I have the delight and privilege of watching (and, I hope, helping) medical students learn how to communicate effectively and efficiently with patients. These first year medical students, many of them only in their early 20’s, are suddenly face to face with another person who is sharing a difficult situation. Domestic violence? Losing their job, health insurance, or home? Struggling to make sense of life when they have lost the most important person in their world? These are crises that most of these students – and probably most of us – have been fortunate enough not to have experienced. And yet, we each see many patients who are going through these difficulties and who turn to us for help or guidance. We are encouraged to show “empathy” – but what exactly is that? How do we relate to people who are going through troubles that we just can’t relate to?
The answer, as Christine Comaford suggests, is to use our own experiences in life to connect to those we are talking with. As a successful CEO, Executive Coach, entrepreneur and former Buddhist Monk, Comaford wields a wide array of experience and skills. She explains that, “if someone is mean or challenging, it’s just because they’re in pain. And so you think, ‘OK, when have I been in pain before.’…when we can exchange our pain for their pain, we can then talk to them far more effectively.”
While we may not have had the experience of being the victim of domestic violence, many of us have experienced fearful times when we felt helpless and trapped. And while we may not have lost someone we love, we may have lost other things that were important to our happiness or gave our lives meaning. Connecting with the emotion of those experiences helps us to understand that the person sitting with us is suffering. Although we may not be able to change their circumstance, simply listening and letting them know that we are a witness to their pain, fear or challenge can be a powerful source of strength and healing for them. As physicians, our role is generally that of an expert – we are supposed to have all of the answers. But feeling as if we have to solve each patient’s problems often gets in the way of feeling empathy for their predicament. In our search for the solution, we move into our heads and out of our hearts. We deprive our patients of our empathy.
Recently, I saw a clear example of the power of empathy. A medical student sat across from an actress who was portraying a patient suffering from domestic violence. Although the student knew that the interaction was “fake” and was created for his learning experience, the woman’s situation touched him in a profound way. He began to lean forward as he connected with her and he stopped trying to remember what he was taught to ask and instead his responses came directly from his heart. He asked about her safety, stressed that she shouldn’t have to be afraid in her own home, and reassured her that he would help with any medical concern. He did not, since he could not, resolve her difficult situation. But she reflected that just knowing that another person heard, understood, and acknowledged her struggle gave her strength and more confidence.
So as we encounter patients, friends, or relatives who come to us with their difficulties, it’s possible that the best thing we can do is to step down from our “expert” pedestal and spend some time just listening. We can find an experience of ours that brought on similar feelings – sadness, grief, fear – and we can feel those feelings, too. By letting the person know that we recognize their struggle, that we understand those feelings, we might be far more useful to them as they face their situation. No life avoids disappointment, pain, or sadness. By acknowledging what the other person feels without rushing in to fix or remove the situation, we tell them that we respect their feelings and we respect them – we believe in their eventual ability to move on from whatever difficulty they are experiencing. That vote of confidence holds more power than we can imagine.