When There Is Nothing Left to Give
Burnout, compassion fatigue, running on empty. Three people who poured themselves out for the sick for years and learned how to keep from running completely dry.
St. Camillus de Lellis
A broken soldier who invented real nursing and ran into the places everyone else fled
Ask him: How do I keep caring when the work has taken everything I have?
Before Camillus was the patron saint of nurses, he was a wreck. Born in Italy in 1550, he grew to enormous height, well over six feet, with a soldier’s build and a soldier’s temper, and he threw his early life away on war and on a gambling addiction so total that he lost his money, his weapons, and finally the shirt off his own back in the streets of Naples. On top of it he carried a wound in his leg that never healed, an open, chronic sore he would live with for the rest of his life. By his mid-twenties he was broke, addicted, brawling, and half-crippled, a man with no future anyone could see. When he finally hit bottom and turned his life around, he tried to enter a strict religious order, and the wound in his leg got him turned away, twice, because a sick man could not keep the rule.
So he went instead to work at a hospital for the incurably ill in Rome, and what he found there set the direction of his whole life. The care was appalling. The sick were neglected, robbed, and left in filth, tended by hired help who despised them and sometimes stole from the dying. Camillus, who knew what it was to be the man everyone had written off, looked at these abandoned patients and could not stand it. He decided the sick deserved to be cared for as if each one were Christ himself, with skill, with dignity, with tenderness, by people who actually wanted to be there. So he founded an order to do exactly that, the Ministers of the Sick, and they wore a large red cross on the chest and went where the fear was, into the plague houses, onto the battlefields to carry off the wounded, to the beds of the contagious and the dying. He essentially invented organized, dignified nursing and battlefield medicine centuries before either had a name, insisting on clean beds, proper food, fresh air, isolation of the contagious, and genuine compassion, and he did all of it on a leg that never stopped hurting, serving personally until he was too weak to stand. He died in 1614, and in 1930 he was named a principal patron of nurses and the sick.
Here is what Camillus has for the nurse who feels she has nothing left to give. Notice that he did not run on a full tank. He ran on empty, from a broken place, with a wound that never healed, and he poured himself into the sick anyway, and it did not destroy him, because he had found the one thing that turns the work from a grind into a calling. He looked at each patient and saw Christ. That was not a slogan for him. It was the thing that let a depleted, damaged man keep going, because when the person in the bed is not just another chart and another set of tasks but someone genuinely worth reverence, the caring pulls something up out of you that mere duty never will. When the tank is empty, duty alone will not refill it, and willpower runs out. What kept Camillus going was seeing who he was actually serving. On the shift when you have nothing left, the thing that can carry you is not gritting harder. It is remembering, in front of one specific patient, that the person in front of you is worth everything, and letting that, rather than your own drained reserves, be what you draw from.
The one line to keep: When the tank is empty, duty alone will not refill it. What carries you is seeing who you are actually caring for.
St. Teresa of Calcutta
A woman who cared for the dying for fifty years while feeling completely empty inside
Ask her: What do I do when the compassion has gone dry and I feel nothing?
Teresa of Calcutta spent nearly fifty years doing some of the hardest bedside work on earth, pulling the dying poor out of the gutters of an Indian city so they would not die alone in the street, cleaning bodies ravaged by disease and neglect, holding people whose own families had abandoned them, running homes for the sick and the dying and the unwanted. The world watched her do it and assumed she must be running on some endless supply of warm feeling, some overflowing spiritual joy that made it possible. That is not what was happening. After her death, her private letters were published, and they revealed something almost no one had known: for roughly the last fifty years of her life, this woman who was the public face of compassion felt, on the inside, almost nothing at all. She described a profound spiritual darkness, a sense that God was silent, absent, that the warmth and consolation she had once felt were simply gone, replaced by a dry emptiness she carried the entire time she was doing the work.
