Paging Dr. Empathy
by Harsh Agrawal
Image source: Unsplash
There is a litany of well-known reasons to be an empathetic physician: better patient compliance, more honest conversations between doctors and patients, more effective treatment, higher satisfaction ratings, etc. However, I suspect that there is something silent—intangible—about the patient experience that changes when filled with empathy. I have heard many stories of sick patients who adore their doctors (and vice versa), intently hanging on to each of their words, asking questions, and feeling optimistic. I have even seen this happen, but only as a fly, silently observing from the wall of an exam room. How could I wholly understand the value of physician empathy, being neither a patient nor a practitioner? Though it might be best to table this concern, for now, I think we should revisit it often, addressing it piece by piece as we learn and mature.
When Dr. Coral Matus recently sent me this article, written by Dr. Minas Chrysopoulo (2021), it reminded me of a similar question, but one I could answer today: What should we do about medical student empathy?
As I mentioned earlier, it is difficult to comprehend the value of physician empathy. Luckily, Dr. Matus and Dr. Chrysopoulo will remind us that it helps them connect more with the patient and provide the best medical care possible. It makes sense, then, that we (students) should be empathetic, too.
Dr. Chrysopoulo suggests one mechanism of empathy erosion is during rotations: having to justify each of their answers, actions, and choices to attending physicians makes students "defensive and withdrawn." He also suggests, to Gregor Mendel’s chagrin, that residents might inherit the bedside manner of their not-so-empathetic attendings.
I think there is a perhaps even more salient concern: empathy is sort of like a muscle—without use or challenge, it atrophies, wasting away into something vestigial. The tragedy of medical education is, as we say, having to drink water from a fire hydrant. And at times, medicine feels like a rat race. Go to class, do your Anki reviews, get into research, start joining clubs, make connections with faculty, figure out summer plans, apply for opportunities. There is little time to exercise empathy.
We run the risk of forgetting how to express kindness and humanity to our coworkers, mentees, and patients. We cannot further alienate patients from medicine; it is already an opaque, scary, and confusing field. And now that we are slowly addressing America’s ugly, racist underbelly, we must do everything we can to rebuild the trust that medicine has historically abused with disenfranchised communities across America. Trying to feel what our patients feel will help tackle these problems, and others, in ways we may not yet see.
I am grateful that my classmates and professors are incredibly kind (I wonder whether this is unique to Toledo). They must have practiced empathy often before coming to medical school. They make me optimistic. I have seen them work hard for Toledo’s Community Care Clinic, where they volunteer to help patients. I have seen them sacrifice to keep their friends and families safe from SARS-CoV-2. I have seen them help each other in times of need, digging and pushing their cars out of Toledo’s poorly plowed snow. They are flexing their empathy muscles, inspiring me to do the same.
Empathy manifests in many forms. True, meaningful apologies are an expression of empathy. An admission of ignorance—I don't know why you're feeling this way, but I want to understand—is an expression of empathy. It is more than simply listening and being kind. There is no shortage of ways to express it if we look hard enough, and it is, conveniently, free. I’m going to explore all the ways to express empathy, and do my best to exercise my empathy muscles often. When it gets tough, I’ll remember the late River Phoenix: “run to the rescue with love/and peace will follow.” I hope you all join me.
Sources
Chrysopoulo, Minas. (2021). Empathy, The Best Medicine? How Doctors Can Help Patients Remember More Information and Make Better-Informed Decisions. Physician's Weekly, from www.physiciansweekly.com/empathy-the-best-medicine-how-doctors-can-help-patients-remember-more-information-and-make-better-informed-decisions/.
Neumann, Melanie, et al. (2011). Empathy Decline and Its Reasons: A Systematic Review of Studies With Medical Students and Residents. Academic Medicine, 86(8), 2011, pp. 996–1009. doi:10.1097/acm.0b013e318221e615.
Newton, Bruce W., et al. (2008). Is There Hardening of the Heart During Medical School? Academic Medicine, 83(3), pp. 244–249, doi:10.1097/acm.0b013e3181637837.
Harsh Agrawal is a second-year medical student at the UTCOMLS.
