em·pa·thy / ˈempəthē / noun
1. the act of correctly acknowledging the emotional state of another without experiencing that state oneself.
Empathy…it is one thing to take care of a patient — to diagnosis, prescribe medications, and operate on them — but being the patient is a whole other animal. I know this experience, firsthand. During my residency, I discovered that it was going to be very difficult to have children due to an unforeseen medical condition that I had recently been diagnosed with. I guess if I am truly honest with myself, the immense stress that I was under did not help. But in the face of possibly not being able to have children, I did what a lot of people thought was crazy and tried to get pregnant intentionally.
From resident to patient
As a hopeful, soon-to-be mother, I was willing to undergo the scrutiny and criticism of colleagues, professors, and staff. I courageously took on the systemic taboo of a female surgical resident having a child while in training. This was a huge unstated no-no! It just did not happen in a surgical residency program. When I finally did get pregnant, my joy and emotions were preemptively masked with caution. I chose not to tell anyone for the fear of the criticism and possible backlash.
Despite all of my efforts, agony, and placing my reputation at risk, it was just not meant to be. Sadly, as fate would have it, I had a “missed” miscarriage at nine weeks and had to undergo a surgery to remove my unborn child. I woke up in familiar surroundings, but this time as the patient and not the doctor.
An angel on Earth
In a post-operative anesthesia dazed state, I was not sure what I was supposed to feel or say. I was gingerly greeted by a PACU (post anesthesia care unit) nurse who knew me on my best days as a strong and decisive female surgery resident. But on that day, I was vulnerable and exposed, with hormonally chaotic emotions that no one could comfort. But somehow, she knew exactly what to say.
She protected me as a patient and cared for me as a mother, one who had just lost my first child. She respected me both as a physician and the invisible professional boundaries that existed between us. To this day I still believe she was my angel on Earth. But more likely, as a nurse and a woman, she was empathetic to what I was going through. She helped me in so many ways: medically, physically, emotionally, and psychologically.
Permission to be a patient
The Versed and morphine meds began to wear off, and I became more aware of my surroundings and the pain that was in my body and my heart. I stoically tried to put my so-called “MD” badge back on, hoping to show that I was not just a patient.
She quickly stated, “You know doctors make the worst patients, right?” I laughed thinking of my mother — also a nurse, and by far the “worst” patient I know. But on that day, she gave me permission to be the patient for a while. I needed that dispensation to say it was ok for me to hurt, to grieve, and — at some point — for me to heal. And in her own angelic, nursely kind of way, she made me laugh through the tears and said that I could ask for more drugs if I would sign off on the order.
Why empathy matters
“You never really understand another person until you consider things from his point of view – until you climb inside of his skin and walk around in it.” — Harper Lee, To Kill a Mockingbird.
Medicine in some respects teaches us to emotionally detach ourselves to do our job. It is understandable that you may not feel exactly what your patient feels, but I would say that you should at least try to be empathetic to them. There are books, blogs, and medical research to discuss how you can improve your empathetic touch.
The idea is simple, says Roman Krznaric in his timely book, Empathy: Why It Matters, and How to Get It, “You are…therefore I am.” More recently, the discussion of emotional intelligence may play a more important role in the training of empathy to medical professionals as well as the business world. Emotional intelligence is your ability to recognize and understand emotions in yourself and others, and your ability to use this awareness to manage your behavior and relationships.
Learning to empathize
I now know empirically what my patients feel when they are in clinic hearing a diagnosis and having to share the possible outcomes with their family. I now know what it means to sign a consent form and hear all the scary things that can possibly happen to you while you are unconscious and have no control. I understand the feeling of physical post-op pain (forget the damn 0-10 scale). I can now fathom the cold, intentional cut of a surgical blade and the sensation of being medically appropriate, but violated nonetheless. I now have a better sense of being on the other side of the table so to speak. Now more than ever, as a physician, I can truly empathize with my patients.
Being the patient meant that I was no longer wearing the white coat, but instead the thin, blue hospital gown with a broken tie string, and mooning the whole floor with my ass out. But now, because of my experience, I “get” a patient who is vulnerable and looking at me for answers, hope, and a reassurance of a prognosis. I can relate to how it feels to be unsure and uneasy, the way so many patients feel. I learned what one perceives when they are exposed and at the mercy of everyone in that hospital, from the surgeons to the janitor.
I was not “Dr.” that day to the transport person that I knew so well. I was a patient in a wheelchair being helped into my car. That day, I gained a whole new perspective — not to mention respect — for my fellow medical professionals, and I gained an even greater appreciation for my patients and understood the importance of empathy in practice.
My 5 tips for showing empathy
Here are some of the most important ways you can empathize with your patient.
- See the patient’s viewpoint, including their needs, fears, welfare, and interest.
- Validate them by sharing your experience or affirming where they are.
- Check your attitude and judgment at the door and seek to walk a mile in their shoes.
- Listen and connect with your patients.
- When in doubt, ask what they need or want…or don’t need or want.
You never know when you will find yourself or a family member on the other side of healthcare. So even in medicine, one of the great commandments works here too: “Do unto others, as you would have them do unto you.” Whether it’s literal or theoretical, “be the patient” and have empathy.
Adapted from chapter 14 of my book, The Rules of Medicine: A Medical Professional’s Guide to Success.