Empathy is a cryptic term. Those in the health care profession can certainly spout off a variety of phrases and metaphors that are typically used to describe the concept of empathy in the educational setting. Throughout my medical education thus far it has been described as “putting yourself in another’s shoes” or “sharing in another’s emotion.”
We are also taught early on what empathy is not. Empathy is not feeling sorry for someone. Now, these are all definitions that might be elicited when asking the average medical student about the concept of empathy. However, discussing empathy in a classroom does very little to advance one’s understanding of it. In fact, I would argue that most students would be quick to rank it as one of a physician’s most important qualities to possess, yet not be able to fully describe what it means. I was one of them. I do not intend to trivialize its importance within the framework of a wholesome medical education. Rather, I feel that its meaning can only be grasped after having employed it in practice.
I am now a third-year medical student, and early in my internal medicine rotation, I was tasked with evaluating a woman in her thirties with stage four colon cancer. She had developed a clot in her subclavian vein, presumably from the port she had placed for the administration of chemotherapy agents. As a freshly-minted clinical student eager to evaluate, assess, and develop a treatment plan I entered the room already thinking of the questions I needed to be sure to ask. I began asking her questions I knew that she had already been asked multiple times, but she graciously obliged. I examined her, gently palpating the area around her port in her left chest, then proceeding into the axilla and down the length of her arm. She winced, but remained as pleasant and agreeable as one could as she was poked and prodded in painful areas.
Despite this, we continued to talk throughout my exam. Eventually, she began talking about her children, and she quickly began to sob. I stopped my exam, and sat with her holding her hand as she confided in me that she was scared. She was scared because she did not know how long she had left, or how her young children would fare without her. I sat with her for quite a while, just listening. It seemed that the more she shared with me, the deeper our emotional connection became until, ultimately, we both had tears in our eyes. In the end, she began to smile seemingly unburdened by sharing her fears with someone else.
Here I was, a third-year medical student who entered this patient’s room having rehearsed in my head my first few questions I would ask. It was an attempt to keep the encounter methodical and organized so I would not miss any crucial information. Yet, despite this, it quickly evolved into an unplanned and unexpected conversation that would prove to be more valuable to both of us than any findings in taking a history and physical exam. She found someone who would listen and share the weight of her emotional burden. She came to a recognizable peace knowing that someone could understand her struggle, and I like to think that the solace that provided made her day just a bit more bearable. For me it provided a tangible example of empathy, bolstering my understanding of those cryptic classroom definitions I had heard before. It became real because I truly felt its meaning and realized firsthand its importance in providing patient care.
As I left the patient’s room, I remember thinking of her children and how difficult it must be trying to prepare them for life without her. I quickly realized that this feeling I had was empathy, but it was still a feeling, better felt than described. Even having had experienced it myself, empathy is no less difficult to define. Indeed, the most eloquent articulation of the concept would still not approach the understanding gained from experiencing the feeling firsthand. Early in my clinical rotations, I was inexperienced, thrust into patient rooms feeling ill-prepared to truly provide the appropriate care patients deserved. However, despite this, my clinical skills continue to improve and I now take comfort in knowing that I will always have my ability to listen and empathize, and sometimes that can be more therapeutic than anything else.
Brian Schnettgoecke is a medical student.
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