Compassion includes ’empathy, respect, a recognition of the uniqueness of another individual, and the willingness to enter into a relationship in which not only the knowledge but the intuitions, strengths, and emotions of both the patient and the physician can be fully engaged’ (Lowenstein 2008).

In my first clinical block at Brooklyn Chest Hospital (BCH) I encountered a patient who had Disseminated TB and according to her folder was also suffering from HIV induced psychosis. The first day that I saw her she seemed to have all her wits about her answering many of my subjective interview questions without any difficulty and showing no signs of having any cognitive issues or having HIV induced psychosis.

The following day I saw the patient again and went through some treatment techniques with her and I even gave her exercises to do in bed when I am not there. The patient seemed to understand and could perform all the exercises I had prescribed for her to do when I am not with her when I asked her to demonstrate them all to me before I left, just to make sure that she was paying attention and that she remembered what I had prescribed for her to do.

On the third time of seeing this patient I had been reminding her of exercises we had done the previous day and suddenly she stopped and gave me a puzzled look. I asked her what was wrong and she replied by asking me if I had seen her the previous day. I answered her and said yes then I asked her why she was asking me that. The patient then started crying, explaining to me that she did not remember seeing me and felt like she was losing her mind. I felt bad for her in this moment and could only imagine how scary and traumatizing what she was feeling must have been for her.

I calmly explained to her that I had been in hospital as a patient myself a few times and that I also couldn’t always remember who had come to see me or which nurse had helped me before or not. This seemed to comfort her and help her to calm down. At the time I thought I was being compassionate towards her by telling her this half-truth but it was a half-truth as I may not have always recognised which nurses have helped me before as a patient I would still remember when someone had come to see me and what the reason was therefore. In this case the patient calmed down and stopped crying as I tried to normalise what she was experiencing even though upon honest reflection what she was experiencing was not normal.

The art piece is a photograph of a woman with a blanked out face holding her hands against her head as if she is losing her mind and this is relevant to my clinical scenario as my patient felt as though she was losing her mind as well, when she could not recall seeing me and having therapy with me the day before.

Reference: Lowenstein J (2008). The Midnight Meal and Other Essays About Doctors, Patients, and Medicine. New Haven: Yale University Press.