The Caring Approach: A Review of Virtues in Modern Patient Care
A deadly disease known as Hansen’s disease, almost nonexistent in the United States, is a major public health issue in other parts of the world, with 662,412 new cases between 2012 and 2014.1 The disease affects the nerves so that as it progresses, numbness and paralysis develop.2 Unable to feel external pain, patients do not realize when they touch something that burns them, they bleed excessively from ignored cuts, and they do not treat wounds because they are not bothered by them. This makes the burns, lesions, and injuries worsen and the body deteriorate. The disease is widely stigmatized, and many people hide their early symptoms to “avoid being shunned by their friends and family”3 which only makes them suffer longer without treatment.
Although there are treatments and programs today working to eradicate Hansen’s disease, throughout history it has been misunderstood, and people with it were more often shunned to suffer in isolation than treated. This was especially the case in ancient civilizations. Traditionally, Hansen’s disease patients were thrown out of society, not to be seen or treated by anyone. However, one man was not repulsed by or afraid of this disease. In fact, he actually expressed being “willing” to treat a Hansen’s disease patient and incredibly, was able to heal him.4 He exemplified the compassion, sympathy, and empathy that is seen by members of the World Health Organization and others today who seek and treat Hansen’s disease patients, but thousands of years ago, when these qualities were so much rarer, that was much more impressive.
Compassion, sympathy and empathy were revolutionary characteristics in ancient times, but are now expected of healthcare providers. The first principle on the American Medical Association’s Principles of Medical Ethics is, “a physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.”5 Similarly, the Hippocratic Oath, taken by all students upon graduation from medical school states “I will remember that…warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”6 Compassion, sympathy and empathy are not just qualities that come to mind when someone describes his or her doctor, rather they are part of the very framework of the healthcare profession. They define the identity of physicians and nurses, enabling us to literally trust them with our lives. But why do we attribute these qualities to healthcare professionals in the first place?
Long before the advanced medicine of today, medical treatment was not very effective in ancient civilizations. In that time, Jews, Greeks, and Romans alike largely attributed sickness and disease to divine punishment for sin. With such a diagnosis and misunderstanding of the cause of disease, methods for treatment were limited to “magic and folk medicine”7. The alternative to ritual remedies like reciting verses over burning branches8 was to completely disregard the sick as members of society. Ancient Greeks believed that “health and physical wholeness were essential to human dignity, so much so that life without them was thought to be not worth living”9. Someone with a deformity or deadly disease was cursed, was a danger to society, and was often written off as a lost cause and exiled in order to protect the healthy from the same fate.
To the sick and their families, especially those who were poor, anyone willing to risk their own health to tend to a disease or disorder was a savior. Despite their compassion, however, those who did were often unsuccessful because of the lack of medical sophistication. So when a man came along not only attending to the dying and dead (those socially unworthy of acknowledgement), but nursing them to health with a single touch, heads turned both in admiration and in skepticism. In his treatment of people like the Hansen’s disease patient, also known as a leper, he compassionately went where no one else would dare go, seeking the sick and deformed to sympathetically and empathetically care for them.
The Bible recounts that much of Jesus’ teaching was centered on healing. He embodied compassion by touching the skin of people no one even wanted to lay eyes on, and in so doing, restored their physical conditions. Witnesses were shocked and amazed by the physical works He performed, though they merely symbolized the even more incredible healing Christians believe Jesus performed on the soul. For example, after forgiving a paralyzed man of sins, lawmakers criticized Jesus for “blasphemy”, for they believed no man had the authority to forgive sin. To prove to them that through believing in Him, a person could be freed from sin, Jesus then instructed the paralyzed man to get up and walk, which he did.10 If Jesus’ personal compassion produced physical miracles, then that divine compassion is the means through which humanity can mend their souls.
Sympathetically approaching the sick people He healed, Jesus would have had to risk His own health. That risk reflects the sacrifice the Bible says He made to deliver people from their suffering on Earth to eternal life in Heaven.11 Remember that sick people in that time were disregarded in an effort to keep the rest of society healthy; there was no sympathy for them because their diseases were thought to be consequences for sin.12 To tend to a sick person was to sacrifice one’s own health. Again, Jesus’ physical healing of bodily ailments pointed to the far more miraculous works Christianity teaches He did for all humans. His compassionate sacrifice of Himself, His health, His reputation among lawmakers and church leaders, as well as the respect and belief people had in Him, was a mere demonstration of the sacrifice Christians believe He made in becoming man and dying for our sins.
