When Pepa was informed that, due to the complications, she would be admitted in ICU from the ward, she told the health care professional that was attending she was afraid. The answer she received was: “Do you have any allergies?”.
Why this professional could not tune with the emotion transmitted and why was it ignored?.
Sometimes we are afraid of the fear of patients and we put a wall of protection. Walls protect, but they also separate and isolate. Scientific and technical training of health professionals can be excellent, but not always includes the management of the emotions of the patients, their relatives, and even less the owns, despite the fact that all of them are going to trigger during the professional life. With this difficulty in emotional regulation, and on many occasions, using the explanation seemingly rational “to be a good professional”, and a supposed “practicality sense”, we focus on the symptom, in sickness or the body… forgetting that everything happend in a human being, and leaving behind a wall of protection the true goal of our profession: attention to the person. As claimed with transparency and harshness the poet and ex ICU patient Miguel Paz: “What I am for you: sputum, viscera, holes, lean meat – and bridal- of the feet…”
We all are provided with empathy, but there are many factors that facilitate or difficult this capacity, some personnels and other professionals. The practice of empathy is a lesson to be learned and to be developed along the whole life, especially in health profession. Empathy supposes the affective participation of a person in a foreign reality (that centers on the feelings and situation of another human being). It is not the same as friendliness, which alludes to an affection feeling towards a person, the attitude or behavior; and it is not also the same as compassion, which supposes a step beyond empathy, since the aptitude to perceive, to feel and to share the emotional state of other, the impulse of relieving it is added.
The term empathy, mistakenly has been translated in multiple occasions as “putting in the shoes of other”. Would you walk well with a pair of shoes that are not yours? Of course not … We cannot put ourselves in the exact place of other. Only the person who lives the certain emotional situation knows to 100 % how the feeling is, because these emotions depend also on the interpretation of the situation, the personality, the history of life … And each of us have our own ones. What we can do is to put ourselves along with the person, with full presence, listening actively to what it is said to us (and not only with the language of the words), to leave that all this resounds in each of us and to feel it. This will be to start our empathy and will allow later an humanised clinical practice on having tried to answer to this emotional state compassionately.
Pepa can remember a cleaning lady of the ICU who whenever she came, she welcomed friendly and smiling, and one day she realized that the clock of the box marked always the same hour. She unhooked it, looked if the batteries properly worked and placed the stalks in the appropriate place. To do this, this person:
- was present in the reality of the other and saw the necessity (in this case, the feeling of being located temporarily).
- left that emotions resonate in herself that could accompany this situation (disorientation, fear, uncertainty…).
- collected emotions (without soaking them, accompanying, without making own the emotion of the other).
- acted to alleviate the suffering with a simple act that even not was explicitly part of her work of cleaning.
Anguish in the face of “the machine of the red light” she asked and no one explained if it was “good” or “bad”, the moments of shame during the corporal hygiene, the fear of suffering of family members that she could not see enough, the professionals who acted or spoke in the box as if she was not there … were combined with moments of welfare when the X- Ray technician explained step by step what he was doing, a nurse auxiliary sought the screen before washing her, a doctor explained in a simple way her evolution, a nurse helped to communicate when almost she could not speak… After almost three years, Pepa remembers every one of these emotions and how the different professionals reacted to them.
Empathy and compassion are the components of the vaccine against the allergy to the emotions we scare. We have not been taught these #humantools during the academic training, but it is never too late to learn. The interaction with patients is an opportunity to develop them. The generosity of ex-ICU patients as Pepa allows us to connect with their fear, feeling of insecurity, disorientation, sadness, as well as with their feelings of well-being, joy, hope… and participate in them. Give you permission in your daily practice to listen, to perceive and to act in consequence; you will be surprised by the end result in your interior and you will not need to raise walls.
(1) Miguel Paz Cabanas (2015). Oración de la negra fiebre. León: Eolas Ediciones.
Pepa (ex ICU patient) and Macarena Gálvez Herrer (Proyecto HUCI)