A new Pope was selected in Rome today.  He is notable for several reasons.  He is a South American.  He is a Jesuit.  He started his career as a scientist, a chemist (I certainly like that fact).  He chose the name Francis (the first time that name has been used).  He is not a Vatican bureaucrat.   I think what is most remarkable is the way he has lived his life.  He has eschewed any luxury afforded him by his office as Cardinal of Buenos Aires.  He traveled by public transport, bus mostly.  When he needed to fly, he traveled coach.  He lived in a small, spare apartment.  He spent much of his time visiting and ministering to the poor in Argentina.  That does suggest that he felt it important to have a connection, be empathetic, with the people.  He has spent most of his life either teaching or being a pastor.  Although recognized as a talented intellectual, he has spent his time with the people.  That all sounds promising.  No matter what your faith, the Pope is an influential world leader.


How do I know what a patient really wants?  I don’t.  Not at first.  Often times they have a better idea what they don’t want.  They may know what they want treatment to do for them but they may not know what treatment will actually do it or what treatment would be optimal.  If the doctor doesn't ask, then the desired result may not be stated and can only be guessed.  This lack of clarity sometimes creates a fuzzy cloud of confusion regarding what the outcome of treatment should be. The doctor and patient can have very different expectations. That can lead to an unhappy patient and doctor.  Allowing a patient to clarify before any treatment is performed is the key.  Listening and asking appropriate questions can lead to answers regarding the desired outcome.  What does that take?  Curiosity, empathy, and respect for the patient’s wishes. 


Photograph by Dave Hutt, www.dmddigitalphoto.com

Does good lead to more good?
Must mental morality scales
balance good and bad?
Our ethical mindset is the key, according to new research published in Psychological Science, a journal of the Association for Psychological Science.  Gert Cornelissen of the Universitat Pompeu Fabra and colleagues found that people who have a Machiavellian mindset are more likely weigh their good deeds against their bad deeds, while those who have a personal code are more likely to have  consistency in their behavior, even if that behavior is bad. 

What does this mean?  If human nature tends to moral relativism, situational ethics tends to amorality, and internally set morality rules lead simply to consistent morality that maybe anywhere on the spectrum, one would come to the conclusion that an external moral compass is the logical, sensible, and necessary guide.  As I have posted in the past, my belief is that humans are inherently empathetic, with built-in mirror neurons that allow living in social situations.  These tendencies are influenced by experience based interpretation.
The individual instinctually sets up a set of rules for survival.  If compassionate behavior is the goal, then teaching relevant values within a moral system is the our responsibility if the desired outcome is a just, loving, and compassionate world. 


G. Cornelissen, M. R. Bashshur, J. Rode, M. Le Menestrel. Rules or Consequences? The Role of Ethical Mind-Sets in Moral Dynamics. Psychological Science, 2013

A Ford dealer named Lee Kemp had the vision to create a testing tool that would allow him to select the most successful sales people.  After significant time and investment, his research revealed the personality characteristics that were most predictive of an sales person being an excellent team member in his dealership.  There were four primary traits.  First, they needed to be motivated, energetic, and enthusiastic.  Second, they needed to be curious about people.  Third, they needed confidence and good judgement when helping customers make decisions.  Fourth, and perhaps most important, they needed empathy.  It is an uncommon talent to understand customers.  That talent allowed them to address stated and unstated desires.  The customer got what they wanted and they felt good about the process.

Compassionate auto sales.


Dan Olweus created a definition of bullying used around the world today: Bullying must involve physical or verbal abuse delivered repeatedly, over time, and feature a power imbalance.    Part of the etiology is immaturity and a need to impress peers by belittling others.  It can happen at any age. There is an essential lack of empathy and compassion in the behaviors.  Bullying has been a classic historical issue in childhood and continues to be a problem.  It is much more visible in recent times with the advent of social media.  It cannot be escaped by going home from school.  It is more of a problem then ever before.

Emily Bazelton’s book, Sticks and Stones, was just published, February 2013.  It explores what is known about bullying. 

She suggests what can be done to better understand and address situations before they turn tragic.


Christians are called to love one another.  Loving another requires understanding and sharing in the feelings of the other.  One needs to be vulnerable.  Lent is a time for self reflection that demands vulnerability.   Individualism conflicts with vulnerability and can prevent authentic membership in the community.    Christ is the model for being vulnerable.  The quest is to release those dark emotions in which vulnerability is a bad thing. 

