As with so much else in medicine, the wisdom of William Osler represents perhaps the best port from which to begin this journey to reflection into our profession and ourselves as practitioners. From the depths of Osler’s wisdom, the fragment which seems most relevant to me is the assertion that “No two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease.” In the midst of this variability stands the physician as a common thread and a single individual called to pilot patients safely through a thousand seas of emotion and expectation. As a first-year medical student, I took my first tremulous steps into these waters and gained a glimpse of the vastness of experience yet ahead.
The experiences which most stimulated both my thought and growth regarding empathy occurred primarily in the simulation center. Throughout much of the past year, while working with simulated patients, I struggled against being critiqued repeatedly as robotic; clinically skilled yet unable to provide comfort. As an individual who pursued medicine in large part out of a desire to support and comfort others this characterization left an indelible mark in my consciousness, became my central academic goal for the block and helped to teach me how difficult it is to express even deeply felt care for another. This reminder to both strive for improvement and accept when you fall short is itself an invaluable aspect of empathy. Patients may often come in having done everything right and yet they are sick and can often feel as though they failed themselves, their loved ones and even you as a caregiver somehow. To have an intimate awareness of this liminality between having truly done one’s best and having it feel insufficient is vital for a physician who wishes to guide others through such moments.
While the simulated patient encounters woven into the curriculum afforded me the opportunity to comprehend the challenge of both feeling empathy for patients and having it recognized, the moment I truly learned its import was during a voluntary inter-professionalism workshop. Superficially this workshop helped breed an awareness that we must be empathetic not just to our patients but to our colleagues and their unique roles, struggles and challenges during the process of care. Far more important was the case itself. In the scenario we worked through the patient’s condition was prompted not by a tangible pathogen or environmental exposure but the diagnosis of their father with prostate cancer. The patient’s condition ultimately left them alienated from friends and loved ones, physically diminished and deeply depressed. Never before working through this simulation was I as intimately aware of the fact that along with each patient we treat their families and those who care for them as well through our conduct, how we deliver information and our general mannerisms during the course of care. Had the doctors within the simulated situation done a better job supporting both the patient’s father and the patient himself during their shared trauma he would not have had to suffer for months. While the situation was simulated these lessons are very real and are ones which I will carry forward into my medical career.
In conclusion, even at this early juncture in my career, it is readily apparent that the value of empathy cannot be ignored or overlooked. To modify the nautical metaphor with which I opened this reflection perhaps rather than pilots a physician is more of a lighthouse keeper and empathy our beam. As our careers progress and we see ever more patients navigating the rocky waters of illness experience will teach us the common hazards and how best to circumvent or at least mitigate them. Ultimately to be ill is to navigate a harrowing and lonely sea but if by the light of empathy that journey can be made brighter and easier that is I think our duty as physicians.