I thank Goetz for her thoughtful remarks regarding the Invited Commentary I cowrote, “Compassion and Health Care: A Discussion With the Dalai Lama.” As a caring fourth-year medical student, Goetz points out the difficulties caregivers have in maintaining compassion in the face of a clinical environment where constant stress and despair are often manifest. As was indicated in the Invited Commentary, compassion, though a natural emotion shared by virtually all physicians, is not easy to maintain when the focus of practice is on productivity and volume. The result is burned out caregivers and compromised outcomes for patients.
I agree with Goetz that the clinical environment must be designed to support compassion and provide caregivers with the opportunity and space to nurture this healing emotion. More broadly, bringing meaning to one’s life (as both a physician and a person) is greatly enhanced by understanding that compassion is a true source of goodness and joy. Yet, it takes mental discipline to sustain compassion. Poetry, art, and time for self-reflection and awareness are pathways to not only appreciate life more fully, but also to sustain a sense of compassion in everyone. I am pleased that Goetz took the time to share her sensitive and meaningful thoughts with us, and I hope she will maintain her focus on compassion in her journey to become an excellent physician.
Ralph Snyderman, MD
Chancellor emeritus, Duke University, and James B. Duke Professor of Medicine and executive director, Center for Personalized Health Care, Duke University School of Medicine, Durham, North Carolina; Ralph.email@example.com.