RUMINATIONS FROM DEEP INSIDE
Cynicism and the Loss of Empathy
By Lavjay Butani
Empathy: the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner.
- Merriam Webster Dictionary
Empathy is trying on someone else's shoes - Sympathy--wearing them.
“Could a greater miracle take place than for us to look through each other's eye for an instant?”
- Henry David Thoreau
“If you can learn a simple trick, Scout, you'll get along a lot better with all kinds of folks. You never really understand a person until you consider things from his point of view, until you climb inside of his skin and walk around in it.”
- Atticus Finch in To Kill a Mockingbird (1962)
Empathy seems so simple, such a 'no-brainer,' a given humanistic quality without which mankind can't survive. Yet, it seems to have become more scarce and harder to find. Or is that just my imagination? Certainly in the medical profession, a profession based on the 'social contract,' a contract that binds its practitioners to a 'service' rather than 'profit' orientation, the values of humanism, altruism, accountability and competence, are key. All of these, in one form or another, can survive only if the members of the profession, i.e. professionals, truly value and engage in empathic practice. Empathy has been very succinctly described as the process of progressing from 'I and you' to 'I am you' or at least 'I could be you.' It's the ability, no even more strongly, it's the desire, of someone, in this case a doctor, to put him/her self into the shoes of another, in this case a patient, and experience their world, their loss, their suffering and their joy. Some consider empathy to be the 'intellectual' or 'cognitive' counterpart of 'sympathy.' From that viewpoint, empathy can be considered as the skill by which one can understand the nature of the feelings that another is experiencing, followed by the ability to communicate and demonstrate that understanding and then acting on this understanding to minimize pain and suffering. True empathy is non-judgmental; it doesn't seek to evaluate the merit of the others' feeling and whether the feelings are justified or not. Empathy is simply pure unadulterated understanding, a communion of sorts with another person, to stand in their shoes and see the world, even if just for a moment, from their viewpoint.
Why has the profession (and I would argue, the whole world) become less empathic? That the medical profession has, is clear from many studies evaluating empathy in trainees and practitioners. Even as early as the medical school years, students have been shown to loose empathy right at the point when they first come in contact with patients-the very point in time when it is most needed!
I can think of many reasons behind this-
a) The lack of understanding and awareness of the values of the medical profession among trainees. Few schools teach professionalism as a subject; I certainly was not aware of the historical roots of how 'professions' came to be in medical school,
b) The many conflicts and challenges to professional values in today's era, where the business aspects of medicine and the well intentioned efforts at improving patient safety and efficiency of practice, and the enormous technological advances have made it easier for 'care' to be provided without even ever touching a patient and have made it permissible to spend as little time as possible with any given person, at the cost of providing 'healing,' and
c) The increasing diversity of the cultures, both of patients and of the professionals taking care of them, which makes it more difficult for the two to 'understand' each other without conscious effort and the desire to do so (at the cost of efficiency)
Temptations abound and await at each corner- the lure of money and the attraction of the power that is inherent in the doctor-patient relationship, all of which further drive us away from the one we were made to serve and towards whom all our efforts need to be focused on- the human being, the 'person' behind the 'patient.'
But perhaps, for many of us, the most challenging aspect of empathy is the pain that comes with being empathic and the loss of power that entails. After all putting oneself in the place of someone who is suffering, reminds us of our own pain, present and future, and can emotionally overwhelm us, make us feel vulnerable and make us feel that we can do little to help, especially when we cannot 'cure' and 'fix' everything. And this makes us cold and cynical. Its easier, isn't it, to never get close to someone, and so never get hurt? Perhaps, it is, but what of our obligation towards society? After all, we have chosen our given profession, out of sheer free will and knowing that, we have no excuse to shy away from our responsibility to provide succor. But even more importantly, without knowing and feeling pain, without sharing such a personal emotion with another, one can never relate with another's world and understand them and without that understanding, one can never provide true comfort.
At times such as these, it is crucial for us to remember that we, as people, always have something to offer each other-and that is our ability to share and understand, to listen, to cry with, to empathize and by this very act, to lighten each others' burdens, without the need to 'cure' or do anything else. The very act of listening can be powerful enough, to lighten each others' suffering and is cause enough to celebrate and feel victorious, and isn't that what true power is all about.
So, let us shed our shell of cynicism and self-doubt to reaffirm our belief in our own selves and our inherent power to share ourselves and allow others to do the same, so the world can be a better place. To believe again in humanity and goodness….for, as in the words of Maya Angelou, “There is nothing so pitiful as a young cynic because he has gone from knowing nothing to believing nothing.”