I’m not referring to folks who are bungee jumping, cliff diving, zip lining or driving race cars here. Rather, the opposite.

While we providers do patch up plenty of such patients in the aftermath of such death-defying (or not!) feats, more often we care for those whose entire lives entail living on the edge.

Think mental illness, chronic pain, the imprisoned, the disabled, victims of abuse, the homeless, dying patients and the poor. Granted, both groups have survival in common. The first, though, tends to be the thriving well. Of the latter, many are just trying to get through their next moment — consumed by life-denying acts.

Let’s examine our perceptions of patients, coping, resiliency and how we care.

“Us” versus “Them”

I woke up terrified the other night, dreaming of being in a parking lot one car length away from an active shooter. Unable to sleep, twisting and turning, trauma from surviving a similar situation a few years ago resurfaced.

Down that rabbit hole I went — accompanied by more missteps, shame, imperfections and other dramas. Reflecting upon the symbolism in the dream, finally, I realized I was that shooter. He was me.

In “Tattoos on the Heart,” Gregory Boyle writes, “Pema Chodron, an ordained Buddhist nun . . . suggests that [compassion’s] truest measure lies not in our service of those on the margins, but in our willingness to see ourselves in kinship with them.” We are not separate.

Coping and Resiliency

“There by the grace of God go I,” my very Roman Catholic mother used to tell us kids all the time. Years later, while working in psychiatric units, her words helped me care compassionately for some of the most in need.

I remember one particularly filthy, incoherent, homeless male, maybe in his early 30s. Breathing through my mouth during intake, as soon as I could, I got him into the shower. He was an absolute mess — I could barely tolerate what I saw and smelled.

More of Mom’s words came back to me, “See Jesus in everyone.” I sure did try. He and I persevered and, once cleaned up, what a transformation! He was quite handsome and, although still very ill, he carried himself with a very different countenance. Dignified, I’d say.

Another memorable patient had a history of molesting children. None of the staff wanted to spend any more time with him than they were required to.

Other patients seemed to avoid him as well. How fortunate I felt to have the capacity to care for him as I would for any patient.

I would often muse about what kept us staff from being locked up like our psychiatric patients were. It seemed to drill down to two things: coping and resiliency. How we handled our difficulties and our ability to bounce back, over and over. Lose these and we, too, might be hospitalized — or worse.


First, let’s consider ourselves. Take one look at most health providers these days — we aren’t doing very well. Among other strategies, we try to escape, distract ourselves, swallow our anger and end up somehow sickened.

We aren’t putting the oxygen mask on ourselves before putting it on the person next to us. Without caring for ourselves, how can we continue to be of true value to others?

Check in with yourself: how is your self-talk and self-empathy these days? Are you doing your self-care practices? Using your support system? Setting appropriate boundaries? Standing up for yourself? Saying “no?” What about your joy quotient?

Once you’ve refilled your cup, can you up the ante of compassion in your caregiving? What can you do differently?

A beloved RN friend recently told me, “Every time I hear about the border situation, it makes me want to run down there, give these folks a hug and some clean underwear.” Sign me up! While this gesture won’t solve the problem, it’s caring: one human being for another.

The root of the word “courage” is heart, from the Latin “cor.” How can we cultivate more courage, more capacity, more connection and choose to practice more compassionately, time and time again? How can we love more?