Should doctors have empathy?
Yes, of course, doctors should have empathy, especially when it involves
treating their patients. It is the only way that doctors can treat
their patients effectively.
What is empathy?
In its literal translation as “in
feeling”, (1) empathy is understood as the “capability to share and understand
another's emotions and feelings.”(2)
We expect doctors to have that
capability. In fact, we go to them with that expectation, otherwise we would
not be seeking medical advice and/or treatment from them. The doctors we visit
are medical professionals, who can and will understand what we are trying to
convey to them about our medical or health-related concerns.
For example, a male patient visits
a doctor to have sutures removed following a bout of surgery. He knows that
this doctor will understand what he tells him about the status of his incision.
He assumes the doctor will then do whatever is required with regard to
effective treatment.
Taking the definition of
empathy further, it is the ability to "put oneself in another's
shoes." (3)
But, if you have you ever tried
to wear someone else's shoes, you soon realize that no matter how hard you try,
those shoes won't fit your feet properly. They may be too large,
small, wide or narrow. In fact, they may hurt or damage your feet, when you try
to wear them. Blisters from wearing someone else's shoes are certainly not much
fun. Ask any child, who has had to wear his or her older brother or sister's
shoes and then, walk a mile to school in them. Problems arise when you try to
wear other people's shoes because you are a different person, as well as being
someone unique, who has different feet than the other person whose shoes you are
trying to wear.
"Walk a mile in my
shoes?"
Taken literally, that may not be a good idea. This also suggests that according to this
particular definition of empathy, something may and probably will be lacking.
In this case, what is lacking is the perfect fit.
Certainly, doctors and
patients often share the patient's medical concerns. Doctors appear to
understand patient's emotions and feelings, at least to some extent. Be aware
that this is always going to be imperfect at best too, because the shoes do not
ever fit perfectly. The shoes may almost fit, but that is not sufficient. In
other words, at best, the doctor understands the patient only in part or
objectively, rather than subjectively. He is merely the outsider, looking into
the patient's medical or health care scenario.
For example, the male patient
reporting to his doctor about his post-operative surgical incision informs the
doctor that he is still experiencing some numbness, in the surgical area. The
doctor knows what numbness in the surgical area means or signifies, even
though he cannot feel it himself. He still lacks the total patient experience,
even though he may be quite astute in his understanding of what numbness is and
how it feels.
Take this one definition
one step further, by looking at the Greek word "empatheia" (4), which
is understood to mean "physical affection, passion and partiality"
(5) or a combination of the Greek words "en pathos" (6) signifying
"in feeling" (7).
Theodore Lipps created the
German expression, we now understand as "feeling into". (8) By this
definition, the doctor is essentially seeking to understand, explore or
objectively "feeling into" what the patient is stating, reporting or
experiencing. Remember that the patient always has the subjective experience and
not the doctor. The doctor's experience is purely objective. The doctor is in a
position of trying to comprehend the patient's actual experience or reality, from an outsider's perspective.
The doctor still may have high
regard, affection or love for his patient. The doctor may be passionate about
his work as a doctor and show distinct partiality towards his patient, at
times. But, at best, he is only able to delve into the matter at hand, to the
extent that an outsider can touch upon another person's actual experience.
For example, if the doctor
could feel the patient's lack of sensation or numbness in the post-op surgical
area, he would know the exact extent of it immediately. Because he is not the
patient, he has to ask the patient where the numbness is, as well as how
extensive it is, at that particular moment in time. Then, he can decide whether
this is something that he should be seriously concerned about.
For example, when the patient
who has just had back surgery, states that there is numbness around the
immediate area of the incision, that is not going to trigger an alarm in his
mind. Patients often experience numbness around a surgical incision. If the
patient states that the numbness extends down to his feet, then there is reason
for the doctor to be concerned. There may be back and nerve problems that
require further investigation, diagnosis and treatment.
The ancient Greek word,
"alexithymia" (9) meaning "without words for emotions",
(10) sheds more light on the meaning of the word empathy, as it signifies
"a state of deficiency in understanding, processing, or describing
emotions in oneself." (11)
From this perspective, one can
begin to see the reality of the true meaning of empathy in terms of the role of
the doctor. Empathy distances the doctor from the patient, at least to some
extent. The patient's medical scenario would consume or devastate the
doctor, if this was not so. That could render him impotent to help the patient
or make him ineffective, in terms treating him effectively.
For example, the patient in the
doctor's office screams in pain, when he tries to move his legs, as the doctor
examines him. The doctor does not resort to screaming in pain, too. The doctor
does not experience either the pain or the same emotions that the patient is
experiencing, at that exact moment, even though he might be concerned or become
alarmed by the screaming.
Thus, in this kind of a
situation, the doctor demonstrates a lack of words for emotions. His
understanding,
processing or describing the same pain and emotions as being his
own, are lacking or deficient. Only the patient can do that. This allows the
doctor to distance himself, far enough away from the patient to be able to
treat him effectively for his pain. He goes on to prescribe pain medication for
the patient and suggests that physiotherapy will help him to become
increasingly mobile again.
Yes, doctors should have
empathy. It is a good thing. In fact, doctors need empathy in order to treat
patients effectively.
1. http://en.wikipedia.org/wiki/Empathy
2. Ibid.
3. Ibid.
4. Ibid.
5. Ibid.
6. Ibid.
7. Ibid.
8. Ibid.
9. Ibid.
10. Ibid.
11. Ibid.
No comments:
Post a Comment