BOOK REVIEW: ‘A Fearless Heart: How The Courage to Be Compassionate Can Transform Our Lives’

Naveen Kumar, MD

As I began reading this book, I had some initial doubts about its utility. “Why do I need to read a book about compassion? As a physician, I have dedicated my life toward healing others. Isn’t that compassion enough?” Interestingly, as I read further it became clear that physicians often forget a key element of compassion: compassion toward ourselves. As author Thupten Jinpa, PhD, writes, “Neglecting our own needs can lead to emotional burnout over time, leaving us depleted and exhausted. It’s a common problem for those on the frontline of healthcare.” In fact, physician burnout is one of the reasons that Kaiser San Rafael Medical Center, under the leadership of my colleague, Dr. Nirupam Singh, offers a Stanfordbased eight-week Compassion Cultivation Training (CCT) course for interested physicians.

The goal of the book and the course is to bring us back to a fundamental aspect of human nature, which is to be compassionate. The problem is that many of us put compassion aside as we struggle to make it through our busy days and lives. However, we pay an emotional price for this. One vignette describes a burned-out young physician who, after taking the course, says, “It feels like what I do has meaning again and I feel more balanced. I intend to keep practicing medicine and compassion.”

Even for those unable to enroll in the program, the book gives numerous practical techniques for “building our compassion muscle.” Like any skill, compassion has to be actively nurtured through training and exercises. These include things like setting intentions (i.e., identifying positive steps you intend to take), cultivating awareness and mindfulness, and focusing the mind through meditation. The exercises are secular, but they are fundamentally based on Buddhist traditions and are described in detail in the book. The author is a former Tibetan monk, and he draws on his past experience and training throughout the book. His own story, as a Tibetan refugee growing up in India, is fascinating. Despite a difficult childhood and losing his mother at an early age, he perseveres and becomes the interpreter for the Dalai Lama.

Luckily the book is a quick read, and as I went through it I found myself identifying more compassion opportunities on a nearly daily basis. One of the radiology technologists I work with does an amazing job of caring for women as she takes mammograms for the early detection of breast cancer. One day a patient told her, “Your job sucks.” When I heard this, my initial reaction was anger at a patient who would disparage my staff this way. I caught myself though and was quickly able to turn that anger into compassion for a patient who was undoubtedly scared, nervous and likely experiencing difficulties in her life. The opportunities are there, in both our personal and professional lives, as long as we have the awareness to look for them.

I have actually started sharing the teachings in the book with my children. School is a place where compassion can often get lost. My 10-year-old son has a strong allergic reaction to gluten. When a schoolmate recently offered him a cookie, he said, “No, thank you. I have an allergy to gluten.” The child then threw the cookie at him saying, “Your life must suck. You should commit suicide.” When I heard about this I was again angry, but I learned about compassion from my son who was concerned for what might be going on in the other child’s home. He worried that perhaps the child was abused . . . why else would he say such hurtful things? In fact, Dr. Jinpa describes how compassion and mindfulness can be incorporated into schools with robust effects on children’s behavior.

Ultimately, the goal of any training is to bring about change. For compassion training, the change is how we behave in the world. This may sound like a lofty, almost unreachable goal, but any big change is made up of multiple small ones that build up gradually over time. Since reading the book, I have seen some changes in my own life, but more importantly I now look for new opportunities for compassion.

Even more exciting is the power that could arise from having multiple people in an organization consciously practicing compassion. As the author writes, “The very ethos of our healthcare system can and must stem from compassion.”

In sum, this excellent book is a mustread for health care professionals.

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Dr. Kumar is a diagnostic, vascular and interventional radiologist at Kaiser San Rafael.
Email: naveen.n.kumar@kp.org