The first baby I ever saw born had no eyeballs.  At first everyone looked at her perfect chubby face and assumed her eyes were closed, but it wasn’t long before it was obvious that she had no eyes.  I never did find out what genetic syndrome she had.  There I was, a student nurse at LAC+USC Medical Center in the early 90s.  It’s a very large teaching hospital with students and residents of every discipline and specialty.  I even had an opportunity to work in a leprosy clinic, but that’s another story.

Back to the baby with no eyes.  As she was whisked out of the delivery room, followed by just about every nurse and doctor in the vicinity, I was horrified, scared, and terribly confused.  But I don’t even think I could let the emotions come to consciousness as I knew there was no place for any of that.  The mother was still in front of me, now in a nearly empty delivery room with only a skeleton crew. If I was scared, where would that leave her–no baby in arms and no one around to lean on. If I let the staff nurse see how affected I was, that would surely show that I wasn’t cut out to be a county nurse.  On went the brave face. Where those emotions went, I do not know.

Through my training, there were many experiences like this one; the small girl dying of AIDS contracted from her father, a homeless woman with 2 broken legs from a failed suicide attempt, a dying man whose family refused to take my calls to come say a final goodbye, and many more.  Even as I write this now, I feel reluctant to admit how these experiences affected me so profoundly. I should have been tougher and able to take it; that I should have been able to get over it, get used to it, suck it up.  But ultimately I was a human before I ever became a nurse.  I decided to become a nurse to help relieve suffering, and yet I feel somehow less of a nurse for being overly empathetic.  How could I have compassion and still be an efficient, competent professional?

This question has dogged me for much of my professional career. I have struggled with feeling too much and needing to numb out, vicarious trauma, and burnout.  I have moved practice locations from large hospitals to small community clinics and now to private practice, but the same issues followed me.  In the end I realized the change had to be internal.  I had to find a way to manage the stress of caring.

It was a very happy accident when I stumbled across Tension and Trauma Release Exercises (TRE®), while surfing the net as I lay in bed with a back injury. I downloaded the book and taught myself over the next week.  Slowly I noticed that I felt better in subtle ways–less tense and numb, more focused and calm.  I didn’t practice often, but when I did, there were steady positive changes.  It was when I committed to a regular practice that things really started to shift.  I was no longer depleted by the end of a day in the office.  I found myself able to see patients and hear their really difficult stories of suffering AND not replay their faces and words in my sleep. I would practice TRE® and literally let it all go.  I still practice TRE® every day.  As patients come to me with more difficult histories and traumas, I can be present with their experiences without closing my heart, nor harming myself.  I am compassionate in a way that is sustainable.  I don’t need to get over my very human reactions. I hope I will never get used to human suffering. And I certainly don’t need to suck anything up. I can let it go.

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  • Raymond

    I would like to offer comfort for all the times and ways you have felt ‘less-than’ or negatively about yourself, when you struggled, with feeling too much and needing to numb out, vicarious trauma, and burnout. The compassion you are talking *IS* YOUR TRUE GIFT. It is not something that can be learnt off the shelves. You have it in abundance and the world is a better place for it. Never again feel ‘less-than’ for being over empathic or empathetic. I’d go as far as saying that this very quality is what has sustained you from crashing altogether at times. Compassion and Empathy – S Y M P A T H Y I like to call it – is our natural ‘default’ condition and so naturally keeps us well. And yes, TRE is great way to shed the tension we pick up during our encounters.

  • trelosangeles

    Thank you Raymond for your kind and wise words.

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