For how long can a man be in the company of Death before it begins to wear on him? I’ve been working at hospice for almost seven months now. During that time about 250 people have come to die in our care (with others having gone into home or long-term care). Add to that the many friends and relatives who accompanied these patients and the number goes to a thousand-plus. Thousand people with whom I entered into an intimate relationship. Strangers arrive and within minutes or hours they invite me (and my dear coworkers) into the most intimate sphere of their lives. And then, within days or weeks—sometimes hours—they vanish. That pattern takes a toll on those who stay behind, opening and closing their hearts of compassion, always ready to receive new “admissions” and to begin the caregiving process all over.
In recent days I’ve felt heavy, like a ballon steadily filling with water. A couple of times I observed my mind wandering into nowhere as I listened to someone speaking to me of anxiety and loss. For the first time this week, I preferred sleeping in to jumping out of bed and bike to work. I’ve begun to miss appointments. Everything’s become a bit of a burden. The lightness of the previous months has faded, to be replaced a sense of fatigue and occasional vertigo. I go to sleep and wake up thinking about work, recalling individuals or a collage of scenes to do with dying.
What’s going on? What is this?
According to a coworker in whom I confided and an on-line source, the concept of compassion fatigue has emerged in the professional literature. It represents the cost of caring about and for traumatized people. Professionals who work with people in pain and anxiety must contend with not only the normal stresses of work, but also with the emotional and personal feelings for the suffering. This, apparently, is not burnout, which is cumulative and relatively predictable and often remedied by a vacation or change of job. Compassion fatigue is very different: it’s a state of tension and preoccupation with individual or cumulative trauma of clients.