Intentionality Starts with Compassion – Dr. Derek Chang

As family physicians, we have been experiencing enormous pressure; the pandemic and multiple crises have added even more weight to our shoulders. We are doing our best to meet our patients’ needs with limited resources and constrained systems. In recent years, the discussion around Justice, Equity, Diversity, and Inclusion (JEDI) has been front and centre in our society, particularly in healthcare. The In Plain Sight report is a prominent example. I recognize the importance of JEDI and its beneficial and critical role for our patients and our profession. However, with so many competing priorities, my bandwidth often becomes limited.

In Thinking, Fast and Slow, Daniel Kahneman described two modes of thinking: system 1 is fast and automatic, while system 2 is slow and deliberate. It’s not that one system is better than the other; the two systems complement each other and are both crucial for our survival as human beings.

When stressed or tired, our system 1 kicks in more readily. We operate in a fast and automatic mode where our unconscious biases can dominate how we think and what we do. I’ve noticed that in my clinical practice and daily life: when my bandwidth decreases, I tend to make up stories or jump to conclusions based on my assumptions or biases.

I’ve been thinking about how to foreground system 2 in my thoughts and actions—How can I be more intentional in how I think and what I do? I haven’t quite figured out how to navigate this tension effectively, but one surprising tool I found helpful is practicing compassion.

As I was reading more about compassion, I came across the teaching by Joan Halifax, a Zen Buddhist teacher, anthropologist, ecologist, civil rights activist, hospice caregiver, and author. In her book Standing at the Edge, she wrote, “Compassion is defined as feeling genuine concern about the suffering of another and desiring to improve that one’s welfare. Compassion also helps us meet our own suffering, and that of others, with an appropriate response.”

Compassion is a complex and messy concept, and I don’t want to pretend I’ve fully grasped it. However, I do find the practice of compassion helps me slow down and be more intentional in my thoughts and actions. Compassion reminds me to recognize when my bandwidth is becoming limited and pay attention to my needs. Compassion also motivates me to meet the suffering of others and improve their welfare, which includes the work of JEDI.

For me, intentionality is key for JEDI, and it starts with compassion. I want to end with the wisdom of Joan Halifax, which I use as the background on my phone screen to remind myself to practice compassion:

May I offer my care and presence unconditionally, knowing that it may be met by gratitude, indifference, anger, or anguish.

May I offer love, knowing that Icannot control the course of life, suffering, or death.

May I find the inner resources to truly be able to give.

May I be peaceful and let go of expectations.

May I accept things as they are.

May I see my limits compassionately, just as I view the suffering of others.

References:

https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Summary-Report.pdf

Kahneman, D. (2012). Thinking, fast and slow. Penguin Books.

Halifax, J. (2018). Standing at the edge: Finding freedom where fear and courage meet (First edition). Flatiron Books.