Published online April 1, 2008
PEDIATRICS Vol. 121 No. 4 April 2008, pp. 825-827 (doi:10.1542/peds.2007-3828)
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COMMENTARY

Love, Pain, and Intensive Care

K.J.S. Anand, MBBS, DPhila and Richard W. Hall, MDb

a Departments of Pediatrics, Anesthesiology, Pharmacology, Neurobiology, and Developmental Sciences
b Neonatal Intensive Care Unit, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas

Abbreviations: NIDCAP, Neonatal Individualized Developmental Care and Assessment Program

The first 20% of the full text of this article appears below.

No activity can give you the joy that service does... . You should yearn for the chance to console, comfort, encourage, heal. See yourself as another, feel his joy to be yours, his sorrow to be yours.

—Sri Sathya Sai Baba1

The drive for objective assessments and measurements in recent years has overshadowed some of the subjective aspects of medical care. Whereas evidence-based medicine informs "what" we can do for our patients, "how" we are providing this care may be equally important. This includes not only the actual details of care delivery but also the attitude, feelings, and emotional state of professional caregivers at the time of patient interactions. Interventions performed without empathy, mechanically, or while distracted by other concerns may be less effective than those imbued with love and care for the patient's well-being.2 Although we explore in this commentary the evidence for this principle related to neonates receiving care in an NICU, the same principle can be applied to other clinical populations and practice settings, especially intensive care.

During training, practitioners are encouraged to maintain objectivity and suppress their emotive reactions or emotional involvement in all clinical situations. Lack of objectivity is often cited as a reason for not treating close relatives, when emotional involvement is expected to occur. This habitual suppression of emotive behavior becomes second nature during the long years . . . [Full Text of this Article]

Address correspondence to K.J.S. Anand, MBBS, DPhil, Arkansas Children's Hospital, 800 Marshall St, Little Rock, AR 72202. E-mail: anandsunny@uams.edu