Sit with how staggering that is. She did not care for the dying because it felt good. For half a century it did not feel like much of anything. She got up every day and did the hardest, most draining work imaginable while feeling empty, unconsoled, and spiritually dry, and she told almost no one, and she never stopped. She came to understand her own darkness as a way of sharing in the abandonment felt by the very people she served, the ones who felt unwanted and unloved, and she kept choosing to love them with her hands and her actions even when the feeling of love was entirely absent. She kept smiling at the dying, kept showing up, kept doing the work, and let the doing be the love, since the feeling had gone quiet. She was canonized a saint in 2016.
For the nurse who is terrified because the compassion has run dry, who used to feel something for her patients and now feels mostly numb and wonders if that means she is failing or finished, Teresa of Calcutta is the answer that no one else will give you honestly. Feeling has almost nothing to do with it. She proved, over fifty years, that you can do profoundly loving work while feeling empty, that the numbness is not proof you have stopped caring, and that love at the bedside is finally a matter of what your hands do, not what your heart happens to be feeling on a given shift. The warm feelings are a gift when they come, but they are not the engine, and they will come and go, and there will be long stretches, maybe years, when they are simply gone. That does not mean you are done. It means you have arrived at the place where love stops being a feeling you ride and becomes a thing you choose, gently, action by action, patient by patient, whether you feel it or not. If the tank of feeling is dry, do the next kind thing anyway. That is not hypocrisy. According to a woman who did it for fifty years, that is the real thing, and it is worth more than the warm version, because it costs more.
The one line to keep: Numbness is not proof you have stopped caring. Love at the bedside is what your hands do, not what your heart happens to feel. Do the next kind thing anyway.
St. Elizabeth of Hungary
A princess who traded a palace for the bedside and wore herself out young for the sick
Ask her: Is it worth pouring myself out like this when I could have an easier life?
Elizabeth was born in 1207 into royalty, a Hungarian princess married young into the ruling family of a German territory, set up for a life of comfort, wealth, and ease that almost no one in her age could dream of. She had every reason to spend her life the way royalty spent it, insulated from the suffering of ordinary people by walls and servants and rank. Instead she was drawn, from a young age, straight toward the sick and the poor, and she used her position not to escape them but to reach them. She gave away food from the royal stores during famine, so much that she strained against the resistance of the court. She had a hospital built below the castle and went down to it herself to tend the patients, and the stories say she cared personally for people with diseases that everyone else fled, including lepers, bathing and feeding and nursing with her own royal hands the exact people her rank was supposed to protect her from ever touching.
Her husband died when she was only twenty, and after his death she was pushed out of the court, and she gave up her royal status almost entirely, took on a simple life, and devoted herself completely to caring for the sick and the destitute in a hospital she helped establish, doing the humblest and most physically demanding nursing work, the washing, the feeding, the tending of the dying. She poured herself into it with such total abandon that she wore herself out, and she died at just twenty-four, worn down by the work and by her own severe self-denial, having spent her short life almost entirely on other people’s suffering. She was canonized only four years after her death, and she is one of the patrons of hospitals and of those who care for the sick.
For the nurse who sometimes stops and wonders whether it is worth it, whether she is a fool for pouring herself into this draining, underpaid, undervalued work when she could have chosen something easier and kept more of herself, Elizabeth answers with her whole short life. She had the easier life fully within her grasp. She was a princess. She could have kept the palace and the comfort and the distance, and no one would have faulted a royal for staying behind her walls. She chose the bedside instead, chose the lepers and the dying, chose to spend herself rather than preserve herself, and she has been remembered and loved for eight centuries for exactly that choice, while the names of the comfortable royals who kept their distance are forgotten. Now, her early death from overwork also carries a warning that the rest of this book will return to, that pouring yourself out is not the same as destroying yourself, and a nurse has to learn to care for the caregiver too. But the core of her witness stands. A life spent on the suffering of others is not a wasted life or a foolish one. It is one of the few things a person can do that is unmistakably worth doing, and at the end it is the comfort you gave, not the comfort you kept, that will have mattered. You did not choose the easy road. You chose the one that counts.
The one line to keep: A life spent on the suffering of others is not wasted or foolish. At the end, it is the comfort you gave, not the comfort you kept, that will have mattered.