Empathy in Action
by Frank Richards, MD
The word compassion is composed of two parts—passion, “to suffer,” and com, “with.” So the definition of compassion is “to suffer with.” I’m going to speak today about compassion and its relationship to tropical medicine programs.
The programs that I direct at The Carter Center assist countries with providing treatments to over 14 million people a year. To share the pain with over 14 million people is to share a lot of pain. And, if we are to follow Bill Foege’s guidance—that in every decision we make and everything that we do we must be willing to see the faces—that’s a lot of faces.
We work on diseases of poverty in the poorest countries. The diseases we treat are both a cause and a consequence of poverty. In my travels, I’ve have opportunities to witness some very remarkable things. The travel is often strenuous, but what I invite you to do today, with regard to the topic of compassion, is open your heart and feel, with empathy, what occurs during these travels. Look into the eyes and at the faces of those we meet. The diseases we address are often called backwater diseases, but when we take time to see the faces, we recognize that the people who suffer from them are not backwater people. They are people who want to do the best for their families. They are people who, given knowledge and support, are able to do marvelous and amazing things.
How does empathy lead to action? I want to step back for just a moment and recall an article in the Lancet in 2004 called, “Tropical Medicine: A Brittle Tool of the New Imperialism.” The article said that during the years 1890-1960, tropical medicine was fundamentally imperialistic in its basic assumptions, methods, goals, and priorities. It was about empire building, colonialism, and racism. Now tropical medicine is a specialty that has become an emblem of social enlightenment, individual sacrifice, and scientific altruism—in other words, empathy in action. Bill Foege spoke about social justice and public health. I think we could argue that because we address diseases of poverty worldwide, tropical medicine health programs are the pinnacles of social justice.
What motivates us to do this work? I’ll begin with the classic arguments developed by Aristotle and his three lines of thinking: the logos, the ethos, and the pathos. As this is a scientific group, I would bet that if we could apply MRI PET scans, we would see that the human brain lights up in different areas in response to these different arguments. Each line of reason results in a different type of action.
The logos argument expresses the business case of “doing good so you can do well.” It is bottom line driven rather than from the goodness of our heart. Closing the gap between the rich and the poor becomes a security issue. Poverty and oppression lead to hopelessness and despair, which lead to anger and violence and that’s not good for us. Norman Borlaug famously said, “You can’t build peace on empty stomachs.” We address their needs so that we remain safe. And, we buy our safety cheaply—free medicines that cost 50 cents to distribute, a five-dollar bed net that three people can sleep under, and a bar of soap to reduce impetigo, diarrhea and pneumonia.
What about the ethos argument? “It’s important work, or people will die!” The ethos argument is the argument of character. It’s the power of example, charisma, the hero that manifests the zeitgeist. It’s the idea that we can articulate the notion of a healthy world, a just society, equal human rights, and a principle of universality and of dignity regardless of gender and class, color and creed. Bill Foege is a manifestation of the ethos of character. It takes a lot to be able to articulate satisfactorily the intellectual quagmire of inequality and unnecessary deaths in the world we live in today.
I cannot talk about pathos, the appeal to emotions, without reading one of my favorite parables, that of the Good Samaritan. “A certain lawyer said unto Jesus, ‘Rabbi who is my neighbor?’ and Jesus answered saying, ‘A certain man went down from Jerusalem to Jericho and fell among thieves which stripped him of his raiment, wounded him, and departed, leaving him half dead. By chance there came down a certain priest that way and saw him and passed on the other side. And likewise a Levite when he was at the place came and looked at him and passed on the other side. But a certain Samaritan, as he journeyed, came where he was, and when he saw him he had compassion on him. He went to him, he bound up his wounds, pouring him oil and wine, and set him on his own beast and brought him to an inn and took care of him. And on the morrow when he had parted, he took out two pence and gave them to the innkeeper and said to him, take care of him, and whatsoever thou spendest more, when I come again I will repay you. Now which of these three thinkest thou was neighbor unto him that fell to the thieves?’ And the lawyer said, ‘he that showed compassion to him.’ And Jesus said, ‘go, do thou likewise, and you shall live’.”
I hear several points in this parable. Compassion led to service and action, and that led to a benefit. However, not only to a benefit for the person who was wounded, but interestingly a benefit for the person who offered to act. Martin Luther King, Jr., when speaking about service said, “Not everyone can be famous, but everyone can be great through service.” In this case, greatness indicates not only expanding one’s small sphere of influence, but suddenly being the one who others want to imitate. Gandhi said about self-discovery, “The only way to find yourself is to first lose yourself in the service to others.” His bottom line was not about money, but peace and purpose.
I invite you to open your heart in your travels on behalf of the efforts in tropical medicine. Recognize the three pieces to your nature—doing, thinking, and feeling. Pericles said, “To do, to think, to feel.” Be sure to include the feeling piece.
(This talk was given at the The Impact of Compassion in Global Health and Tropical Medicine, ASTMH Symposium in Philadelphia, December, 2011.)
Dr. Richards is an expert in parasitic and tropical diseases, who has worked extensively in Latin America and Africa. His professional interest is in the safe and effective delivery of available tools to control or eliminate tropical infectious diseases. The health programs he directs at The Carter Center have helped ministries of health and local communities to provide more than 200 million preventive chemotherapy treatments for parasitic disease in 11 countries. The malaria program has helped provide nearly 15 million insecticide-treated bed nets in Nigeria, Ethiopia, and Hispaniola.