Yet as strange as it sounds, all that empathy can backfire, flooding you with the other person's pain, and leaving you exhausted, angry, even unable to care anymore. No one likes to talk about these feelings; they seem selfish, shameful, indecent. They take a toll, however—on both you and the patient. And they're a growing concern among physicians, who have a name for what's happening: compassion fatigue.
"About 6 to 8 percent of physicians and nurses suffer compassion fatigue," says Michael Kearney, MD, the lead author of a report on the subject published this year in the Journal of the American Medical Association. Unlike burnout, which is caused by everyday work stresses (dealing with insurance companies, making treatment choices), compassion fatigue results from taking on the emotional burden of a patient's agony. In a way, it's similar to post-traumatic stress disorder, except that the stress is a reaction to the trauma of another. As with PTSD, symptoms include irritability, disturbed sleep, outbursts of anger, intrusive thoughts, and a desire to avoid anything having to do with the patient's struggle.
Deborah Garner, a social worker at Hospice and Palliative Care of Greensboro in North Carolina, has suffered from the condition. "There was one patient I particularly bonded with," she says. "After somehow managing to fulfill this woman's last request—getting her three very large dogs to the hospice—I was drained. I felt like if someone asked me to do one more task that day, make one more phone call or see one more dying patient, I would scream. I had no energy left." Garner drove home in a daze and sat on the couch with her 8-year-old daughter—no TV, just talking. "It took three or four weeks to feel the joy—the calling—of my job again," she says. The biggest help: sharing her feelings with her coworkers.
Philip Muskin, MD, a professor of clinical psychiatry at Columbia University Medical Center, has also gone through compassion fatigue. In the course of treating a young man who became more and more depressed, Muskin says, "Nothing I did worked. Here was a really talented person with tremendous potential. His suffering became my suffering." After trying every medication and therapy he knew of, Muskin felt angry and demoralized, and went to see a therapist himself. "He told me, 'People send you these patients all the time. It isn't that you don't know enough; maybe no one does. Maybe the only way to help this person is to just try to be with him and understand his pain."
For the millions of ordinary people who become caregivers, Muskin says the most important way to prevent compassion fatigue is simply to recognize that it can occur. "It means saying to others, 'This is really getting to me, not because I'm weak or inept, but because it's a terrible situation.'" Caring for yourself may seem like a low priority while trying to care for another—but it's essential for the patient. "Knowing that someone is crying for you and feeling your pain," says Muskin, "really is therapeutic."
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