Clinical Medicine

What is the Rabbit Effect? Kindness in Medicine

The last few years have been marked by chaos. The world has trudged through a pandemic virus, marked not by defiant courage and solidarity, but by skepticism and distrust. Racial tensions have flared. Thousands have taken to the streets to protest their cause. Politicians, pundits, and “influencers” feign sincerity while indulging in rancor and divisiveness. Once praised as heroes, burned-out medical professionals have been all but ignored. So what can we learn from the rabbit effect?

There seems to be no shortage of trial and trauma, cynicism, and hostility. Fake outrage is all the rage. Arguments aren’t decided on the basis of merit but on the level of offense taken. Mankind has certainly had its fair share of hardships as of late, but does that wholly explain our predicament? Not likely. It’s much simpler than that. No, the most perilous contagion we face today isn’t a virus. It’s unkindness. 

Kindness in the Clinic

One of the most common questions aspiring doctors, nurses, and PAs get is: “Why do you want to go into medicine?” The indisputably correct answer is: “To help others.” Most people probably mean it and will eventually be handsomely rewarded for it. Medicine combines compassion and science and affords its workforce a comfortable life–what’s not to love? 

But healthcare workers are people, too. Imperfect people who have troubles and bad days of their own. Burnout is a continual topic of discussion. And with good reason, too. Insurance companies put profits before patients, taking shelter behind an impenetrable bulwark of prior authorizations, denials, and exclusions. Misguided government programs encourage waste and abuse. Appreciative patients are in short supply. Together it’s enough to inflict a seemingly inoperable moral injury which is killing kindness. Yet kindness is exactly what we need. It’s needed in the clinic as much as it is in the Capitol.

The Rabbit Effect and Why Kindness Matters in Medicine

In the 1970s, researchers wanted to examine the effects of diet on the heart. After a group of New Zealand White rabbits were fed diets high in fat, their arteries were examined for plaque buildup. All of the rabbits had developed fatty deposits, but curiously, some of the rabbits had less than half that of their fellow subjects. The researchers were befuddled. 

What could have accounted for the vast differences between rabbits of the same breed, all kept under the same conditions, and fed the same diet in the same amount? Identifying the hidden variable could lead to a critical breakthrough in the treatment of heart disease in humans. 

Eventually, it was discovered that all of the rabbits whose arteries showed substantially less buildup had been under the care of an “unusually kind and caring individual.” This particular researcher didn’t just feed the rabbits as the others had done. No, “she talked to them, cuddled, and petted them. … ‘She couldn’t help it. It’s just how she was.’” In a word, she was kind. 

Could this be true? Can kindness really make us healthier? New York City psychiatrist, Dr. Kelli Harding thinks so. She wrote a book on the rabbit effect, as it’s come to be known, in 2019. Dr. Kelli is an Assistant Clinical Professor of Psychiatry at Columbia University and a specialist in mind-body medicine. The full title of her book is The Rabbit Effect: Live Longer, Happier, and Healthier with the Groundbreaking Science of Kindness

“How we treat one another in every aspect of our day-to-day lives matters,” writes Dr. Harding. “…no one exists in isolation. Every human being is part of a complex, interrelated system.” Dr. Harding also believes that access to quality medical care only explains about 10-20% of our overall state of health. “Individual and collective health isn’t just happening at appointments in hospitals and clinics but also in our everyday experiences,” she says. The rabbit effect connects kindness and compassion with better physical health.

How the Rabbit Effect Stands Up to Science

Have any other scientific studies looked at kindness and human health? Or was the rabbit effect just a fluke? Let’s ask Stephen G. Post, PhD who has spent much of his career studying giving, empathy, and compassionate care. We could start with his 2009 paper, appropriately titled “It’s good to be good: science says it’s so. Research demonstrates that people who help others usually have healthier, happier lives.” 

Or perhaps we could look at another 1970s classic from Medalie and Goldbourt demonstrating that men who perceived their wives as being loving and supportive had half the rate of angina than those who felt unloved and unsupported. The love of a good woman can also apparently ward off duodenal ulcers.

