Compassion Fatigue and the Canary in the Cage

I don’t know if I was compassionate when I started in medicine.

Not really, anyway.

I think I wanted to be. Or at least, I thought I was. But compassion is a slippery thing. The moment you say you’re compassionate, you’re probably not.

The people who truly are — they never brag about it. They just get on with the job, quietly bleeding for others in a system that barely gives them a plaster. And, right now, 70% of UK GPs report compassion fatigue serious enough to impact care quality, with

62% of doctors overall showing signs of emotional exhaustion.

And if compassion is the currency of our profession, cynicism is the tax. Paid in full, monthly, by Direct Debit.

The Slow Erosion

Compassion fatigue doesn’t crash through the door. It seeps in. Bit by bit — through snide remarks, impossible consults, and the Sisyphean task of helping patients in a system where staff burnout is dismissed as an individual failure.

One day you catch yourself rolling your eyes at a patient convinced their husband is poisoning them. That’s not empathy fading—it’s gone.

Advocacy vs. Capitulation

Compassion doesn’t mean compliance.

You can care deeply and still say no—sometimes, “no” is the most compassionate option. But if your empathy bucket is dry, that no sounds callous. Even when their “truth” comes TikTok‑certified, compassion must anchor your words.

THAT Patient

You know the one—drama, trauma, complexity, the unfixable stuff.

You’re tired.

Not just tired. Emotionally exhausted—the kind of fatigue where “if one more patient asks for pregabalin, I might kill myself” doesn’t feel humorous anymore.

When that client pushes your buttons, don’t just react. Ask:

- Are they triggering unhealed wounds?

- Are they emotionally exhausting?

- Are you at your limit?

If shutting down is your first impulse, you’ve crossed the line. That’s compassion fatigue in action —and nearly two-thirds of UK doctors have felt it.

Systemic Silence

Here’s the kicker: the system won’t notice.

No one’s going to tap you on the shoulder. Everyone’s exhausted. Everyone’s silent.

Burnout is still framed as personal weakness, not systemic failure—despite repeated parliamentary findings about the NHS investigatory and blame culture. So we’re left being stoic, being “resilient”—essentially told to suffer in silence.

When you’re too tired to care, you’ve already lost.

Dispassion Doesn’t Mean Dysfunction

Not everyone’s gushing. Radiologists don’t need to cry in the dark oubliette they dwell. That’s fine.

But if your empathy has died, it’s not a quirk. It’s erosion. Emotional labour isn’t a boast—it’s your cost of entry.

Without empathy, we stop advocating. We stop humanising. We become carbon copies of what patients already fear: cold, transactional functionaries.

The Mirror and the Mask

True clinicians see when they’re overloaded.

They hold themselves accountable. They say:

“I don’t think I can help today—but I’ll try tomorrow.”

Because compassion fatigue is common—but beatable, especially with peer support and self-care systems in place.

They know the cure isn’t hiding—it’s time, space, and sometimes tears in a Tesco car park.

Final Word

So if you’re three years into training—or twenty years in—and you feel that numbness, that “just one more patient” bar raising:

You’re not broken. You’re human.

But listen: the moment people become interruptions instead of humans, something’s gone horribly wrong.

Compassion fatigue is the canary in the cage. If it stops singing, don’t wait for silence.

Step away. Reset. Then come back—but only when you’re ready.

Stay Connected

—DW