Sunday, 1 December 2019

Desire, Joy, Sadness: the critical emotions of compassion in action?


Well it was an extraordinarily busy week last week. I’m glad I have retired, otherwise I wouldn’t have had the time to fit everything in. Amidst all the busy-ness, I found myself immensely distracted by listening to last week’s Radio 4 programme, Start the Week, with Andrew Marr. The focus was on Love and Unreason and featured, among others, Clare Carlisle, who talked about the forthcoming publication of George Eliot’s translation of Spinoza’s work ‘Ethics’. I was absolutely fascinated by the story. Mary Evans (as she was then) first had to teach herself to read Latin, before translating Spinoza’s work into English. This was in 1856, some 99 years before I was born. Totally remarkable. Spinoza was a fascinating philosopher. In Ethics, he talks about emotion, suggesting the essence of a human being is characterised by just three emotions: Desire, Joy and Sadness. All other emotions are derivatives of these three. Clare Carlisle is herself an expert on Spinoza’s work and it is through her efforts that the new book will be published next February. Too late for a Christmas present, but I know there is a certain wedding coming up in April… just saying.

And of course, if you are also a Radio 4 fan, I’m sure you will have been listening to George Eliot’s wonderful Middlemarch – if you haven’t, I highly recommend you listen on catch up. 

Tuesday was the first of a number of meeting days. The last meeting was with the Care Quality Commission (CQC), who were spending the week undertaking a ‘Well Led’ review of the Trust. It is the second such review I have been part of in my time as a Non-Executive Director at the hospital, but they are always different. We had prepared well and as I knew I was to be interviewed, in part because I chair the Quality and Safety Committee, something I have done for over five years now, I was fairly confident. It was my favourite kind of interview; the type where the answers are best constructed around the telling of stories. Although not to the same level of complexity and intrigue as George Eliot’s work, there were many good stories to tell.

The CQC attended our monthly Board meeting the following day, and although the Part 1 of the Board was fairly unexciting, it was good to see so many from the Council of Governors there at the meeting. Part 2 was a little more exciting, because our new Chief Executive (who has been in post a mere five weeks) set out the headlines of where he saw the Trust going, and the elements we should be building our strategy on. Interestingly, he believed that it would be demographics rather than technology (or politics) that was likely to shape the future UK health service. That said, I’m sure politics and technology will help us resolve the growing problems posed by an ever increasing older population and the complex health and social care needs they experience.  

I met someone else later that day who was also worried about demographics. I attended a workshop facilitated by international expert in leadership, Professor Michael West. It was the second time that week where I found myself spellbound listening to a softly spoken, confident and knowledgeable person – the first was Clare Carlisle. Michael West’s workshop was focused around compassionate leadership. I have read much of his work, but had never heard him speak. He also had a fascinating story to tell.

He took the workshop through the four elements of being a compassionate leader. The first being the ability to ‘be present’ – how many of us have been stopped by someone who wants ‘just 5 mins of our time’ just as you are on your way to a meeting that starts in a few minutes – your mind is on the meeting and that paper you haven’t yet read, rather than being with the person in front of you; the second element was ‘listening with fascination’, really working at hearing what’s being said (or not said); the third element was ‘empathising’ – something that I personally feel is really difficult to do, or to do well; and then lastly, asking how you might help the person. These four elements, if used together, that is ‘compassion in action’, will help shift the boundaries between our self and our self and others. I didn’t know, but the simple act of asking and striving to help others actually elicits a physiological reaction, particularly around the reward centres in our brain. Michael posited whether we are actually hard wired for altruism. Maybe a question for another blog posting.

I reflected on what he what he has said and wondered if the moral distress many nurses experience is because they perhaps feel that they can’t do what they should be doing to help others, because of the sheer demand on services and the daily busy-ness of health care today. It was Don Berwick who famously said that there should be only one rule book, and that book should only have one rule: Do what you think is the right thing.

Friday, I saw someone doing the right thing. I went to my chemist, housed in my local health centre. It’s a wonderful place. You can go for a swim, eat at the café, take a book out of the library, use the gym, have a walk in the gardens, pick up a prescription, oh and yes, if you want to, you can also see a GP or Advanced Nurse Practitioner. The chemist had texted me to say my prescription was ready and I was interested to note a new service, where I could elect to pick my prescription up 24 hours a day, 7 days a week, from an automatic hole in the wall dispenser. I immediately thought this might be the solution to the problem of a retiree with time availability issues.

And then I saw Kylie. She was standing in front of the counter at the chemist and was having a heated conversation with one of the assistants about her medication. She was clearly distressed and becoming more so by the moment. I don’t know what the problem was other than she had run out of her medication and the prescription for a new lot hadn’t been signed off. The conversation became more heated and eventually, Kylie stormed out. Without any hesitation, the assistant rushed after her, caught her by the door and wrapping her arms around the young lady, gave a her a hug, saying ‘come with her and she would sort things out’. They disappeared into that little cubicle chemists have for ‘private consultations’ and as they did so, the other assistants jumped into action to get one of the GPs (there are always some at the health centre) to get the prescription signed off. 

I don’t know what happened to Kylie, but in terms of Michael West’s compassionate leadership, you couldn’t have seen a better example of compassion in action.

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