Paul Kalanithi was a neurosurgeon in his last year of residency. He had an impressive résumé and was very skilled at his work. His advisors had told him he would be able to obtain any job in the country he wanted, even hinting that Stanford, his alma mater, would almost certainly hire him if he applied to a position that was not yet open. Then, at 35 years old, about to become a practicing neurosurgeon and professor of neuroscience, he was diagnosed with terminal lung cancer. He continued working, finishing residency while undergoing cancer treatment. Of the incredible experience he had saving lives while his own deteriorated he wrote in his autobiography, “as a doctor, I had had some sense of what patients with life-changing illnesses faced – and it was exactly these moments I had wanted to explore with them. Shouldn’t terminal illness, then, be the perfect gift to that young man who had wanted to understand death? What better way to understand it than to live it?”13
What better way to understand it than to live it? What better way for Jesus to understand the life of pain and sin from which He was saving humanity than to take on human flesh? Paul Kalanithi was known to be warm and caring toward his patients before his diagnosis. Imagine how much more compassionate and empathetic he was after. How understanding would your doctor be in explaining your treatment plan if he had just come from an appointment with his own oncologist? How much more comfortable would you be with him? How much more would you trust him to care for you? Jesus’ followers then and now trust Him to heal them and to save them from sin and pain because He lived and understands the human experience. If a dying doctor can understand his patients in ways beyond the training and superb intelligence he had, imagine the level of care and compassion Jesus has for people on Earth after having experienced their pain.
Having compassion for those no one else cared about was just part of what Jesus’ healing miracles demonstrated. Christians believe His greatest miracle involved His suffering extreme torturous pain in order to save humanity from sin. He understands physical pain because He felt it in thorns,14 nails15 and sword.16 He understands our fear of dying because He feared His inevitable murder.17 Beyond sympathy, Jesus demonstrated the empathy necessary to heal a person. Remember that the Hippocratic Oath emphasizes that “sympathy and understanding” 18 can be more powerful than even medical technology. Understanding is key to a doctor’s ability to treat and heal patients. As Paul Kalanithi wrote, sharing the patient experience can provide incredible insight into truly understanding it.19 I believe Jesus did just that, taking on the human experience, suffering pain and death in order to show us the understanding He has for each of our own sufferings and allowing us to trust Him with saving us from them.
Despite being demonstrated by Jesus so long ago, in a time with so little medical knowledge, sympathy and empathy are still central to the way sickness and injury are treated today. Why are these the qualities still sought after in a physician or nurse? Why do graduating doctors still vow to remember these attributes as even more powerful than their physical tools? In showing compassion, sympathy and empathy through His miracles, Jesus also revolutionized the way we approach the sick by demonstrating how powerful these qualities are. And though they may have been demonstrations for the healing of our souls, they were still impressive medical miracles that would produce long lasting effects when Jesus sent out His disciples to spread God’s word.20
Johan D. Tangelder explains how Jesus “expected his disciples, along with their teaching to heal.” Jesus told them, “when you look after the sick, you look after Me.” Tangelder documents the early Christian missionaries’ journey spreading God’s word and Jesus’s compassion to the Romans. He cites the difference between Roman and early Christian medicine as a lack of compassion in Roman medicine, while Christians would disregard their own safety in order to heal. As this selfless approach to treating sick people spread, early Christians were able to treat more sickness, and the field of health care grew.
In the first hospital, which was built by St Basil in Caesarea in 369 A.D., “deaconesses worked as nurses, visited the sick and the poor, contacted pastors for spiritual care when deemed necessary. Christians searched for the sick in the city, and the latter were brought to the hospital.”21 The first hospital was a network of people carrying out God’s work in the way Jesus had demonstrated. Compassionate enough to seek out the sick, sympathetic enough to gather them and treat them, and empathetic to the common human needs of the soul as well as the body, these hospital workers continued Jesus’ healing works. Of course, medical technology was not what it is today, but the first hospital laid the foundation for that technology to grow. The qualities of a health care professional, those qualities which are still valued today, at times even above “the surgeon’s knife or the chemist’s drug”,22 were instilled in a place that welcomed the kinds of people who had previously been disregarded.
Those values that Christ taught were the driving force behind early Christians’ mission to heal, and remain imperative to the same mission two thousand years later. Compassion, sympathy and empathy were first embodied medically by Christ as He demonstrated that He could save lives eternally, and have now become archetypal characteristics of healthcare professionals. And He instructed others to care for the sick the way He had, spreading those characteristics and fostering the love of caring for others that physicians still have today. Perhaps by allowing us to identify healthcare professionals as possessing these qualities, and consequently, trust them with our lives, Jesus still demonstrates that we can trust Him with our lives as well.
1 Leprosy. (October 2016). World Health Organization.
2 Hansen’s Disease (Leprosy). (April 2013). Centers for Disease Control 3 Advocacy. (2016). Leprosymission.org. 4 Luke 5:13. NIV 5 Principles of Medical Ethics.(June, 2001). American Medical Association. 6 Tyson, P. (March, 2001). The Hippocratic Oath Today. PBS.org. 7 Ferngren, G. (2009). Medicine and Healthcare in Early Christianity. JHU Press. 8 Sickness in the Ancient World. (2016). Biblehistory.com. 9 Ferngren, G. (2009). 10 Mark 2:3-12. NIV 11 Revelation 21:4. NIV 12 John 9:2. NIV 13 Kalanithi, P. (2016). When breath becomes air. Random House. 14 Matthew 27:29. NIV 15 John 19:18. NIV 16 John 19:34. NIV 17 Matthew 26:38-39. NIV 18 Tyson, P. (2001). 19 Kalanithi, P. (2016). 20 Luke 9:2. NIV 21 Tangelder, J.(February, 2007). Reformed reflections: A Christian perspective on healthcare. 22 Tyson, P. (2001).