The Science of Compassion
Through her research, Lidia Schapira MED '82 has demonstrated that empathetic communication between physicians and patients can lead to better outcomes—that compassion, in and of itself, is medicine. As a clinician, researcher, and mentor, Schapira brings this sensitivity to every interaction—with patients, colleagues, and students—carrying on an attitude of caring her Dartmouth Medical School (now Geisel School of Medicine) teachers passed down to her.
An associate professor of medicine at Stanford University School of Medicine and director of Cancer Survivorship at the Stanford Comprehensive Cancer Center, Schapira has studied the vital role physicians play in relieving their patients' anxiety and empowering them in their own care. Her work focuses on the pivotal juncture when doctors first deliver a diagnosis of a life-threatening illness.
"This is one of the most challenging moments in medicine. You have to collaborate with a patient and set the agenda together," she says.
In training compassionate clinical teams, she emphasizes the importance of taking time to establish good rapport with patients before giving a diagnosis or exchanging vital health information. It starts, Schapira notes, by acknowledging everyone in the room and including family members in the conversation.
"It's not necessarily intuitive," she says. "When I was starting out, doctors often had to do their best without any preparation or training, which also meant patients had vastly different experiences, depending on the skill of the treating physician."
Schapira had witnessed, through her work with Joseph O'Donnell, MD, James Bernat, MD, and other members of Dartmouth's medical faculty, the possibilities to support patients using an empathetic approach to medicine. "I studied with extraordinary clinicians who connected with patients," she says. "They fostered a culture of attention to the human side of healthcare, in which every patient is valued. They taught me to create ripples of compassion in everything I do."
I studied with extraordinary clinicians who connected with patients. They taught me to create ripples of compassion in everything I do.
During a three-year fellowship in hematology at Brigham and Women's Hospital, Schapira wanted to learn more about meeting patients' emotional needs effectively and began to look at treatment from a patient's perspective. How did patients respond to hearing they had cancer, and what role did doctors play in helping them absorb that news?
When she asked her fellowship director if she could research this, "He raised his eyebrows," she recalls. "At the time he saw no connection between the relational aspects of medicine and the science of treating the disease."
Schapira persevered. To date she has co-authored numerous studies on the doctor-patient relationship and healthcare outcomes. In 2016, she was named the editor-in-chief of Cancer.Net, an award-winning patient information website of the American Society of Clinical Oncology (ASCO), and is consultant editor for the "Art of Oncology" section of the Journal of Clinical Oncology. She has also served on the Board of Directors of the American Psychosocial Oncology Society.
In fact, Schapira's caring relationship with a patient, Julie Goldman—a Harvard University graduate student with metastatic breast cancer—led to a life-changing professional collaboration, starting in 1999. The two worked together on an educational training film, "One Story, Two Voices," that details what a patient with a life-threatening illness needs from a doctor. Together, Schapira and Goldman presented at grand rounds and medical conferences. In 2000, Goldman died at age 38, but the film has been widely used in nursing and medical schools.
"One of the greatest teachers and partners is the patient," Schapira says. "They teach you valuable lessons about the healing powers of connection and compassion."
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