Bedside Manner:
The Case For Compassion

We hear a lot about the importance of compassion — and the lack of it — in medicine these days. Compassion comes from Latin words meaning to “suffer with.” If taken literally, compassion in healing seems irrational. Why would a medical professional want to suffer alongside his or her patient? Suffering with one’s patient might cloud one’s professional judgment. When sick, patients need the cool-headed objectivity of their doctor and nurse — not co-suffering or sentimentality. But compassion means more than “suffering with.” It involves entering the mind-space of other persons so completely that one senses what the experience of illness is like for them.

The reason why compassion matters in healing can best be seen at the bedside. My favorite example is an event from the life of Sir William Osler (1849-1919), who is often called the “father of modern medicine.” At Johns Hopkins Hospital in Baltimore, he revolutionized the teaching of medicine by bringing students out of the lecture hall for bedside clinical training, and created the first residency program for the specialty training of physicians.

After revolutionizing how medicine was taught and practiced in the United States and Canada, in 1905, at the peak of his fame, he was lured to England where he became the Regius Professor Medicine at Oxford. One day he went to a graduation ceremony at Oxford, wearing the impressive academic robes that are a feature of the occasion. On the way he stopped by the home of his friend and colleague, Ernest Mallam.

One of Mallam’s young sons was desperately sick with whooping cough. The child would not respond to the ministrations of his parents or nurses and appeared to be dying. Osler loved children greatly and had a special way with them. He would often play with them, and children would invariably admit him into their world. So when Osler appeared in his dramatic ceremonial robes, the little boy was captivated. Never had he seen a human like this! After a brief examination Osler sat by the bed, peeled a peach, cut and sugared it, and fed it bit by bit to the enthralled, speechless boy. It was his first nourishment in days. Although recovery was unlikely, Osler returned for the next 40 days, each time dressed in his magnificent robes, and personally fed the child. Within a few days the tide had turned and the little boy’s recovery was assured.

That’s compassion. Osler had the ability to enter so fully into the mind of the little boy that he knew how to entice him to take food. He made use of the boy’s imagination and wonder with his dress. He understood how to evoke a healing response in someone who was dying, all without the use of drugs or high-tech interventions. Osler was the intervention. Only someone who understands compassion is capable of such things.

Osler was noted for his ability to convey caring at the bedside of his hospital patients on brief visits. He cared greatly not only for his patients, but also for the young physicians under his tutelage. He wanted his tombstone to say only, “He brought medical students into the wards for bedside teaching.” His most famous saying was, “Listen to your patient, he is telling you the diagnosis.”

Some say compassion is out of date. These days, physicians have only minutes to spend with patients in most medical settings. No physician can make a house call on a single patient for 40 days in a row, as Osler did. But that is not the entire story. Compassion can be conveyed in moments; it is not proportional to time.

Compassion is not antiquated. It remains a crucial factor in healing and will never go out of style. It is always available for any healthcare professional who is wise enough to claim it.

Sources:

Bliss M. William Osler: A Life in Medicine. Oxford, UK: Oxford University Press; 2007.

Golden RL. William Osler at 150. An overview of a life. Journal of the American Medical Association . 1999; 282(23): 2252-2258.

This distinguished Texas physician, deeply rooted in the scientific world, has become an internationally influential advocate of the role of the mind in health and the role of spirituality in healthcare. Bringing the experience of a practicing internist and the soul of a poet to the discourse, Dr. Larry Dossey offers panoramic insight into the nature and the future of medicine.

Upon graduating with honors from the University of Texas at Austin, Dr. Dossey worked as a pharmacist while earning his M.D. degree from Southwestern Medical School in Dallas, 1967. Before completing his residency in internal medicine, he served as a battalion surgeon in Vietnam, where he was decorated for valor. Dr. Dossey helped establish the Dallas Diagnostic Association, the largest group of internal medicine practitioners in that city, and was Chief of Staff of Medical City Dallas Hospital in 1982.

An education steeped in traditional Western medicine did not prepare Dr. Dossey for patients who were blessed with "miracle cures," remissions that clinical medicine could not explain.

"Almost all physicians possess a lavish list of strange happenings unexplainable by normal science,"" says Dr. Dossey. "A tally of these events would demonstrate, I am convinced, that medical science not only has not had the last word, it has hardly had the first word on how the world works, especially when the mind is involved."

The author of twelve books and numerous articles, Dr. Dossey is the former Executive Editor of the peer-reviewed journal Alternative Therapies in Health and Medicine, the most widely subscribed-to journal in its field. He is currently Executive Editor of the peerreviewed journal Explore: The Journal of Science and Healing. His colleagues in medical schools and hospitals all over the country trust him, honor his message, and continually invite him to share his insights with them. He has lectured all over the world, including major medical schools and hospitals in the United States –Harvard, Johns Hopkins, Cornell, the Universities of Pennsylvania, California, Washington, Texas, Florida, Minnesota, and the Mayo Clinic.

The impact of Dr. Dossey's work has been remarkable. Before his book Healing Words was published in 1993, only three U.S. medical schools had courses devoted to exploring the role of religious practice and prayer in health; currently, nearly 80 medical schools have instituted such courses, many of which utilize Dr. Dossey's works as textbooks. In his 1989 book Recovering the Soul, he introduced the concept of "nonlocal mind" - mind unconfined to the brain and body, mind spread infinitely throughout space and time. Since then, "nonlocal mind" has been adopted by many leading scientists as an emerging image of consciousness.

Dr. Dossey's ever-deepening explication of nonlocal mind provides a legitimate foundation for the merging of spirit and medicine. The ramifications of such a union are radical and call for no less than the reinvention of medicine.

In 2013, Larry Dossey received the prestigious Visionary Award by the Integrative Healthcare Symposium, that honors a pioneer whose visionary ideas have shaped integrative healthcare and the medical profession.

Dr. Dossey lives in Santa Fe, NM, with his wife Barbara, a nurse educator and author of several award-winning books.