The necessity of compassion

A large woman, she has soiled herself.  With practiced motion, Bob rolls his wife onto her side. Yellow diarrhea has leaked out of the diaper, soaking the nightgown and sheets, finding its way into each fold, crease, and flaw.  The room fills with odor, but the winter house remains dark; outside wind blows down the empty street. It is 2:00am and Bob is cleaning shit.  Only 90 minutes asleep, he works quickly through fatigue’s fog, as her breathing rasps.  He rolls her gently back, her breath is again even, and she slips into the safety of dreams.  Bob cleans up the detritus, climbs back in bed, hoping for two hours.

I read a fortune cookie the other day that said, “What one must, one can.”  Not classic literature, but it got me thinking about caregivers.  Who decides for them what they ”must” do?  I mean, why all the bother?  What is it about human beings that we sacrifice so much to help, when it would be easier, efficient and reasonable to “pull the plug,” and walk away?  Why do we waste our lives in the service of those who will never return the favor.

That got me thinking about Bob.  His wife was very sick for many years with a fatal neurologic disease and she required almost complete care.  She could not live one day, one hour without him.  She would never recover, never “give back,” and she leeched years from him.  I asked, sometime after she died, why he did it. Bob said, “You do what you have to do.”  Salt-of-the-earth wisdom.  And I think, partially wrong.

Now I am not saying that necessity is not the mother of action. I am saying that this kind of massive sacrifice is much more than a required chore. Far deeper than “its time to make the donuts.”  For Bob, and the millions of caregivers who give of their lives when there is no hope for recovery, these altruistic gifts are complex and speak to the soul of man.  It is more than love.  I think these actions connect us to the mystery of life itself.

Whatever there is evil about the soul of man, one of our great goods is our need to mend each other.  What makes the gift of caregivers for severely ill patients so remarkable is that it is given, at least partially, without hope of recovery.  Rather, such actions define what it is to be human as they connect us to all men, present, past and future. We understand through evolutionary intuition that to allow another person to fall, without trying to gentle that landing, is to sever our link to the long line of mankind.  Our unbroken relationship with each other is our bond to eternity.

While it may seem, for moments, that we are individual, single and alone, the reality is that all of humanity, past, present and future, is but one life, one long experience, bridging time and space.  Compassion is what connects us all.  It is as necessary as oxygen, water and sun.  We are there, with Bob’s wife in the empty morning, in every alley, hospital room, nursery, and at every desperate moment.  Alone there may be no hope at all, but together there is hope for all tomorrows.


  • Carolyn Hughes
    Wow, Jim, this one is amazing. You hit the nail on the head. People are so much more than we can ever realize. And compassion, I believe, is a reflection of something, Someone, far greater than us. In "Les Miserables," the lyrics "to love another person is to see the face of God." come to mind Thanks for a beautiful morning. Your words today are very encouraging for those of us who are caring for the very elderly, and sometimes feel exhausted and down. Have a blessed day!
  • Janet Visokay
    We do what is handed out to us because of compassion, but inside is the constant cry of PLEASE DON'T LEAVE ME....I will be here for you.
  • Thank you. We know who we are and why we do it. Compassion is a word to live by.
  • Maybe just me but I would never want my loved ones to have to care for me like that when there was no hope of recovery.
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  • I think the "hope" in caring for a terminally ill patient is that they get the best care possible and they be treated with dignity. And I totally agree that this type of care goes beyond and is greater than love. Enjoyed this blog entry a lot!
  • D Someya Reed
    Anyone who could or would ask himself why he is wasting his life in the service of someone who will never return the favor cannot possibly have any idea what your post is about. Unfortunately there are far too many of them that do ask, do walk away, do "pull the plug" (and not always in a literal sense) so that I cannot agree with the universal theme you propose to be inherent in the human race. It's not there for many when it comes to strangers and too many times not even for loved ones. I just had it shoved in my face last night when a neighbor asked me for help with his injured (not terminal) wife. He said that he was done, exhausted, unable to have even an hour to himself or to play his favorite sport and bemoaned even about having to feed the dog. How long has he been doing this...5 days. That's not a typo. I agree it's more than love, more than honor, more than's just more. You do it and you don't even think about why...don't think about reward, recognition or reciprocity. If you do, then not only are you doing it for the wrong reasons but you're not doing it well. As things are today, I agree with pam956 but I am working my utmost toward a reality (not a hope) that all terminally ill patients will get (not might get) the best care possible and be treated with dignity. And that's a dignity that's more than just the word, without definition, that it is today. Joan Davis, your comment, "We know who we are and why we do it" is both concise and magnificent! Dr. Salwitz, another thought-provoking post.
  • What a great read..that was wonderful and lovely--I love your writing style as well......Thanks for taking the time to share all these great stories.....They are always so great and enjoyable...................mimi
  • Debbie Hadam
    Beautifully said Jim. Caring for my parents in their own home with unconditional love, compassion and the dignity that they deserved was the last gift that I could give them, and the most important job that I could ever have. Janet Visokay, I can so relate to your comment. Again, Thank You, and your wife too, for your visits, your compassion and for always being there.
  • Penny Egan
    This brought back memories from 23 years ago when we chose to bring my mom to our home for her last few months as we were told she had 3-6 months to live from her doctor at the time...Anxious to fine a new physician ... we found you Dr. Salwitz and your partners mom received not only great care, support, and encouragement to enjoy the day, she was able take mini vacations, stay at her own home part of each month.... This was a gift you helped give my mom and me...... At the end of the day she died with us all loving and caring for her ....not in a hospital but home.... I do have to say this doesn't diminish the love one has if they are unable to be the care giver full time for a loved one... .. I was blessed with outstanding love and support... I remain forever grateful.... Now another day another time as you care for my husband. Thank You never seems enough! There's something I always tell my children and grand kids...." As we age we only get more so".....a happy soul gets more so, a caring one the same.... You have diffinitely gotten more so! All in a good way... in everything you do! Your postings are in refreshing ... Informative and supportive... Penny Egan
  • such meaning full sentence "Why do we waste our lives in the service of those who will never return the favor" Darwin said competition among species, even altruism is also part of evolution

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