Abstract
Kindness is a virtue sometimes undervalued and often unacknowledged. Yet it is arguably our greatest strength and something that is inherent to our professional lives. Imagine for a second a world without kindness; what a desolate, barren world that would be. But exactly what is kindness? Is it always a positive virtue and how should it be used? Or not be used? Professional boundaries make us ask if one can be too kind? Can it be mis-interpreted or mis-placed? And the phrase ‘cruel to be kind’ describes an interesting paradox.
Kindness is defined by the apple dictionary as ‘the quality of being friendly, generous, and considerate’. Mark Twain from a compassion point of view considered ‘Kindness [as a] language which the deaf can hear and the blind can see’ (Lorette, 2016).
Prince Ea (www.facebook.com/PrinceEa/) states: Acts of kindness increase our oxytocin (love hormone), energy levels, lifespan, serotonin levels, lights up the reward centers in our brains as if we were the one receiving the gift, and increases our overall level of happiness. Kindness also decreases our pain, stress, anxiety, depression, and blood pressure! So clearly, in giving, we're receiving.
Aristotle defines kindness as ‘helpfulness towards someone in need, not in return for anything, nor for the advantage of the helper himself, but for that of the person helped’. The term ‘generosity is its own reward’ is apt here.
In my view, patients should feel a sense of kindness and caring when they consult, for reasons that are obvious. The challenge comes when the correct clinical management does not meet their expectations. Can one radiate a sense of kindness when advising against antibiotics, a referral or a sick note? It is a skill that, in my view, can be acquired. Furthermore, should one inappropriately meet patient expectations under the premise of kindness? Is that good or bad? I have heard doctors claim that patient satisfaction surveys can be limited in their assessment of doctor performance for this reason and that receiving gifts and accolades may in fact be rewarding patient expectation rather than good clinical practice. Conversely, good clinical practice can lead to dissatisfaction and complaint. I have heard of a doctor who suffered a complaint for referring a child to social services for highly legitimate reasons; a classic example of where patient satisfaction is not an accurate measure of performance.
The concept of ‘cruel to be kind’ is interesting, yet seems to highlight the importance of maintaining good and safe clinical practice over and above the need to be kind or to always satisfy our patients. Medical indemnifiers often stress the need to be liked by patients as you are far less likely to suffer litigation if you are. ‘It’s harder to sue a doctor you like’, is what I hear.
So too little, yet too much, kindness can be undesirable. Our professional boundary is there to maintain objectivity, yet we lose and gain when the boundary becomes too thick or too thin. There are so many skills and virtues clinicians need to balance in the consultation; so much so that we usually leave it to the subconscious to handle and learn from each experience.
Kindness towards colleagues is yet another complexity that may be more straightforward, but I shall leave you to reflect on that one.
So, as with the many intricacies of our role and skills, kindness has a degree of challenge and complexity. What are your thoughts? Time to reflect on your kindness; too much or too little?