The love and kindness of a parent can have a significant effect on the health of their child later in life as shown by Russek and Schwartz in 1997. 91% of study participants who did not perceive that they had warm relationships with their mothers had midlife diseases such as coronary artery disease, high blood pressure, duodenal ulcers, or alcoholism vs only 45% who did report having a warm relationship with their mothers. Attentive fathers have similar effects on their children. Only 50% of those who were close to their fathers had midlife diagnoses vs 82% for those who did not. 100% of respondents receiving little love and kindness from either of their parents had midlife diagnoses. 

The sort of kindness and selflessness that focuses on the well-being of others is known as altruism. It’s being a helper for the sake of helping. Midlarsky and Kahana found that altruism was associated with improved morale, self-esteem, positive affect, and well-being. In a sense, kindness is akin to happiness. 

Volunteerism in older adults has been associated with a reduction in depressive symptoms, higher life satisfaction, and even a lower mortality rate. And as the old saying goes, it really is better to give than to receive. Feeling overwhelmed by the needs of others has the opposite effect, however. 

Community Kindness 

At its core, kindness is putting the needs of others before your own. It’s an active process; one that requires looking outward. If we are completely absorbed in our own lives and what we need physically and emotionally at any given moment, even perceiving the needs of others will be a challenge. 

And what about showing kindness to ourselves? As the saying goes, “It’s impossible to draw from an empty well”. So don’t be harsh or uncharitable towards yourself. Speak to yourself as you would a cherished friend or family member. Be patient and forgiving with yourself. Don’t dwell on the negative. Make it a point to have some quiet time, time to just be alone with your thoughts. Too many of us are far busier than we ought to be. 

While It’s easy to be kind to someone you already know and love, it’s much harder to extend compassion to strangers and maybe harder still to grant it to an adversary. But filling your life with kindness involves reaching out to those different than yourself and building a sense of community. 

Here’s something to try:

  • Think of someone completely different than yourself
  • Then identify things that you do have in common 
  • Notice how your feelings toward the person start to change

Man is a social creature. Even the most introverted among us require meaningful relationships with others. A recent study showed that a weak sense of belonging was associated with worse general and mental health. Communities don’t just offer the individual a sense of belonging or purpose but also the more tangible benefits of security and support. 

Cultivating Kindness

UC Berkley understands the value of science-driven interventions and established the Greater Good Science Center. Here, they share several activities that have been shown to increase feelings of kindness and compassion for others. One way to cultivate kindness and experience more happiness yourself is to engage in random acts of kindness. Here’s how it’s done:

  • Perform five acts of kindness on a given day. They recommend a variety of acts such as:
    • Feeding a parking meter
    • Picking up litter
    • Helping a friend with a chore
    • Providing a meal to a person in need
  • Then, write about it and how it made you feel

But remember that it must be your choice to do something for someone else. You won’t be as satisfied if you felt forced to comply. You can also make your charitable acts more successful by striving to make a personal connection with the person you are helping. Humans are social animals, remember? 

Another way to make your random acts of kindness more effective is to focus on the one. It can be hard to feel like your effort means something when it involves a charity or other large organization. In truth, your contribution may not be all that impactful in the grand scheme of things but when you focus your efforts on the individual, even small things may be remembered forever. 

Humans are more likely to show kindness to others when they feel a part of something larger than themselves.  Spend some time in nature or with a meaningful piece of art or architecture. The effect is even stronger if the experience is a new one. Turn off your phone and actively observe everything you can–what you see, smell, and feel. Don’t forget to write about the experience or share it with others. 

Kindness Kinda Matters

The science is pretty clear–as much as we need doctors, nurses, and PAs, we need each other even more. So let’s unplug a little more often and build our kindness muscles. Let’s give the gift of our time to someone who may need a lift. Remember the rabbits.

2 thoughts on “What is the Rabbit Effect? Kindness in Medicine

  • No matter YOUR day; make someone else’s day better and brighter. It will come back to you in a great way

  • Anne Mortensen

    I love this book and have found it soo inspiring. I am a Nurse and a Nursing Instructor and have implemented it into our Curriculum to teach our Nursing students the importance of social interactions, kindness, etc into their practice and self-care.
    I agree with your post and appreciate it. This is exactly what we need coming out of all of the tensions and burnouts from the Pandemic.


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