“Pobrecito” – The Fine Line between Compassion and Infantilization

By Fabiana Juan Martinuzzi

“Pobrecito”– she said as we discussed the patient’s pneumonia course before entering his room.

Pobrecito” – she repeated as we donned our gloves.

Pobrecito”- she mouthed to us in front of our patient.

Pobrecito”- she whispered in my ear as we left the room.

That day, “pobrecito” became a word I eliminated from my vocabulary. In Spanish “Pobrecito” translates roughly to “poor thing” or “poor baby” and it is an appropriate word to use to show empathy with an endearing connotation. However, when one of the healthcare providers in the team used it incessantly to show pity in front of my 60 year old patient with cerebral palsy and dementia I began to cringe every time I heard her say it.

Yes, I indeed felt empathy for my patient who had been admitted for more than a month due to a pneumonia that was not improving. However, I showed my empathy by treating my patient in a respectful manner every time I rounded on him. I saw him every morning for two weeks during my rotation. I would enter the room and greet him and his caretaker, I would talk to him like I would to anyone else. Some days he would be happy to see me and would let me examine him, and other days he just wanted to be left alone.

So, “Pobrecito” sounded right the first time she said it. I too thought it was sad that my patient was only slowly recovering from his pneumonia. I too thought that no one should ever be in this condition and have no loved ones to care for him. But even though I thought this, I channeled my feelings by treating my patient like I would any human being. Whenever she said the word, it was almost as if it had lost its endearing connotation and become a way for her to make the rest of us, except the patient, know that she felt bad for him. And even if she truly felt empathy, “Pobrecito” is all she could say.

At first I thought I had been too harsh on her for oversharing her empathy, but when she stroked his bald head with her gloved hand and smiled at us saying “He’s a child!” I questioned her training and I questioned her emotional intelligence. He was not a child, he was not a poor thing. He was a pleasant man in his 60s with a medical condition that impaired his cognition. He deserved to be treated in the same way that she treated the other patients on the floor.

Empathy and compassion were words I used to describe the qualities I thought anyone in the healthcare field should have. I repeated these words incessantly during my medical school interviews. I saw these qualities in many physicians I shadowed or volunteered with and hoped to portray them when I interacted with my patients in the future. Now, as a third year medical student, I have become very protective of empathy, compassion and the fine line between them and feeling pity or being condescending towards a patient.

My goal as a future physician is to show my patients empathy and compassion while treating them with the respect and dignity they deserve. I hope too that in the same way I learned this skill from my best mentors, one day someone will learn to do so from me.

 

Fabiana Juan Martinuzzi is a third-year medical student at the Florida International University Herbert Wertheim College of Medicine. She advocates for a strong patient-doctor partnership. She is considering pursuing a specialty in general surgery.

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