Judge not, lest ye be judged. It's an idea that's become ingrained in our cultural notions of what constitutes good behavior. And yet I think we constantly and consistently leave out half of the equation. The act of passing judgment is frowned upon. Judgmental we use in the perjorative: You shouldn't be so judgmental, Jessie. And yet the definition of judgment encompasses behavior we all engage in, every day: "the forming of an opinion, estimate, notion, or conclusion, as from circumstances presented to the mind".

Either we're never supposed to have any opinion about anything, ever, or we're missing something essential.

Perhaps I'm simply a victim of the same overly-dichotomous framework we modern Western types bring to everything, but judging (bad) must have an opposite (good) against which to measure it. Here's what I come up with: "compassion: a deep awareness of and sympathy for another's suffering".

And yet, compassion feels like endorsement. Rendering judgment in the conventional sense--expressing disapproval and rejection of a person or behavior--is a pushing away. I'm distancing myself from behavior I don't like. I'm making certain I'm not considered a party to it. I'm planting myself firmly in the "anti" column. And so compassion--an opening of arms, a kindly involvement, an emotional investment--is a pulling in, an embracing, an endorsement.

But what happens when compassion and judgment collide? Can we maintain compassion for people, acts, or ideas that offend our sense of morals, ethics, or simple good manners? Can we be compassionate and repulsed?

I transported a patient recently who, like so many others, called an ambulance for loneliness. Though cloaked in complaints of shortness of breath and other more legitimate-sounding problems, her issue was simple: she was painfully, pitifully depressed and anxious and alone.

Right or wrong, my first, internal response to people like this is one of disdain. Of judgment, in the negative sense. I want to call them pathetic, weak, laughable. They call 911 because they can't get their own shit together. That's not my idea of an emergency.

I want to be overtly rude to them, to openly criticize them for not knowing how to take care of themselves, for misusing emergency services, for not understanding what an Emergency Room can and cannot do.

My patient was older. Her chest hurt. She said she couldn't breathe. She was terrified of having a stroke. She thought she was on the wrong medication for her high blood pressure--because she was having the normal, if unpleasant, side effects. She was taking Xanax every day. She cried in the back of my ambulance.

She'd made poor decisions. The only way she'd learned to get her own needs met was to make a scene and put the problem in someone else's hands. She was a little bit hysterical, a little bit hypochondriacal, a little bit overwrought. But she was someone's grandmother, mother, daughter; and when I look into her eyes I saw nothing but fear. It didn't matter that I considered her fear disproportionate, out of place, manipulative. Her fear was very real to her, in that moment.

And that's when the judging went mute.

I'm not claiming a Mother Theresa sort of moment--I still believe she and so many others are looking in the wrong place for help when they call on EMS, and I still maintain a vestige of smug superiority to those I perceive as weak or ignorant. What I'm saying is that my judgment, my internal condemnation of her situation and behavior, wasn't accomplishing anything. It wasn't going to magically make her the slightest bit more prepared to deal with her feelings; it wasn't going to grant her a burning insight or a sense of peace or all the answers. What she needed from me in that moment was hand-holding (both literal and figurative), gentleness, and some time away from her life. And looking into her eyes, I couldn't bring myself to refuse her any of those things, judgment be damned.

Was I enabling her in her weakness, encouraging her to remain sad and passive? Was my compassion an endorsement of a state of being I find repulsive? Does it matter?

I want to impose expectations with my compassion--expectations that people find the resolve to finally remove themselves from the situations that demand my understanding and pity in the first place, expectations that the self-perpetuating miseries become instead joys. But, then, my compassion has just become the nicer-looking cousin to my judgment--both are, at their core, a rejection of the current state of affairs. While judgment gives its object an overt middle finger, compassion pats it on the head before quietly suggesting it's crap and needs to change.

So maybe, good or bad, compassion or judgment, our very human capacity for forming opinions, estimates, notions, or conclusions exists for one reason: to prompt change. It might have a curt dismissal or a gentle nudge behind it, but either way we're incited to evolve. And thus the biblical/cultural injunction contains an essential truth--judging not is simply not an option for most human creatures. Our big noggins are designed specifically for such tasks. And since we will indeed judge, will indeed do our small part to promote change, we must be prepared ourselves to change. Judge not, lest ye be judged. The earth turns, the universe boils & bubbles, and nothing in it may stand still.