Empathy in the ER
On Monday night I started to feel sick, and thought I might be coming down with the cold that had been going around my office. Unfortunately, a few hours later I realized it was more likely that I'd gotten food poisoning from my lunch. The next hours were a blur, but at a certain point I decided that I needed some help rehydrating. So my husband called an Uber and we headed to the nearest hospital, the driver mercifully avoiding every pothole.
If you've ever been to an emergency room in New York City, you probably know to expect a long wait. I don't even know how long we waited after I went through triage - I was still in a haze - but after I got a bed the minutes seemed to drag. I could hear people being treated all around me, and every time a nurse or doctor walked near my bed I got my hopes up, only to be let down. I was in pain, but I was also in line, behind people whose needs were more dire. Knowing that didn't make me feel better, but it did help that the people my husband spoke to were calm and polite. At one point, a man waiting with a patient in the bed next to mine got agitated. He started to rant and rave, but even in the face of that, the nurses remained calm.
I'm not sure if we can call this empathy. Saying "I'm sorry" in a flat tone doesn't express much actual sorrow. But when you have to say it over and over, dozens if not hundreds of times a day, it's bound to sound trite eventually. When I finally did see a nurse and a doctor, they were both efficient, though not cold. They struck a balance of responding to my questions and concerns without entertaining them too much. It didn't feel like empathy, but it was enough. I got my IV and some medication and was quickly on the mend, and that was what mattered.
But there's a growing body of research that shows doctors could stand to be more empathetic, both for our patients' sake and their own. A 2011 survey of 800 people who had been recently hospitalized found that only 53 percent of them felt empathy from their doctors. Another study videotaped encounters between doctors and patients with cancer, and found that doctors often tended to dismiss patients' complaints rather than take them seriously, responding with empathy only 22 percent of the time. More recently, a study published in the journal of the Royal Society of Medicine argued that doctors need to develop better empathy skills in order to protect themselves as well: "Doctors are at risk not only of personal distress but eventually burnout if their feelings of sympathy and compassion for patients override the more nuanced stance of empathy," wrote Dr David Jeffrey, an honorary lecturer in palliative medicine at the Centre for Population Health Sciences in Edinburgh in the U.K. Instead of imagining themselves going through what patients are going through, Dr. Jeffrey wrote, they should imagine being the patient undergoing the patient's experience.
Leslie Jamison took this issue on in a more literary way in her book The Empathy Exams. I'll leave you with this essay from the book: A Medical Actor Writes Her Own Script.
Note: This post went out earlier this week in my twice-monthly newsletter, On Empathy, which you can subscribe to here: eepurl.com/coCp5X