Conspiracies of Kindness

This book is written for anyone who takes the matter of compassion seriously. In such a time as we live, I dare say nothing is more important. Simple-minded and stubborn, this book proposes that compassion is a craft and thus can be learned and practiced like cultivating crops or raising animals. The refinement of compassion, like any true craft, is a life s work. The transition to caring for the ill is as fierce as any tribal rite of initiation, though few speak of it as such. From listening to the stories of doctors and nurses, three intertwining themes emerge that define the struggle to keep the heart open. First, there is staggering within the reality of suffering, the sheer mass of unanswerable needs. How does one sift through overwhelm and find the person of the other, as well the presence of oneself? How does one gracefully discern what can be given and what cannot? What is the place of kindness and generosity towards oneself? Second, there is the specific shape of oneself, one s wounds, one s fears of giving and receiving compassion. Many of us were told as children and in our professional training not to feel too much. Clinical distance was praised as professionalism. Watson, on the other hand, writes that authentic connection and responses are necessary as an ethic: the authenticity of the self reveals the integrity of the professional. Relationship-based caring, a new and ancient shift of paradigm that is beginning to reawaken the soul of medicine, is fundamental to this book. Last, as Aldous Huxley wrote in The Perennial Philosophy, the institutions of the modern world are based on organized lovelessness. Thus again the severing and reestablishing of relationship. Every healthcare provider has experienced the systemic crushing of the compassionate impulse if only through something as brutal yet ordinary as understaffing. The heart closes when one is in a hurry. This book progresses through the interplay of reflections and stories, many of them my own, some gathered from others. The names of the ill have been changed to protect the privacy of individuals. The book also includes interviews with other healthcare practitioners, who offer their own perspectives on the practice and experience of compassion. Their names have not been changed. They are elders, people who have walked the path of compassion long enough to act with depth and directness. They are not unique. No doubt elders of their caliber walk the halls of healthcare facilities across the country. Their colleagues and patients know them. When one strips away the cliché and sentimentality that sometimes attach themselves to the word, what is compassion anyway? How does one realize it? What is compassion in truly hopeless circumstances? How does one bring heart to a heartless situation? These two words, craft and compassion, then, twine into a single idea: the craft of soul-making in the activity of compassion. The gesture toward a suffering being is at the same time a gesture towards one s own awakening. This craft requires the full gamut of what one is. When one vows to learn compassion, one soon realizes one has pledged one s whole life from now until one s certain death. We are forever the apprentice with regard to what we don t yet know. Nothing less than the complete transformation of the self is required.