Can a Physician Always Be Compassionate?

"Let compassion breathe in and out of you, filling you and singing"[1]

The day was beautiful. I felt energetic and looked forward to morning office hours. Several new patients were scheduled, which always adds adventure to the routine and the possibility of an intimate moment of connectedness.

About mid-morning I entered one of the examination rooms where a new patient was waiting. She was slightly overweight, in her fifties, and after her "good morning" her accent revealed her to be German. Her chief complaint was that her shortness of breath was getting worse. She had sought me out because her friend told her that I spoke German, which would make communications more comfortable for her.

When I started taking her history we switched to German. During the system review I asked about her family. Her husband had been killed fighting for the "Fuher." Her son was in the Hitler Youth; he was only ten when the Allies overcame the "Reich." She and her son had come to the States reluctantly, but food and housing in Germany were scarce after the war, and she had a sister in New Jersey who could provide both. Her role during the war was to supervise slave laborers--Jews, Poles, and others--in a defense plant near her hometown. She did not regret using these "Minderwertigen" (scum, low-downs) to further the goals of the "Vaterland." There was little doubt in her mind that these vermin got what they deserved: elimination by hard labor and starvation.

When I finished taking her history my script was almost illegible, due to my shaking hand. Could I treat this person? Could I be compassionate? Neutral? Should I tell her that I am a member of the vermin, the Jewish race, that my father had been in a concentration camp, that many of my relatives had died there? What would I accomplish by telling her this? Should I refer her to a pulmonologist for her chronic obstructive pulmonary disease and thus resolve my dilemma? Would that fulfill my professional ethical responsibilities?

It certainly was not the first time that I was confronted with anti-Semites who, unaware that I am Jewish, emptied their venom in front of me. It was the first time, however, that I was presented with a Nazi, whom I was to heal, who, as all patients, demanded and deserved compassion. This was a different relationship from that...