The science of compassion
Postgraduate medical journal
I recently met an anaesthetist called Robin Youngson who has had a most unusual career. He was brought up in various parts of the British Empire, as what he describes as an 'army brat'. He went to an English boarding school where he was badly bullied, before going to university and becoming an engineer. He then worked in oil exploration, saving up money in order to study medicine. He emigrated to New Zealand, where he became a senior anaesthetist. However, over the course of time he came to
... that there was something profoundly wrong with the way that he and most doctors were practising medicine. He gradually became aware of the automatic and detached manner in which he and his colleagues were working. 'As a doctor' he says 'I was the one to set the agenda, I had a single track purpose that I relentlessly followed regardless of what was important for the patient.' 1 He realised that he had experienced a kind of brutalisation in his medical training, similar to the experiences he had suffered at school. He acquired a belief that the only way to transform this approach to health care was for everyone to practice systematic kindness, both to themselves and those around them. He started to change his own behaviour, especially towards patients he had previously seen as 'difficult', or towards colleagues who had seemed 'uncooperative'. He observed the positive effects this had on them. He applied the same approach to teams and institutions, promoting compassion as an aspect of quality improvement projects, patient safety initiatives and organisational change. He began to collect evidence both in New Zealand and from around the world, to show how improvements in attitudes and behaviour can improve medical care. In 2012 he founded 'Hearts in Healthcare', a movement dedicated to rehumanizing healthcare. 2 He now lectures internationally on the subject, with a simple but compelling message: compassion is not just a cosy add-on to good technical care. It is the most important factor in achieving good health outcomes. In a book entitled 'Time to Care', 3 Dr Youngson brings together different strands of his experiences and ideas, and the evidence in favour of compassionate care. He writes of how health care has become industrialised, with an emphasis on carrying out mechanical tasks rather than making an emotional connection with patients, often leading to burnout and disillusionment in health care staff.