Contribution from Ms. Madeline Frech, Notre Dame graduate.

Williamson County native and American author, poet, and speaker, Brenda Demonbreun

opened the 2024 International “Close the Loop” Capillaroscopy and Scleroderma Conference

hosted by Vanderbilt University Medical Center with a poem (and future novel) entitled, “Nola’s

Tattered Shoes.” Presenting her work in front of dozens of medical experts from around the

world, Demonbreun shared a powerful story of abandonment, neglect, and shame through the

eyes of a child boldly reclaiming love’s power, a story that encouraged the attending physicians

to reflect on compassion as their motivation for providing care to those most in need. Her words

perfectly encapsulated the underlying theme of the conference, as patients and physicians alike

spent their weekend, many taking on personal travel expenses, to attend the event. This free

event hosted by Vanderbilt University was dedicated to training physicians at prominent

institutions across the United States in the diagnostic tool of capillaroscopy to enhance the care

of patients with the rare autoimmune disease “Systemic Sclerosis” (or Scleroderma).

Demonbreun expressed how it was “an honor and joy to share [her] belief that patient care is

destiny care.” Nola’s ultimately triumphant journey required physicians who cared. As an

assistant organizer for the conference and current student at the University of Notre Dame taking

classes through the Hillebrand Center for Compassionate Care in Medicine (CCIM), I found this

inspiring event to be the perfect opportunity to discuss the value of compassion not only in

medicine but in the greater context of our world at large.

What is Compassion? Why is it Necessary to Healthcare?

Scientists define compassion as the recognition of another person’s suffering and the

motivation to help alleviate it. Though oftentimes used synonymously with empathy, sympathy,

pity, or concern, compassion goes beyond a simple awareness and emotional response to

another’s pain. Specifically, in addition to this affective component, compassion demands action:

a person must be motivated to directly act in a way that aims to relieve another person’s

suffering.

In the world of healthcare, compassion is often reduced to bedside manner, a component

of what Dr. Stephen Trecziak, Chief of Medicine at Cooper University Health Care and Notre

Dame Adjunct Professor at the Hillebrand Center for CCIM, calls the “art of medicine.”

However, in his book Compassionomics: The Revolutionary Scientific Evidence that Caring

Makes a Difference, Dr. Treciak argues that compassion likewise has measurable effects in the

science of medicine: patient outcomes and physician resilience to burnout are empirically

enhanced by compassionate care.

In his book How Doctors Care, Hillebrand Director Dr. Dominic Vachon presents the

Clinician Compassion Mindset Process to guide a physician’s interaction with a vulnerable

patient. Requiring the medical provider to internally reflect on various elements of the encounter,

the Clinician Compassion Mindset Process serves as a roadmap that ensures a patient receives

care that meets the criteria for compassion. For instance, it asks the physician to consider

whether they are putting their own self-interest over the needs of the patient, or if social bias is

potentially influencing the way they deliver care. Though intended primarily for practicing or

aspiring healthcare professionals, the Clinician Compassion Mindset Process can in many ways

inform every human engagement, guiding us all to treat each other in a way that respects our

common human dignity.

How Do You Cure a Compassion Crisis?

A few weeks ago, Dr. Ana Nobis, the Medical Director of the Occupational Health Clinic

at Vanderbilt University Medical Center, was stuck at a red light while driving to work when she

noticed a man standing on the edge of the overpass, seemingly prepared to jump into oncoming

traffic of the highway directly below him. Immediately exiting her car, Dr. Nobis slowly

approached the man, her arms stretched out widely as she calmly repeated, “It’s going to be

okay.” Hearing her words, the tearful man stepped away from the ledge. Dr. Nobis left

immediately as the police arrived to help, but the woman behind Dr. Nobis in traffic, having

missed the light on the overpass, screamed in frustration at Dr. Nobis for causing her and others

to be late to work. When did arriving somewhere on time become more important than saving

another person’s life?

The violence, suffering, and discrimination we encounter on both the microscopic and

macroscopic scale leads us to the disheartening conclusion that our world is experiencing a crisis

of compassion. Despite the fact that humanity is shaped by the emotional and personal

connections we share, our society instead appears plagued by conflict, indifference, and hatred.

Overcome by fury, we exhibit road rage when someone cuts us off in traffic, attributing the

transgression to the driver’s “idiocy” rather than considering their situation. We compose “to-do”

lists in our heads during a meal with friends and family, distracting us from their expressed pain,

concerns, or emotional needs. No person is perfect, but I urge readers to reflect on how they

engage with others. The poet, patients, and physicians at the Vanderbilt University 2024

International Capillaroscopy Conference and Dr. Nobis’s story serve as beautiful examples of

demonstrating compassion. We all should take concrete actions to assist someone in service to

the greater good. Our community should be inspired by the powerful message and embody the

spirit of local artist Ms. Demonbreun’s poem; reclaim the power of love and reconnect with what

it means to be human.

Resources:

Trzeciak, Stephen, et al. Compassionomics: The Revolutionary Scientific Evidence That Caring

Makes a Difference. Studer Group, 2019.

Vachon, Dominic O. How Doctors Care: The Science of Compassionate and Balanced Caring in

Medicine. United States, Cognella, Incorporated, 2018.