Chokyi Nyima Rinpoche

The road to compassion is paved with common sense, said Chokyi Nyima Rinpoche, a teacher of Tibetan Buddhist philosophy whose evening talk on July 7 in Snyder Auditorium launched a two-day program on expanding compassion and trust in medical training and practice.
A sensible approach to compassion may remedy the "compassion burnout" and "compassion fatigue" several audience members brought up in the question-and-answer sessions.

"All of us have the capacity to care for one another with loving kindness and compassion," said Chokyi Nyima Rinpoche. "It is part of our nature. But we need to improve upon it. We need to increase the quality that is already there."

Chokyi Nyima Rinpoche spoke part of the time through a translator, Erik Schmidt, as he offered Tibetan Buddhist philosophy combined with practical tips and humor. HSPH Dean Barry Bloom opened the program, observing the need for humaneness in health care.

Chokyi Nyima Rinpoche said that when a health care professional "has a kind and caring heart, the words that he or she speaks, the tone of voice, and the facial expressions naturally instill and generate trust. It's very powerful. The patient feels acutely that this doctor or this nurse really cares for me and wants to help me. That makes it easier for the doctor to heal the patient. That makes it easier for the patient to accept the cure."

Chokyi Nyima Rinpoche has co-authored with David Shlim a book used in the two-day program, Medicine and Compassion: A Tibetan Lama's Advice for Caregivers. The program and talk were sponsored by the HSPH Center for Continuing Professional Education. The Center's director, David Shore, co-chaired the event and focused on the concept of "return on investment" in trust in health care. Former HSPH Dean Harvey Fineberg, now president of the Institute of Medicine, also spoke during the two-day program. The July 7 event was open to the public and drew mainly health care professionals.
"This is a realistic viewpoint about how human beings work, about how compassion works, and how to train one's capacity for compassion," Shlim said. If compassion can become effortless, he continued, health care professionals can be more effective with less energy. Merely adding "be more compassionate" to your "to do" list will not solve the problem.

Several audience members commented on the frustration and difficulty that result from seeing patients one after another in time-pressured sessions. "At the end of eight or nine hours of seeing a patient every 15 minutes, it's hard to muster a whole lot of kind compassion on patient number 32 or 33," one woman said. "I'm too spent to be kind and caring. How do you sustain oneself as a doctor in that situation?"
Chokyi Nyima Rinpoche advised audience members to be realistic about time. Take a second or two for empathy to become more mindful and clear about the patient's needs.

"Then the priority should be to focus on how to solve the problem," he said. "It's not the job of the doctor to sit and suffer with the patient."
Otherwise, doctors get stuck under the load of suffering, which diminishes the ability of one's intelligence to solve the problem. Doctors are supposed to be concerned with how to cure pain. They need to know that the patient is suffering, and they need to acknowledge that pain.

Chokyi Nyima Rinpoche suggested that health care professionals engage in meditation to achieve a mindful state and to avoid feelings of anger, envy, and dissatisfaction. With these attitude adjustments, a person can aspire to the highest virtue, benevolence.

Such mindful compassion is needed to accommodate the fear, doubt, and pain that clouds the minds of patients, as if the physical sickness were invading their minds, Chokyi Nyima Rinpoche said. "You need a lot of patience, a lot of tolerance, a lot of energy."

The trust generated by a health care worker creates a more relaxed atmosphere, allowing patients to speak up more easily and disclose their fears without shame, he said.

The most important sincere words the patient needs to hear are short and simple, noted Chokyi Nyima Rinpoche: "We will do our best;" "Don't worry too much;" "Be strong;" "We need to work together."

--CCM