—- Empathy in Medicine —-
As I alluded to in the beginning of this post, we as clinicians are given this incredible privilege of trust from the patient. Trust that you will, with this intimate information, do everything in your power to alleviate their condition and suffering. I am trying to think of another profession or situation in which such trust is given before meeting the other party, but I simply cannot. Thus as clinicians it is our duty to do whatever we can to fulfill the potential of this relationship. Empathy is a major tool needed to achieve this, and it would be a shame not to at least try and develop it.
There is school of thought in medicine that developing this empathy would be more emotionally draining (resulting in higher burnout rates) and also detract from the objectiveness of a clinician, a tool that is needed in critical times. My thought is this: I cannot deny that burnout rates and objectivity may be affected by the practice of empathy. But if the ultimate goal is optimal patient care, and numerous studies have shown that displaying empathy results in better outcomes for the patient, then there is no question: it must be taught and developed as a part of training.
Now, whether a skill such as this one can be taught is a separate issue. I am not so sure empathy can be taught. But while I do believe that in most cases empathetic instincts are inborn, to a certain degree it can be developed. I liken this to the idea that while someone like LeBron James may be born with talents that make him great, there is no doubt that it took hours upon hours of practice and development to make him the player he is today. Empathy, like shooting a basketball, is a skill that needs to be developed. And while it may not result in a multi-million dollar contract with Nike, it could result in something more precious: better care of the patient.
I consider Amy Romain an expert in the field of empathy. As I mentioned in an earlier post, Amy is a dear friend that serves as our office social worker. I consider her such an expert on the subject that I consulted her when writing this piece. She responded by saying, “Empathy is the heart of medicine. It is an essential medium to the art of healing.”
—- My Fear —-
A friend of mine confided in me earlier this year that she had suffered a miscarriage. When she told me, my heart sank and I was devastated. I immediately thought of the time my wife and I thought she had miscarried; it was a horrible experience, one filled with grief and loss. But even though inwardly I was devastated by this news, outwardly all I could muster was, “That’s terrible, I’m sorry.” I knew that while this was a sympathetic response, it was only 1/100th of what I actually felt. Even though I knew at the time that I wasn’t accurately showing her how this news made me feel, I could not change it, it was almost like I could hear the words come out of my mouth, and part of me yelled to myself, you idiot! “That’s terrible, I’m sorry” is all you can say? Say what you’re feeling! But as much as I wanted to, “That’s terrible, I’m sorry” is all that came out. Did this tumor take away my ability to portray empathy ?
I am currently in the process of a return to residency going through what seems like an endless stack of paperwork and red tape. I must say that my greatest fear about coming back isn’t the titubation or my delayed speech. My fear is an unknown: have I lost my greatest strength as a clinician—have I lost my ability to show empathy? After this meeting with my friend who miscarried, I sent Amy an e-mail telling her of my fears of returning. She agreed that this was a legitimate concern and that I could work with her in developing strategies to circumvent this possible short-coming. But I knew, even before sending her the email, that the empathy I showed to patients would either be there or not, and I would only know the answer of whether or not I could portray it when I actually saw a patient. I guess part of my irrational side hoped that some of her abundance of empathy would rub off on me.
I can be comforted by the fact that even though it may not show on the outside, inside my mind immediately tries to put myself in your shoes and ultimately show empathy. Maybe with this tumor, and the experience I’ve been through I now have more of a leg to stand on. Only time will tell if I can learn to convey these feelings outwardly.
 It is for this reason I like my wife to give a ‘heads up’ to whomever I am to encounter. This way, I figure, the initial element of surprise is at least dulled.
 I’m lucky to have a friend who cried when dropping off my family a meal. The ‘luck’ for me is having someone like that in my life. For her, the thought of my situation and ordeal brought her to tears.
 Perhaps they were always there, I’m just picking up on them more now. It’s like the consumer in the market for a new car who says, “I didn’t realize how many car commercials there were until I needed a car.” For me, I didn’t realize the signals their body language was giving me until I looked.
 For a great article on the topic check out http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1466742/pdf/0020576.pdf