Reviving the Lost Art of Empathy:
A Doctor’s Dilemma
By: Manahil Akmal
Since your first day in medical school, you are constantly reminded of one supreme principle that governs the doctor-patient relationship — empathy. You are told, again and again, that empathy is crucial in developing a good rapport with your patients and in ensuring patient satisfaction, adherence, and compliance. As a naïve medical student, generally oblivious to how the healthcare system works, you take it. You save this advice for the day you will start seeing patients; you promise yourself that you won’t make your patients feel as though you were a robot incapable of understanding their problem.
Then your clerkships begin, and you are thrust into an entirely different set-up where you see, disturbingly often, the principle of empathy being ignored or even violated. You see exhausted, frustrated, and emotionally-drained doctors meticulously taking down patients’ notes with no reverence or concern for the anxiety on the patient’s face that is so strikingly visible to you. You feel angry. ‘How can this be guy be so callous? Hasn’t he got any sense of humanity? Doesn’t he know that all his pieces of advice are going to fall flat if he doesn’t develop a good rapport with his patient?
You vow to yourself that you won’t become the insensitive machines that these doctors have become. After all, this is what medicine is all about: caring for people, understanding their woes, alleviating their suffering. This is what you signed up for when you entered this field. What you don’t realize is that no doctor purposefully turns into a robot, that it requires constant vigilance and evaluation of one’s own behavior to not turn into one — something that doctors rarely get the time for.
As clinical rotations become a part of your routine, your life gets more hectic than it had ever been. Your rigorous schedule blurs your sacred view of this field to more than a degree. You start to look at diseases rather than patients, trying to make connections between one sign and the other, struggling to come up with diagnoses. Nightmares about distressed patients don’t ruin your sleep anymore. At some point, you can even grab lunch right after witnessing the death of a patient. You learn to separate your life at the hospital from the life you live with your friends and family.
No one blames you for becoming insensitive and growing distant; this is something you must do. You cannot spend your whole day mourning the deaths from the previous one. If you did, who would show up to do your rounds the next day, well-prepared to face the reproach of the senior doctors? As the workload and exhaustion take over you, all the concern you felt for patients at the beginning of your rotation seems to be fading away. You just want to get done with the day. Did someone mention pain? Oh, you know what to ask: ‘When did it start? Where does it radiate? Does anything make it better or worse?’ ‘No doctor, I don’t remember when it started, seems like I’ve always had it.’ ‘It seems to radiate everywhere, sometimes it feels like it has reached my head.’
Now, what is the diagnosis? Well, the explanation doesn’t quite fit into any of the diseases you’ve ever read about. The symptoms of this patient might actually match those of a known illness, but because you failed to understand his/her emotional state, you are unable to translate his explanation into medical terms. Patients don’t look at a checklist when describing their condition — they just want you to understand what they say.
In this case, for example, you might not have noticed that the patient was just in extreme agony, and thus thought that his entire body was in pain. Had you acknowledged this fact and told him, ‘Mr. X, I understand that you’re in distress about your situation, but we can help you make it better if you could tell us when it got bad enough to stop you from going to work?’ This is by no means a gold-standard way to go about it, but it is certainly better than just sending the patient off because he/she couldn’t explain the condition.
You see, being a human and a professional at the same time is not easy. On one hand, you must grow accustomed to seeing death and disease every day and to not let your emotions and feelings cloud your judgment. On the other hand, you must learn to understand the emotions and concerns of your patient and to attune your responses and treatment strategies as such. If you act too objectively, too ‘business-like’, the patient will very likely switch to another doctor who actually ‘listens’.
There is plenty of research backing up the fact that our empathy declines as we progress in our career. But there is nevertheless a consensus among experts that an empathetic relationship with patients fosters good outcomes not only for them, but also for the doctors that treat them. Attempts must be made to help our students and doctors develop this crucial skill and, more importantly, to maintain it.
There is no doubt that stress and exhaustion tend to negatively influence our ability to be empathetic, however, these problems are deeply embedded in the field of medicine. What we must find is a way to ensure that doctors are better equipped to deal with their stress. Healthier ‘coping’ mechanisms are necessary for doctors to continue to look at patients and not diseases. To serve this purpose, we must incorporate the training of empathy into the medical school curriculum at a clinical level, and perhaps even during residency and fellowships, in order to reinforce this principle in our physicians’ mind at every step in their training.
Manahil Akmal is a fourth-year medical student from Pakistan. She loves sharing her medical school experiences through her writing. When not buried in her textbooks, she enjoys reading fiction, writing for her blog, learning photography and listening to TED Talks. You can find her other pieces of writing at The Subtle Art of Existence. You can also follow her on twitter @ManahilAkmal.
Have an exciting medical story to tell or some advice to give? A unique background or path into medicine? Want to share your own post or experience with our followers?
#LifeofaMedStudent welcomes posts from our readers! Have your VOICE heard to all those in medical training! Contribute to #LifeofaMedStudent!
To save money on study products, check out our “Medical Student Discounts” page. 20% or more off your favorite education resources!
Featured Sponsor:
Wolters Kluwer Lippincott® resources:
At Wolters Kluwer, we’re dedicated to providing trusted educational content that meets the needs of today’s medical students. To that end, we publish textbooks and test-prep resources to support you through every step of your journey. We’ve also added a brand-new learning resource that helps students study smarter — Lippincott® Connect. Now, included with the purchase of the print format of Lippincott® Connect featured titles you get even more:
- Access to the full, searchable eBook
- Additional digital resources, such as diagrams, audio and video tutorials, and self-assessment
- Study Collections, created by you to best suit the way you study
- Multi-functional highlighting and note taking features
- Seamless navigation between book chapters, sections, self-assessments, notes and highlights in a single view/page
Learn more about Lippincott® Connect on
Save 30% on Lippincott® Connect featured titles and more Wolters Kluwer resources designed to support your medical education journey today!
Check out the other great companies that help sponsor our page here: #LifeofaMedStudent Recommended Sponsors
Be the first to comment