PRACTICE PARTNER
was less affected by repetitive pain exposure
than people who are not health-care profes-
sionals.
The evidence is all preliminary. Still, Profes-
sor Jackson suggested that the longer health-
care professionals practise, the more numb
they become to the pain their patients feel.
While the fMRI wasn’t an empathy detec-
tor, Dr. Goldman questioned if he was fully
attuned to the emotional state of his patients.
When a patient is waiting anxiously for a bed
or for a diagnosis, when they’re scared or in
distress, are you on their wavelength?
Empathy isn’t an add-on. Dr. Goldman
explains that you can learn a lot about a word
by looking at its opposite meaning. If you
don’t think that empathy is important, con-
sider its antonym: apathy.
Of course, any doctor needs sound techni-
cal skills. But nobody would argue that a
doctor who lacked interest, enthusiasm or
concern, who was indifferent or unresponsive
to patients, was doing a good job regardless of
their other competencies.
The good news, says Dr. Goldman, is that
most people are empathetic. But, time pres-
sures and other work stresses can make it
harder to show empathy all the time. So hang
out with people who are good at it. It can rub
off, he says. Stay mindful of basic courtesies.
Minimize distractions. Be in the moment
with your patients. Find out their stories.
We may be hard-wired to be empathetic
and kind. Yet empathy is not a biological
obligation. “Empathy,” says Dr. Goldman, “is
a choice.”
MD
Let Down Your Guard
What gets in the way of feeling empathy with patients?
One obstacle for doctors may be their worry about
making mistakes, and the perceived repercussions.
Many doctors, says Dr. Goldman, believe they have to be
100% perfect. That’s impossible. Still, that feeling can lead
to defensiveness when they’re challenged, or shame when
they make an error or are seen as not knowing everything.
His theory? When doctors have their guard up, it becomes
more difficult to connect with others. “Shame kills
empathy,” he says.
There’s a system issue at play. “You want your mistakes
and you to escape detection. Obviously, that’s not good
for making the system safer,” says Dr. Goldman. One
solution, he says, is to foster a culture of empathy among
health-care colleagues.
“If you feel ashamed that you pushed the wrong drug
or made the wrong diagnosis, tell someone you trust,”
he says. “As soon as you talk about it, you remove the
mystique of silence. You no longer fear having your
mistake discovered; you beat it to the punch by revealing
it. The person you tell needs to listen empathically. Studies
on shame inform us that doctors who make mistakes
want the person they confide in to state that you’re still
competent, still deserve to be accepted as a doctor.”
As Dr. Goldman writes at the end of The Power of
Kindness, if you want to connect with others, the first
person you have to connect with is yourself. If you want
to be kind to others, be kind to yourself.
ISSUE 3, 2018 DIALOGUE
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