To suffer with: The poetry of compassion

Abstract

Suffering is the experience of distress or disharmony caused by the loss, or threatened loss, of what we most cherish. Such losses may strip away the beliefs and symbols by which we construct a meaningful narrative of human life in general and our own in particular. The vocation of physicians and other health professionals is, insofar as is possible, to relieve suffering caused by illness, trauma, and bodily degeneration. However, since suffering is an existential state that does not necessarily parallel physical or emotional states, to relieve suffering physicians cannot rely solely on knowledge and skills that address physiological dysfunction. Rather, they must learn to engage the patient at an existential level. However, medical pedagogy discourages such engagement and, instead, promotes psychological detachment, or 'detached concern.'In practice, medical education favors a process of progressive detachment from patients that devalues subjectivity, emotion, solidarity, and relationship as both irrelevant and potentially harmful. Such sought-after detachment (fortunately not achieved by most students and physicians) almost ensures that practitioners are unable fully to appreciate and respond to human suffering. The term 'compassionate solidarity'summarizes an alternate model of the physician's response to patients and their suffering. Compassionate solidarity begins with empathic listening and responding, which facilitate objective assessment of the other's subjective state; requires the physician to develop reflectivity and self-understanding; and is in itself a healing act. Going beyond compassionate solidarity, the physician may in some cases also understand the disharmony in the patient's symbolic world and, thus, be able to further relieve suffering through symbolic healing. Reading and writing poetry, along with other imaginative writing, may help physicians and other health professionals grow in self-awareness and gain deeper understanding of suffering, empathy, compassion, solidarity, and symbolic healing.