Lent is the focus time for Christians.  Christianity at its core is about empathy and compassion.  Jesus empathized with humankind by becoming human.  He preached and demonstrated empathy and compassion for all.  In an ultimate act of empathy, he suffered and died as a human.  In turn, humans can empathize with that suffering and death.  During Lent Christians are asked to make a choice of how each can exercise empathy for others by experiencing some level of suffering.  By generating empathy for others, there is then a choice.  The rules by which people live their lives, morals and ethics, are the guide.  Empathy leads to compassion leads to action. 

Acting upon compassion means making an effort to alleviate suffering in the world.  That is love. 

I downloaded the above video from YouTube. 
It was made by a physician.  I found it on cranquis.tumblr.com/.  His posts remind me of my time in residency at Lutheran Medical Center in Brooklyn, NY and they can be funny and even touching.  This one illustrates a point that is perhaps different than Dr. Cranquis intended.  The patient is complaining of being stuffy.  The doctor notices life threatening issues.
The doctor  focuses on the heart failure and diabetes and the patient doesn't understand.  I think the doc misses the point.  Even though the patient's concern seems unimportant, even irrelevant to the doctor, it is the patients concern.  It takes just a bit of empathy  and mental dexterity to address the patients concern and make the other conditions relevant to them.  When the patient feels understood they are much more likely to act.

I used this video to illustrate the point with a small group of doctors last week.
As if I planned it, the very next day one of them was presented with a very similar situation.  She remembered and handled it with sensitivity.  The patient had both problems addressed, felt heard, the doctor was a hero, and I got guru credit.

What does “old” mean?  For demographic purposes, the age of 65 has been chosen.  It was somewhat arbitrary, a combination of the choices made by the Reichstag and Otto von Bismark in 1881 Germany, a later adjustment, and what was decided in 1935 by the US Congress and the Roosevelt administration.  In reality, age is determined by genetics, stressors, environment, life style, and social standing.  Chronologic age is not nearly so important as biologic age, the accumulated wear and tear.

Ageism is defined as the prejudices and stereotypes based on characteristics shared by only a few members of the older population, yet are applied to all older people on the basis of their chronologic age.   It is quite clearly false.  I would compare it to racism and sexism. Chronologically higher age-number people are portrayed in negative, inaccurate, or stereotypical ways.  They are typically characterized as sick, feeble, opinionated, disagreeable, and living in the past.  They garner no respect and may be ignored, the belief being that they have nothing to offer and that their age defines their capability and roles.
They may be portrayed as gray haired, slow, wrinkly, and saggy.

Traditional culture tended to value and take instruction from the elderly.  They were a valued resource. The current youth oriented culture tends to view aging as an illness rather than a natural process.  

Each of us needs to come to terms with our own feelings regarding aging.
The only just approach is to assume every person is an individual with unique strengths, weaknesses, choice, and opportunities. Even a person that is very disabled with Alzheimer’s disease may have intact emotions.  Those feelings should be respected and people treated with dignity, no matter what the level of disability.

Compassion based meditation training has been shown to boost empathic accuracy.  This was proven out both by behavior and by functional MRI testing.

"It's an intriguing result, suggesting that a behavioral intervention could enhance a key aspect of empathy," says lead author Jennifer Mascaro, a post-doctoral fellow in anthropology at Emory University. "Previous research has shown that both children and adults who are better at reading the emotional expressions of others have better relationships."

The meditation protocol, known as Cognitively-Based Compassion Training, or CBCT, was developed at Emory by study co-author Lobsang Tenzin Negi, director of the Emory-Tibet Partnership. Although derived from ancient Tibetan Buddhist practices, the CBCT program is secular in content and presentation.

"The idea is that the feelings we have about people can be trained in optimal ways," Negi explains. "CBCT aims to condition one's mind to recognize how we are all inter-dependent, and that everybody desires to be happy and free from suffering at a deep level."

.J. S. Mascaro, J. K. Rilling, L. Tenzin Negi, C. L. Raison. Compassion meditation enhances empathic accuracy and related neural activity. Social Cognitive and Affective Neuroscience, 2012; DOI: 10.1093/scan/nss095