, Crossing the Quality Chasm: A New Health System for the 21st Century, that was published in 2001.
Medicine and Compassion reminds us that a compassionate physician copes better than one who is not. Compassion not only produces better care for the patient, it also strengthens the physician’s ability to engage the difficult clinical situations of the terminally ill patient, the demanding patient, or the frustrated patient. Strengthening our compassion reminds us, too, of the motivation that led many to choose a career in medicine. In the face of multiple demands on doctors today, such reminders are more welcome than ever.
