Empathy is an essential ingredient of the work of a doctor

They say a good doctor needs to be able to stand in his patient’s shoes, but Stuart only had one; a size 12, left foot Nike Air Max. Back in May 1991, after his car ran off an Australian country road, wrapping itself around a gum tree, Stuart ended up losing a leg. In a photo taken at the scene of the accident the following day, you can see a majestic eucalypt, standing tall in the midst of the wreckage, untouched. Waking from his coma three weeks later, Stuart found himself in the Intensive Care Unit at the Royal Melbourne Hospital, his life returned to him, but altered forever.

I first met Stuart one summer’s morning in 2003, twelve years after the accident. Confined to a wheelchair, unable to work, he looked old and withered at the age of thirty-six, despite his 6ft 3inch, 180 pound frame. Activities he used to take for granted, now carved a huge chunk of time out of his day.  Since the accident the sheer struggle of daily living pre-occupied his thoughts; transferring from his bed to the toilet, shopping for food, preparing meals, or simply pulling up his pants. He came to see me about a stump ulcer that had been giving him no end of trouble, making it impossible for him to wear his prosthetic leg.

“I’ve had it, Doc,” he said to me with a broad Australian drawl, his brown eyes looking dull, his skin pasty and sallow.

I remember that morning for another reason too. In my rush to get to the clinic on time, I had left my four year old daughter in the arms of my husband. They stood in the backyard watching a man with a chainsaw cut through a thick, rotting branch of our old lemon tree. It was that beautiful and solid tree in the center of the lawn that made us decide to buy the house in the first place. As I was quickly checking my face in the hallway mirror to make sure my lipstick wasn’t smudged, I heard an enormous crack. I rushed outside to find my daughter screaming hysterically, her blue swing lying crumpled on the grass.

“The tree is bleeding!” She pointed at the dark red sap that oozed from the wound where the branch had been attached to the trunk.

I needed to get to work, so I hurriedly tried to reassure her:

“We’ll fix the swing, honey.”

Later that morning, when Stuart wheeled himself into my office, I was still anxious about my little girl’s sorrow.  Then I stared at his stump and felt ashamed, my own worries receding into insignificance. How could I begin to understand what he must have been through since his accident? The closest I had come was hobbling round on crutches for two weeks when I sprained my knee in a skiing injury.

Stuart told me the hardest thing for him about losing a leg was being forced to give up work. We chatted about his love of the outdoors, that grew from being a country boy. It suddenly struck me that helping his ulcer heal would not be the only thing, and not even the best thing I could do for him. He needed to have a passion again, a focus, as well as a way of contributing to others; I knew this would be a crucial part of the healing process. It had taken me many years to realize that empathy is an essential ingredient of the work of a doctor. The rigors of medical training and constant exposure to the harrowing nature of illness, the necessity of maintaining rational objectivity in order to make accurate diagnoses and carry out difficult procedures, often blunt a doctor’s emotional involvement in a patient’s care. The trick is finding the right balance between head and heart.

“How about a hand cycle?” I said.

It was a simple idea. A three wheel cycle, specifically designed to enable Stuart to propel it, using his upper body. I fought the Traffic Accident Commission tooth and nail to get him one. The hand cycle changed his life; he trained on it for hours every day for the next few months, gradually developing wonderful six-pack abs and pecs that any gym junkie would be proud of. The following year he completed the New York marathon on his bike.

Stuart has since become an elite athlete, travelling widely to participate in international competitions, currently ranking seventh in the world in his cycling class. Recently he came in to tell me he had just won a scholarship to the Victorian Institute for Sport and would soon be commencing training for the next Paralympics in London. The gum tree, the inanimate object that nearly killed him, ironically ended up giving him a life he had never dreamed of prior to his accident. He has managed to live well with his disability, not only by striving to achieve his personal best, but also by sharing his experiences with others, writing his memoir and touring schools as a motivational speaker to bring home the message of the impact of road accidents to teens.

I remember coming home that evening, after meeting Stuart for the very first time, to find my husband pushing our daughter on her swing, which he had strung from a different branch of the lemon tree. He told me she calmed down that morning as soon as he explained to her that a tree that has been cut can re-grow. I watched our little girl’s legs sailing towards the sky.

“Higher, daddy!” she squealed. “Push me higher!”

Leah Kaminsky is an Australian physician and writer. She is the editor of Writer, M.D., an anthology of prominent, contemporary doctor-writers. The patient, Stuart Tripp, is the author of Travelling Hopefully.

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  • Anonymous

    Awesome expression of the power of the GP to turn lives around, alongside treatment of symptoms. Your article should be part of the curriculum in medical school!

    • http://www.facebook.com/people/Leah-Kaminsky/625708644 Leah Kaminsky

      Thanks for your comment verypatient! What we don’t give credit to very often though is how much patients can turn doctors’ lives around for the better!

  • Anonymous

    err, comment already appeared below…