On Compassion

Nutmeg, my forty pound hound dog, pounced into the air.

She landed in my lap before I had a chance to register the lightning. I heard thunder, and realized her fear was ignited by a sudden storm. Her body trembled. My chair rattled, not from the storm, but from her shaking. The corners of her mouth pulled back. She panted with increasing desperation, as if air would not pass.

Lazy Nutmeg on a not-so-stormy day.

Three years ago, I experienced my first panic attack. Suddenly, out of nowhere, sitting in a tiny hotel room near the beach, my heart raced. The walls closed in. For no apparent reason, I felt that if I didn’t escape the room, I might die.

For years I had heard people describe “panic attacks”. I imagined anxiety, fear. In this moment, though, anxiety didn’t begin to describe what I was feeling. I was a wild animal, caught in a trap, clawing and scratching, desperate to be free. There was no logic to this feeling. My room was calm, quiet, cool. I was with my husband and children, the people I love most in this world. And yet, my brain was convinced that my life was at risk.

Though I knew I was experiencing panic, no amount of deep breathing or kind self-talk could tame the terror. I left the hotel room, telling my kids and husband I was going to get some fresh air, hoping they wouldn’t notice the tension in my voice, my desperation to escape.

In the hotel lobby, the panic softened to a gentler anxiety, but I knew if I returned to the room, the panic would surely return in full force. I went outside. The warm summer air smelled like salt. I sat in my van, wondering if I should try to sleep there. Eventually, I headed back upstairs, and, in fact, the panic did return. This continued for sometime, until eventually I was able to calm into a steady, but tolerable state of anxiety. And then sleep. The next morning, I was fine.

Back to Nutmeg and her storm. With each flash of lightning, her body seized and shook. Panic, no other word for it. I tried to slow my breathing hoping she would sense my calm. I massaged her ears and neck, slowly and with deep pressure to help her notice her own body in the midst of her hijacked brain.

The storm lingered, and though the thunder wasn’t particularly loud, Nutmeg’s fear was unrelenting. Her panting grew more desperate. She opened the back of her throat, trying to get as much oxygen as possible. I could only imagine she felt something akin to my hotel-room, claustrophobic panic. My anxiety had been perpetuated by self-awareness, and snowballed into an inescapable physiological and psychological storm in my own brain. Could Nutmeg recognize her own panic? Could her fear of being afraid exacerbate her distress?

But this isn’t a story about panic. Nor anxiety. This is a story about compassion.

As Nutmeg sat, trembling in my lap, I didn’t feel empathy. I didn’t “try on” her panic, or attempt to share her emotions in my own body. While I remembered feeling panic in that hotel room, I didn’t relive that hijacked state of mind.

Instead, I felt deep sorrow, deep compassion. I allowed that compassion to guide my own physiology into a deeper, calmer, more purposeful state.

Rather than panicking with her, I settled my own breathing to hopefully help her calm. Instead of allowing my own throat to constrict, shortening my breath and raising the tone of my voice, I gently deepened my voice, speaking slowly and softly.

I also did something I often do with nervous patients. I spoke less. Clients, dog and cat owners, will often talk more - faster and in a higher pitched voice - when their pet is stressed. “It’s okay! Bailey! You’re okay! Good girl! Good girl! I promise it’s okay! Want a treat? It’ll be over soon!!” What does Bailey hear? The owner may as well say, “Yes, Bailey, you’re right to be terrified!”

Over years of practice, I’ve trained my brain to move into a calm space, even when I feel anything but calm. A patient arrives in respiratory distress. A client is screaming at the front office, furious over their bill. A team member comes into my office and shares a terrible personal crisis.

Whatever the situation, my voice reflexively goes softer and deeper. My pace of speech slows. A friend calls it my “doctor voice” and she says that, whenever I use it, she knows things just got serious.

When this voice emerges, I’m not taking on the negative, sad, or desperate feelings of those suffering near me. Not with my clients. Not with my patients. And certainly not with Nutmeg in her state of storm terror.

Instead, I move into compassion.

Sometimes intentionally, other times subconsciously, I assess how the canine, feline or other human in the room might feel. But I don’t linger there. Lingering there could be debilitating. Lingering there would be suffering with my patient.