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I Feel Your Pain, Actually, Really?

I Feel Your Pain, Actually, Really?

Allan Tasman, MDAllan Tasman, MD

Editor in Chief

I’m trying to have a relaxing time away from the office. No last-minute requests to do something incredibly important but that no one had told me about. No having to be someplace every Tuesday at 10 am. No deadlines. And here I am, up against a deadline to write an editorial for Psychiatric Times I was trying to avoid until the last minute. Do you feel bad for me? I doubt it.

I treated a patient from a family of meager means, who had made a fortune from her business, a true self-made woman. Then disaster struck, her company went bankrupt, and she lost everything going forward (although her prior assets weren’t touched) and had an episode of severe depression. Was I empathic? It took a little work, but yes, certainly.

I saw a woman and her husband who were Syrian refugees in the US. The mother had been inconsolably depressed for a year but had refused psychiatric care. The precipitant? The day before the family was to leave for the US, their only child had been killed by a roadside bomb. It was hard not to feel her terrible experience, and it still affects me as I write this.

We know, just as with many other human characteristics, that empathic ability comes on a continuum, and that it takes at least some effort. One of my recent medical students was hobbled by her inability to “leave her work at the hospital,” and she spent many evenings while on our service re-experiencing the feelings she had when listening to the often troubling and very painful stories she was told by our patients. Others seem unaffected, but most lie somewhere in the middle. And we know that part of training to become a psychiatrist involves helping our future colleagues enhance their empathic listening skills.

It’s an occupational hazard for psychiatrists and other clinicians to try to stay empathic in the face of work stress. I, and many others, have written about the burgeoning problem of burnout in health care. There’s even a clever cliché coined to describe this: “compassion fatigue.” And all of us, whether in solo or group practice, office, community health center, or hospital, in teaching or non-teaching settings, struggle to not only maintain, but even better, maximize our empathic capacity and to teach others how to do the same.

But, like all things in our technologically advanced society, for all hard-working, empathy-challenged doctors comes a new and easy, although not painless, way to gain empathic ability. The New York Times1 reported that someone has just put on the market a nerve-stimulating machine that, when turned up to high output, can induce purportedly Parkinsonian-like tremors, thus allowing someone to be more empathic when treating patients. This device was apparently developed in response to stimulation (yes, I know it’s a bad pun) by a pharmaceutical company to help its salesforce be more empathic about the experience of Parkinson disease—a focus of one of the company’s products.

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