Empathy is the ability to put yourself in someone else’s shoes and understand what they are feeling. This is something that psychiatrists try to do in our everyday work. Those of us who have worked in medical schools have struggled with the question of whether or not we can teach this to young men and women who are learning to be doctors or whether it is something that they either have or do not have. Certainly I have seen medical students who seemed to be decidedly lacking in this quality, just as I have seen students to whom it came very naturally and some who were far more empathic than I was as a student or even after years of experience.
Choose Empathic Students in the Admission Process
I have gone through many phases in trying to figure out how medical schools can graduate doctors who have this empathic quality. My first thought was to try and influence the selection process so students who seemed to have this natural quality would be chosen. I had the opportunity to join the admissions committee of the medical school where I taught and participated in the interviewing and selection of prospective students.
Actually, there were a few psychiatrists already on the committee along with other medical specialists and basic scientists who would be training the students in their preliminary non-clinical years. It was relatively easy to determine which students had this quality in abundance and which students did not. I could see the tears in a student’s eyes as he or she told me about experiences which he had known someone who had been ill or disadvantaged and how this had motivated him to want to be a doctor. I remember the caring response of one student to me as I was suffering with allergies with my eyes running on a particular day that I was interviewing her. On the other hand I could detect the intellectual response of students who ticked off their many volunteer activities or told of their dedication to finding the cure of cancer because it would then increase life expectancy. However, when it came down to the votes on the committee, a student being the most empathic would never trump the one with potential to become a world famous doctor.
Trying to Teach Empathy in the Classroom
I had opportunity to see if it were possible to teach students to be empathic. It was traditional in our medical school for psychiatrists to teach students interviewing technique both in formal lectures and at the bedside. In preparation for a formal lecture I made a video tape (we were not yet using DVDs) in which I had some senior students act as doctor and patient in a hospital room in various scenarios. In one of them the “doctor” asked the “patient” if anyone in her family had a cancer. The patient began to cry and said her daughter died of cancer. I then showed three possible responses. In the first one the doctor just continued with the interview and kept asking questions. In the second scenario, the doctor got up and excused himself and said he would come back later when the patient was feeling better. In the third case the doctor offered the patient a tissue and said that he was sorry. Obviously the third vignette was meant to be the correct one, and most students seemed to get it. However, a group of Asian students approached me after the lecture and told me that they did not agree with the choice of the best vignette. In their particular culture it was a sign of respect to let a patient be alone in that particular situation. Excusing one self and walking out of the room was the correct response as far as they were concerned. So I began to realize that this was not an easy task.