Book Review: "The Craft of Compassion at the Bedside of the Ill"

Disclaimer: As always, I received no payment for this book review, only a copy of the book from the author in order to facilitate the writing of this post.

"The Craft of Compassion at the Bedside of the Ill" is a poetic and moving discourse on compassion by nurse, author and medicine man Michael Ortiz Hill. In this stirring book, Mr. Hill presents his view of compassion as a craft that can be learned, honed and developed, a notion that many in the nursing and medical fields would be wise to heed.

In "The Craft of Compassion at the Bedside of the Ill", Michael Ortiz Hill offers a salient collection of essays by guest writers, as well as his own stories and musings that clearly illustrate his heartfelt contention that compassion is a craft that can actually be learned.

He clearly states, "I believe compassion is a craft and therefore learnable like nursing. Lovingkindness is a matter of the heart, but it is most certainly also a matter of craft. As a craft it can be learned and refined. In modern times the idea of craft has been flattened into learning an employable skill. We no longer live in a medieval world where the craft of making a mandolin was passed from father to son, from son to grandson. Yet craft suggests lineage, suggests the possibility of mastery, the full commitment of your life. It suggests, I believe, even spiritual grace and practice."

And in speaking about compassion, Mr. Ortiz Hill contends that self compassion is the root of the developing of the craft:

"In responding to the hell of human anguish, nectar is gathered and the soul is shaped to contain it. In this text the nectar is self-compassion, presence for another, the capacity to act skillfully in an ambiguous world."

Mr. Ortiz Hill divides his book into four specific sections or steps, the names of which denote his trajectory of thought vis-a-vis the development of true compassion:

• Step One: Self-Compassion
• Step Two: Compassion for Another
• Step Three: Radical Empathy
• Step Four: Living Compassion

In modern health care, the author contends that the energy of "institutional narcissism" often steers  the delivery of care, and this form of narcissism leads to an environment "in which the afflictions of the profession loom larger than those of the patients". And when institutional narcissism is at its worst, health care workers experience irritation and resentment regarding the tasks which they must perform for patients, patients who are viewed more as objects or disease states than actual suffering human beings. Mr. Ortiz Hill further illustrates that, in the presence of institutional narcissism and the dysfunction inherent therein, the worker and the patient are both equally objectified.

"For an employee, a hospital can become a prison in which you live a life that is not your own. You endure this life and yearn for the life that won't be lived until re-careering or retirement.....The work life becomes embattled, the nurse's station a rampart against roiling chaos."

As an antidote to institutionalized burnout and the objectification of both the patient and the health care worker, this prescient and sensitive author suggests that employees of health care facilities can actually take part in "conspiracies of kindness" that recognize the interconnectedness between workers and patients, forming alliances of the heart that improve care and help to prevent burnout and compassion fatigue.

"Burnout among healthcare professionals is endemic because we flatten what we do of meaning. It becomes 'just a job'. We trivialize the work of our hands, do not recognize the web of interconnection we are a part of, or the conspiracies we might join on behalf of our patients or each other."

Thus, once true self-compassion and compassion for another is attained, radical empathy can be the fountain from which the nurse or health care worker drinks.

"What I've experienced in the hospital is that when it comes to suffering, most professionals would prefer to distance themselves and pretend that it's being experienced by inferior beings that they could never become since they're superiors. When health care practitioners get ill it's such a shocking experience.  

"Learning radical empathy requires stepping aside from our own fear from things that have happened to us or learning to see our story and say, 'Well, I could be in that story but I'm not today so I don't need to let me fear interfere with being present for this person who is having this experience today. Why don't I just step aside from all the fearful stories of what might happen and just be present?' "

Mr. Hill makes a powerful case for the role of compassion and radical empathy in the lives of health care workers, and he also makes an equally powerful case for the sad reality of the institutional narcissism that can stand in the way of true healing and connection.

"Sometimes the narcissism in a modern hospital manifests as the presumption of the nobility of those who condescend to the care of those who are suffering."

Through his personal narrative, chapters featuring interviews and essays by nurses, rabbis, doctors and others, as well as clear descriptions of the road from self-compassion to radical empathy and what the author calls "living compassion", this book leads the reader on a journey of self discovery and realization that could potentially serve to transform the experience of the delivery of health care.

While we acknowledge that nurses and other professionals often suffer at the hands of faceless institutions, we also acknowledge that the nurse/health care professional holds the key to subverting the dominant paradigm and becoming a channel for true compassion and empathy.

"The Craft of Compassion at the Bedside of the Ill" is a guidebook for a journey of the heart, and I wholeheartedly recommend it to any nurse or healer who wishes to learn the craft of compassion and take his or her practice to the next level. Michael Ortiz Hill teaches this craft to nurses and health professionals around the world, and as we embrace the notion that we can develop and hone the skill of compassion and radical empathy, we can slowly but surely transform the delivery of health care, the institutions that deliver that care, and the human beings who intersect within that system. Compassion is in itself a radical practice, and Mr. Ortiz Hill boldly elevates it to a tool of humanistic transformation of which we should all partake as both professionals and as human beings. 

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To reach Michael Ortiz Hill or to order a copy of "The Craft of Compassion at the Bedside of the Ill", please visit his website. To hear a recent interview with the author on RN.FM Radio, you can access the archived recording here.