Some health-care providers treat patients who have lost function as a regular part of their practice. One might expect that the more dramatic the loss, i.e. blindness, deafness, paralysis, the more compassion needed. However, any loss of function may be considered devastating to the individual who places great value on something others may not consider. The practitioner with great bedside manner is never complacent about exhibiting the utmost compassion for any and all losses experienced by their patients.

Upon first meeting with the patient experiencing a loss of function you should acknowledge the disability with an expression of life affirming spirit.

“I could never understand what you are going through, but I can assure you I know many people dealing with your same problem, because that’s my job.  I am here to help them all day, everyday. I’m here to help you.”

If the patient is receptive, your treatment and their recovery will go well, however if the patient is in the self-pity stage of healing, other tactics may be employed.

“There are two ways you can deal with your loss, the negative way or the positive way. If you choose the negative way, you will let this loss defeat you and you will never recover. The positive way to deal with your loss is to accept it and let it make you stronger, so strong, in fact, that you will be able to deal with everything that comes your way better than most people.”

You can work on your own life affirming speech, or perhaps tell the patient about some interesting or famous person who overcame the same problem and went on to conquer the world. Patients need encouragement and the knowledge that you and your team are there for them.

When you specialize in treating severely handicapped individuals, you might forget that aside from special physical needs they have special emotional needs. Treatment without compassion is not humane. I remember an internship at the head and neck cancer center where the chief of the service had us gather around severely disfigured patients while he described them as objects of interest and treated them without dignity. To show us anatomical points of interest he made each patient experience pain and gag to the point that several interns had to leave the room. He seemed to be devoid of any emotional understanding of their plight. To him these patients mattered little in the scheme of things. This doctor had no bedside manner.

LOSS OF COMFORT 

            Patients are often fearful and anxious when they go to their healthcare providers. Their fears can be psychological as in neuroses or obsessions, or they may be grounded in real life issues from the fear of a painful procedure to actual mortality concerns regarding a terminal diagnosis.

            The doctor with great bedside manner must deal with the fears and anxieties of their patients with extra time to allow them to voice their concerns and address them, both real and perceived. Offering comfort and confidence helps to allay the patient’s fears.

            If the patient needs your services, and you convey to the patient that you are going to do your best and that you are the best, it offers comfort. The patient feels they are now doing everything they can to deal with their problems.

            With a terminal diagnosis, it is imperative to offer hope even when there may be none based on your medical experience. There is always the possibility of miracles and you must keep that hope alive for the patient. Consider using statements like, “Even though the survival rate is low at ten percent, there is no reason you can’t be in that group, and I will do everything in my power to help you be in that group.”

While you should never give false hope, there is no reason to show any negativity. Humanity dictates that you always show compassion.

For the patient who is fearful of the procedure you perform, you must explain things clearly and realistically. You should inform them, “I will do everything in my power to make this as pain free as possible.” Naturally you should utilize the latest, greatest techniques to minimize pain.

You don't want to lose the patient's trust by telling them things that aren't true. If there is some pain associated with a procedure, prepare them and offer encouragement, much like the hand-holding required for an apprehensive child. You may have to offer a psychological hand-holding for the fearful adult. Use distraction techniques and have your auxiliary staff talk the patient through a difficult procedure.

When a patient is in pain, you may have to address the pain before moving forward. With acute pain, as might be encountered in the emergency room, it may take more than compassion and talking to the patient. In those situations you may need to resort to medication, sedation and even anesthesia to get the patient out of acute pain. Naturally, there are times you can't achieve that goal when you need to get medical information for the safety of the patient.

Situations that involve acute pain can frustrate the practitioner and that must be suppressed. That is the time compassion is needed the most.

LOSS OF LIFE

The loss of life is so difficult for most people to accept that it requires special scripting and study to become adept at delivering the bad news in a compassionate manner, and even then, it is never easy.

For tragic situations in medicine, you will need to have prepared responses and avoid anything that sounds detached. Never say to a patient’s family, “There is nothing more that I can do.” While you may know this to be the case, you simply must have a better way to say the same thing.

Quite often religion is the best excuse to offer comfort when preparing a family for the end. You don’t have to be religious and you can even be an outright atheist. It is not necessary to divulge your personal beliefs to comfort people at time of need. While they may curse you along with God, at least you’re in good company.

“We’ve done everything possible to help your mother, and now it’s in God’s hands.”

“What does that mean?”

“It means that everything medically has been tried. Now we’ll see what God wants for her.”

“But I don’t believe in God.”

“I’m truly sorry, and I hope you find comfort in your family and friends.”

____

“I am so sorry to have to tell you this, but while we tried everything available, your father didn’t make it through the operation. Though I could never feel your pain, I, too, lost someone very dear to me and my pain was overwhelming.”

While some may perceive mentioning your loss as self involved, others will appreciate that you, too, shared a loss and have some understanding of their pain.

If expressions of compassion don’t come naturally to you, memorize these lines and practice saying them in the mirror. Make up your own expressions of comfort, use others’, and learn each time you encounter responses from grieving families that make you feel awkward. Gradually, you will develop many offerings to help comfort those in need.

Physical manifestations of compassion like the embrace, hug, and pat on the shoulder are extremely effective nonverbal tools. The use of endearing names is another important ancillary form of expressing compassion. These techniques are detailed in the chapters, First Names, Endearing Names, and Touch and Delivering Bad News.