A Little too Late?

In order to truly feel compassionate, we must "[adopt] progressive stages of a compassionate attitude"(Rinpoche, 91). However, at what stage does a doctor need to stop? I believe it is a very delicate scale and the more emotionally invested a doctor is, the more it has to take out of something else. Thus a doctor needs to understand how to value a patient in a detached manner, for as Dr. Cox says on Scrubs, "All we do is prolong here." Eventually, all doctors have to deal with loss, especially when on an average day at a large hospital one in three patients will die.

One in three patients dies at Sacred Heart Hospital.

"The first stage is to try to stop thinking of ourselves as being more important than others"(Rinpoche, 91). This stage is one that we should all achieve, especially doctors. If we can elevate everyone to our own level and treat each life as if it were our own, we can truly make a difference. This attitude is not specific to the field of medicine, either. We often look down upon others, and it never leads to any type of positive emotion or outcome. In valuing those around us, we better ourselves as people. This is simply the characteristic of being humble, but put into application because it also allows us to value others and put their agendas aside our own.
"The second stage is to try to mentally put ourselves in another's place"(Rinpoche, 91). This is simply the ability to put ourselves in another's shoes.

Although we don't literally have to try another person's (or animal's) shoes on, we do need to take a moment and imagine ourselves in their position.

A patient is normally delighted to see a doctor because a doctor can understand things normal people can't. Patients are delighted when doctors suggest they may be feeling something without the patient having to mention it. It makes them feel as if they are truly understood. A doctor can only do this by putting himself in the patient's shoes. It goes beyond memorizing side effects, but really looking at your patient and seriously suggesting some form of comfort.
Patients expect their doctors to be compassionate and knowledgeable.

Putting ourselves in another's shoes is harmless and I believe it is once again something that all doctors can do.
"The third is to regard others as more important than ourselves"(Rinpoche, 91). This is the stage where things get tricky. This statement does not mean that we put our patients immediate needs before our own; that is stage number one, seeing others as equally important. The third stage suggests selfless love and caring. It is even stated that "a mother's (or father's) feeling for a child is a very good example of the attitude we are striving for in the third stage in cultivating compassion"(Rinpoche, 92). It is much easier said than done, however.

Women are often completely changed after having a baby.

If we invest ourselves to the point that every patient we lose is like losing a child, it would obviously take some kind of a toll on the doctor. It may be easy for a lama to preach instant love and then detachment, but let's face it- that takes extreme conditioning. It is not something we can quickly and consciously decide to do. I don't believe the preceding steps even prepare a doctor enough to progress to the third. There is a good reason that "as you start to see more and more patients, you become a little less sensitive"(Rinpoche, 139). Aside from simply being exposed enough, it is a natural defense mechanism because we cannot stand to take fresh pain over and over again. Ultimately, when facing death, "they key point... is to let go"(Rinpoche, 147), and taking concern while fully accepting that you will have to let go in one way or another is love with detachment.

Religion and spirituality play very large roles in our acceptance of death. We can wish our loved ones well through words, prayer, or ceremony.

We have to be able to train ourselves so that suffering evokes a driving empathy in us, but not attachment or pain. "That is why training in meditation is so important"(Rinpoche, 101), because it teaches us to mediate our emotions. Another consideration is that this book is written for doctors, who are often very busy. It is ideal to "enter a monastic situation"(Rinpoche, 118), but it is not feasible for most doctors who may have difficulty finding the time to read this book. They have to attempt to train themselves as they go, "actively involved in the tasks of daily living"(Rinpoche, 118). "This is the most difficult path"(Rinpoche, 118), and there is no guarantee that most people will even be able to pull off this great feat.

In "The 12 Types of Med Students", the normal one is depicted as the one who quits. Demanding lifestyles often drive these students to the edge. (http://theunderweardrawer.homestead.com/twelvemedstudents.html)

Philosophy is great, but I believe that messages like those in Medicine & Compassion should be administered to doctors before their intense training, in the first two years of med school. All in all, the message is great, but it may be getting out there a little too late. Med schools should focus on creating well-rounded, knowledgeable, and compassionate doctors.
The Message needs to begin in med school. Yoga classes should be required!