Interview with David Brenner, MD, vice chancellor for health sciences at UC San Diego,
QUESTION: What is the T. Denny Sanford Institute for Empathy and Compassion and how will it benefit and affect the University of California San Diego?
ANSWER: William Osler, who's the founder of modern medicine, said that physicians need three attributes: They need skill. They need knowledge. And they need compassion. Without all three, the other two are ineffective. We really believe that compassion should be an integral part of medical education and the practicing physician. How are we going to do this? We are so lucky that we are going to establish the T. Denny Sanford Institute for Empathy and Compassion. This is going to be in the school of medicine and it is going to provide us the opportunity to train the next generation of physicians to be compassionate for the patients, but also to be self-compassionate, to take good care of themselves.
It has two main components: The first component is that we are going to provide research to understand the neurobiological basis of compassion. We are convinced that we can use state-of-the-art technology to understand compassion at the same level we understand taste and smell. This has never been done before. This is the first time that advanced state-of-the-art technologies are applied to understanding compassion. That's the first goal of the institute.
The second goal is then to use that information to educate people better. First, medical students, and then extended to others. So it has two big components, a research component and an educational component. Why in medicine? Medicine is now faced with a crisis of physician burnout. Physicians are not taking good care of themselves and because of that they're not taking good care of their patients. We think that if we teach compassion to medical students and physicians, we can make a big dent in improving this. We think that physicians need to be self-compassionate. They need to take better care of themselves. They need the tools in order to do this. We would like teaching compassion to become an integral part of the medical education, just like we currently teach skills and knowledge, just like Sir William Osler originally proposed.
QUESTION: How do you do that? Obviously, there's neurobiological research on mapping compassion in the brain, but teaching compassion is not like teaching skills where you open a textbook. How do you actually teach students who are very foreign to this idea to act compassionately towards themselves and others?
ANSWER: I think there are really two approaches. The first, look at what best practices are throughout the world. There are several different groups of serious thought about how you can teach compassion to everyone from elementary school students all the way through teaching to hospital systems and physicians. We'll look for best practices. The second is that by doing research we can actually do evidence-based teaching. We can actually look at when you intervene, does that change neurocircuitry in a way that favors compassion? We don't have the information to do that yet. So we'd like to take best practices, understand them at a circuitry basis, and then bring them back to evidence-based teaching.
We don't have to wait to get all the results first. We can actually start now, get some information, reassess, readjust. But I want all of us—students, residents, physicians—to participate in this. So this would be to UC San Diego Health and the Jacobs Medical Center, a learning laboratory where the T. Denny Sanford Institute gets to use us in a way that we can advance our understanding compassion and our physicians have the opportunity to participate in compassion education.
QUESTION: Why is UC San Diego one of the only places in the world where this sort of research can actually be carried out?
ANSWER: When we were thinking about establishing the Sanford Institute, we wanted to ask two questions: Why now and why here? Why now? We really believe that we have state-of-the-art tools that will let us do serious in-depth research on the neurobiology of compassion. We didn't have that before. We didn't have the advanced imaging, the genomics, the metabolomics, the biomarkers. We really think we can approach this like we can any other clinical problem. That's number one. Number two: Why here? I think that San Diego, UC San Diego and our surrounding community are uniquely collaborative and multidisciplinary.
We can bring people from all different disciplines, from psychology, from cognitive sciences, big data, neuroscience, neurobiology, radiology, to work together, to do multidisciplinary research and use tools from other people to combine, to get information we would never be able to get otherwise. I know this was tried at other institutions, including some very famous institutions, and it didn't work because they were so siloed.
QUESTION: In addition to having this wonderful collaboration across campus and across the entire Mesa, UC San Diego also has a really good foundation in compassion. We have the PACE program here, we have the HEAR program here. Compassion has been a buzz word around campus education for quite some time. How will this be different? How is this taking it to the next level in terms of medical education?
ANSWER: It's very important that we have a tradition of being interested in understanding compassion and using it. We have programs for physicians. We have programs for our medical students that emphasize this. So, how is this different? The Denny Sanford Institute will actually provide a neuroscientific basis. No one has had the resources or the collaborations to actually do in-depth state-of-the-art research. All the other programs…they sort of look around and say, "This looks useful. Let's try to teach people this."
They never had the opportunity, the resources to try something, assess it, measure it when the most important thing is to actually measure something, do an intervention, and then measure it again and see if you improve it. That interaction between research and education has never been done before. There have been a lot of programs that have done their very best with their limited tools to educate people to be more compassionate, but it was never based on a scientific, rigorous investigation. It was always sort of based upon historical interests or things that look good or things that other people use and try to adapt. We're going to look at what best practices are and then we're going to rigorously test them. We're going to measure them. We're going to intervene and we're going to do it again.
QUESTION: In your own words, what is the real world impact of this gift? How's it going to affect people on the ground?
ANSWER: The T. Denny Sanford gift is for a program. It's one of the largest gifts ever that was not for building, not for a school, not for a hospital, but to actually advance a concept that we should have a more compassionate world. It approaches this in a very logical, well-thought-out way, taking advantage of all different strengths across the campus, across the university, across the country. I think if you look back at this, I bet this has the biggest impact of any gift ever made to the University of California because the ceiling is so high to make it a more compassionate world, starting with medical students, going on to physicians and then extending it.
QUESTION: Why is it so important to Denny Sanford to give a gift like this?
ANSWER: Denny Sanford is one of the world's great philanthropists. He has made a commitment to reinvest his wealth into the community to make it a better place. He has invested in hospitals. He has invested in research. He has invested in education. But one of the ideas that most appeals to him is how do you make people more compassionate? He's interested in how do you make children more compassionate and then how do you take those skills all the way up to adulthood? When he heard about our concern about physician burnout and the lack of self-compassion for physicians, he said, "David, this is something I would like to invest in. I think my interest in compassion and the University of California San Diego School of Medicine's concern about physician burnout can be combined to build a program that the world has never seen before."
Denny Sanford is originally from Minnesota. He currently lives in South Dakota, but fortunately for us, he has adopted us and he is interested in helping make San Diego better. He recognizes the greatness of the San Diego research and scientific community. Denny Sanford has invested in stem cells, the Sanford Consortium for Regenerative Medicine. He said, "I want to see how stem cell research can be applied to patient care," and then he invested in the Sanford Stem Cell Clinical Center. Now he has looked at our mutual concern for compassion, and he said this is his next big investment, that he can make a big difference in the compassion that physicians have for themselves and for others and that can be extended to his overall interest in how do you educate people to be more compassionate?
QUESTION: Is there a link between the way that Denny Sanford thinks and looks at the world and the way that UC San Diego looks at the world?
ANSWER: That's great question. I think one of the things that Denny Sanford and UC San Diego have in common is that we are both entrepreneurs and we both look for the hard topics. We like to approach hard subjects, not easy subjects. We're looking for something that's transformational, not mildly evolutionary. We think that if you do something really difficult, you can make an enormous difference and that his enthusiasm, his resources, the university's enthusiasm and resources are natural partners to do really exciting projects together.