Sensible Compassion: Principles I Thought I Had Mastered

For years, I’ve proudly carried a set of principles to prevent compassion fatigue. They sounded noble, looked impressive for me, and made me feel like a seasoned sage of healthcare. 

First, I practiced slow noticing. In reality, this often meant noticing things only after they were pointed out by someone else. My version of slow noticing was sometimes so slow that the moment had already passed, the person had already left, and the opportunity for compassion had died of geriatric problems.

Second, I believed in sensible boundaries. This sounded very mature until I realised my boundaries were mostly designed to protect my schedule, my efficiency, and my ability to walk briskly through corridors without being interrupted by humans.

Third, I practised micro‑restoration. This was the one principle I genuinely excelled at - but mostly because it involved coffee, trees, and occasionally pretending I didn’t hear my phone ringing.

I had convinced myself that these principles made me a balanced, compassionate healthcare professional.

But being a patient by-stander recently gently proved otherwise.

The Security Guard Who Outperformed My Principles

Walking into the main campus of a tertiary institution*, with its busy crowds and purposeful chaos, I witnessed a scene that both assured and unsettled me. Assured, because compassion still permeates health care; unsettled, because it reminded me of the many opportunities I have missed in my forty‑plus years of so‑called compassionate healthcare.

A security guard was directing traffic — clearly his assigned duty. Yet through his peripheral vision (which was evidently far superior to mine), he noticed a confused family about fifty metres away. Unable to leave his post, he called out to them, listened to their difficulty, and guided them.

Compassion in action - not merely sentiment.

He didn’t need a workshop on empathy. He didn’t need a lecture on patient‑centred care. He simply noticed and responded. Meanwhile, I stood there thinking, “Ah. So that’s what slow noticing looks like when done correctly.”

The Nurse Who Recalibrated My Ego

It happened again when, as doctors temporarily demoted to patient and bystander, we asked our daughter to empty and measure the urine. A nurse gently reprimanded us later.

“This is our responsibility,” she said. “You don’t have to do it yourself.”

Her tone was kind, but the message was unmistakable: Please stop trying to be helpful. You are currently the patient’s family. Kindly behave like one.

I realised that my second principle — sensible boundaries — had been applied only to myself. I was good at telling myself not to overextend, but apparently not as good at respecting the boundaries of others who were simply doing their job with dignity.

Compassion in the Small, Sacred Moments

Compassion appeared again when a nurse came early in the morning to pray before the surgery. It showed up in the nurses who tolerated the constant stream of visitors entering and leaving the room, yet still reminded us — kindly — that postoperative periods were not meant to resemble bus stations.

It appeared when the operating surgeon called me from the OT, probably just after un‑scrubbing, to reassure us that the procedure had gone well. I imagined him still half‑dressed in surgical gear, phone balanced awkwardly, compassion leaking through. It was evident in the medical team, walking in out, early mornings or late nights, with a forced smile(visible only to my trained eye), after a full day in OT or OPD or busy night shifts.

It even appeared in the coffee shop staff who recognised me and joked about sugary versus sugarless choices. Nothing says “we care” like someone remembering your dietary indecision.

Everywhere I looked, compassion was not merely felt; it was visible. Expressed through action. Often beyond the call of duty.

And I, the seasoned healthcare professional with decades of experience, found myself quietly humbled — and occasionally amused.

A Mirror I Didn’t Ask For

In contrast, memories surfaced — uncomfortably — of moments when I had been less than compassionate.

Speaking medical jargon over a patient while they strained to understand.

Talking down to patients as though knowledge automatically conferred wisdom.

Standing and hovering over them, forcing them to look up at me like schoolchildren being scolded.

Walking quickly through the campus with my head down to avoid eye contact that might interrupt my schedule.

Noticing a confused individual in the crowd — and ignoring them because I had “more important” things to do.

These were not dramatic failures. But they were real. My principles, which I thought I had lived out faithfully, suddenly felt like they needed refreshing — perhaps even rebooting.

A Gentle Humbling — and a Second Chance

What encouraged me most was not guilt, but gratitude. Even if I have been insensible and insensitive at times, there are many who still embody sensible compassion with grace and consistency.

The security guard.

The nurses.

The surgeon and the medical team

The coffee shop staff.

Ordinary people doing ordinary work with extraordinary attentiveness.

They reminded me that compassion is not a grand virtue reserved for special occasions. It is a daily discipline, a posture, a way of seeing. It is noticing through the corner of your eye. It is speaking kindly even when correcting. It is remembering that every person — confused family, anxious patient, tired doctor — deserves to be seen.

Perhaps I too should be given another chance to practise sensible compassion. And perhaps, after all these years, I am still learning — with humour, humility, and a little help, by being a patient by-stander. 

* Christian Medical College Vellore