One of my favorite writers about health care, oncology nurse Theresa Brown, described her envy of some aspects of battlefield medicine as a way to illustrate the crushing burden of charting on nurses in her latest piece, “Caring for the Chart or the Patient?” But then, demonstrating her amazing ability to keep her sights on what matters most, she took a left turn into talking about compassion:

The care we give our cancer patients is obviously much different from what we do for soldiers who’ve had their legs blown off by an I.E.D., but the threat to life and limb is no less real. I have no drop-down menu for charting “Empathized with patient over fear of metastatic disease and death.” And yet, that’s exactly what the patient needed.

“If it isn’t charted, it isn’t done,” we hear. But as the paperwork demands proliferate, my worry is that if it can’t be charted, it won’t be done.

On the other end of the caregiver-patient relationship, I can say that her worries are well justified. In fact, I think that the way empathy has been marginalized by efficiency in “modern medicine” is fueling the interest in alternative medicine.

From a skeptic’s point of view, a lot of the benefit from therapies like acupuncture or Reiki comes from things incidental to what’s being touted as the treatment; they argue that a lot of the “therapy” is in fact therapy in the psychological sense: the patient gets to share her problems with someone who cares. I think there’s some truth there, and it’s a shameful commentary on “modern medicine” that people with health problems aren’t getting that empathy from the mainstream medical establishment. On the other hand, I don’t believe the skeptic’s reduction explains it all. I’ve felt what can only be described as chi moving along meridians and been surprised by the specificity of Reiki. There is more going on there than “just” the power of empathy. But even if empathy is the major contributing factor, Ms. Brown, and all good nurses and caregivers, recognize that’s powerful medicine. So powerful, in fact, that it’s almost magical.