(Image from G Carsten-Peters via Unsplash)
My job requires me to regularly evaluate trainees. “Evaluation” literally means “the action of appraising for valuing (goods, etc.); a calculation or statement of value” , according to the OED (which goes on to observe that this word is “now rare”). And the word comes from Latin ex- (out) + valere (to be strong, to be well). Literally, then, one might think that “evaluating’” should mean drawing out and emphasizing the evaluee’s strength or wellness. However. The OED says the verb “(to) evaluate” means “to express in terms of something already known”. So in evaluating, we are basically also judging — comparing to some standard.
Evaluating, especially in the latter sense, assumes expertise, or at least experience, on the part of the evaluator. Which, to me at least, implies distance (see “D”).
Examining patients (or, in a different sense, students who “take exams”) implies distance as well.
And it seems to me that distance, without conscious attention, raises the risk for what has been described as “burnout”.
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Last week my husband and I attended (virtually) a presentation of an art exhibit on the theme of the Good Samaritan. I was struck by the forceful depictions of “the one who showed compassion” as embodied: embracing, anointing, lifting. His care for the injured traveler was close up and personal, not distanced!
Taking full advantage of the benefits of Zoom, we immediately moved to another city for a (completely unrelated) discussion of a newly-released book on empathy. The author made the point that empathy requires vulnerability. She went on to suggest that to act ethically is to have, and show, empathy — and that this is, in fact, “the essence or authenticity” of being human. The parallel to the embodied Good Samaritan was impossible to miss.
The next morning, during my institution’s (again virtual) Grand Rounds, a colleague argued that we must go beyond empathy (“into” + “feeling” ie “understanding and appreciating another’s feeling”) to compassion (“with” + “suffering” - or “the feeling or emotion, when a person is moved by the suffering or distress of another, and by the desire to relieve it; pity that inclines one to spare or to succour.”). In fact, he presented this as the antidote to burnout (a topic of much discussion in health care of late - see below.) We can minimize the distress of distance by, among other things, taking time to extend compassion by listening to patients.
Aha, one could say— that’s why working in the NICU can burn people out! It’s almost impossible to listen to our patients! And, sadly, their parents often aren’t able to be physically present (a challenge even before COVID). No listening to be done here, right?
Well — even though babies don’t talk, they find ways to communicate. In any event, when we make time to listen, whether literally to parents or colleagues, or ‘only’ by paying quiet attention to a baby, it helps us at least as much as it helps them.
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So all this — embodiment, empathy, ethics, and compassion — was making a lot of sense. And yet, I still sensed a gap: a distance to be bridged. Because, even given all the public attention to “burnout” and “compassion fatigue” in health care professionals over the past decade or so, there’s very little evidence that we’re getting any better at avoiding or fixing it.
Isn’t it true that whether or not we’re health care professionals, most of us are already exposed to others’ suffering after a full pandemic year? And most of us would describe ourselves as empathetic. And we certainly try to listen.
Yet, more often than not, we still back off, distance, and submerge ourselves in anything but the real, embodied coming-alongside with our families, our friends, our colleagues, our patients … ourselves.
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On Monday of Holy Week, in the sonnet “Jesus weeps”, Malcolm Guite describes our “world that, weary with its weeping, /Benumbed and stumbling, turns the other way…” and goes on to conclude that “we might waken yet, and face those fears, /If we could see ourselves through Jesus’ tears.”
In the end — there is no way to “do self-care” and/or to “extend self-compassion” without personally knowing Jesus’ love (Ephesians 3:14-20) . He is God embodied and humanity exalted. He has embraced the essence of our weakness in order to offer us, by the Holy Spirit, His own energy and strength.
And He is risen indeed!
Happy Easter.