“Why do you wish to become a nurse?” The Matron of the Radcliffe Infirmary, Oxford, asked her new student Jean Stone in 1943. “What a strange question,” Jean thought. Later she would write that she realised the Matron had wanted her to refer to attributes like “understanding, compassion, kindness and common sense” as her reasons for wanting to join the profession. Compassion is one of a family of emotions that have, in modern times, become associated both with women and with those in caring professions.
Lists of the emotional and character traits expected of nurses can be found in textbooks dating back to the nineteenth century. In 1884, Eva Lückes, Matron of the London Hospital, listed the personal qualifications of the nurse in an introductory lecture. These included truthfulness, obedience, punctuality, loyalty, calmness, cheerfulness, forethought and “a kindly, pleasant manner to your patients”.
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The required qualities have not stayed the same over the years, and nor has the way they’re framed and understood. Lückes did not mention “compassion” in 1884, and it is unlikely that Jean Stone would have chosen that word to describe nursing in 1943, either, as opposed to when she came to write her autobiography in 2004. So why do we associate compassion with nursing and care today?
The word “compassion” comes from the Latin, literally meaning “to suffer together”. The Greek-derived “sympathy” means the same thing. The two words have at times been synonymous – though not always. The changing emphasis laid on compassion, sympathy and the modern word empathy (introduced to English in 1908 by psychologist Edward Titchener) is an interesting one. Among emotion researchers today, compassion is usually seen as a combination of emotion and action. It is a feeling of shared suffering, and a desire to relieve that suffering. The modern concept of sympathy, however, tends to be more closely aligned with pity.
Historically, the different terms have waxed and waned in popularity. From the late Middle Ages to the seventeenth century, compassion was the favoured term for expressing an idea of fellow feeling. As the political philosopher Thomas Hobbes put it in his famous work Leviathan (1651), compassion, like pity, emerged from grief and imagination.
“Griefe, for the Calamity of another, is PITTY; and ariseth from the imagination that the like calamity may befall himselfe; and therefore is called also COMPASSION, and in the phrase of this present time a FELLOW-FEELING.”
From 1750, however, the word sympathy rapidly increased in use, eclipsing compassion in the 1830s and rising to a peak in the 1890s. Sympathy, unlike compassion, related to the pleasures as well as the pains of another. Explanations of it were increasingly related to changes in the body and mind of the person experiencing it in the work of Alexander Bain and, later, Charles Darwin.
Both sympathy and compassion could be cast in heavily gendered terms. “Sympathy and service is the province of woman,” wrote Joseph Johnson, a prolific author of late Victorian self-help books, “She turns as naturally to sorrow and suffering as the sun-flower to the sun; if she cannot aid by her hand she gives the sympathy of her heart.” A few years earlier, the artist George Frederic Watts had painted sympathy in female form. This womanly sympathy was a rather passive affair. Women sacrificed for the good of their family because they were unable to assist more actively – “aid by the hand” as Johnson put it. Men, in contrast, actively pursued humanitarian ideals for the good of civic life.
Towards the end of the nineteenth century, some scientists reclaimed the word compassion. Vivisectionists spoke of the compassion that enabled them to suspend their horror at experimenting on living animals by focusing on the potential results of their work: reducing the suffering of fellow humans.
The humanitarian benefits outweighed the immediate suffering of the animal. In nursing, by contrast, sympathy and compassion were expected to be immediate and personal, visible on the nurse’s face. This idea owed more to conservative Victorian ideas about women than to the new science of sympathy. When the Nursing Mirror held a competition to find the “typical nurse” in 1939, the paper defined typical as a nurse “whose features suggest not merely beauty of line, but professional capacity and human sympathy”. A tall order for one photograph!
Sympathy remained a popular virtue in nursing through much of the twentieth century, though usually accompanied by other traits. The rise of the term compassion is a much more recent one. In the 1980s, the British Nursing Index contained just 6 references to compassion. For the most recent decade (2010 – 2019), this leapt to 1,645, a sharp rise well out of proportion to the overall increase in articles in the database. This rise is specific to healthcare. One modern study has found that the phrase “compassionate care” is associated with nurses rather than doctors, surgeons or managers across both professional journals and UK newspapers.
A sharp spike in the use of the word compassion in the UK occurred in 2013, the year the final Francis Report was published. The Report was the result of an independent investigation into failings in care at Stafford Hospital from 2005 – 2009. The first report in 2010 outlined the causes of poor care to include chronic staffing shortages, poor management and low morale, but identified the case as “as much a story of very poor nursing care as of anything else; nursing care that lacked attentiveness and compassion”. The 2013 report recommended “an increased focus on a culture of compassion and caring in nurse recruitment, training and education”.
As the history of compassion shows, however, we can’t consider this interpersonal emotion outside the context it is used in. To define compassion, we need to look at the environment, at political claims and at cultural ideas of gender or class as well as the seemingly individual nature of the emotion.
- Lauren Berlant, ed. Compassion: The Culture and Politics of an Emotion
- Rob Boddice, The Science of Sympathy
- Thomas Dixon, The Invention of Altruism
- Susan Lanzoni, Empathy: A History
From the History of Emotions Blog
- Riana Betzler, Review of Empathy: A History
2 January 2019
- Mark Honigsbaum, The Politics of Empathy
3 December 2012
- Carolyn Pedwell, Circuits of Feeling in the Age of Empathy
17 February 2014