Six months ago my son’s father-in-law suffered a massive heart attack requiring emergency intervention and four stents. Feeling short of breath a few weeks ago, he visited his Cardiologist and, within three days, had an urgent quadruple bypass. This man has a zest for life that I have personally never seen in another person. I happened to be with him and his family the night before surgery when his surgeon paid him a visit.
“When can I get back to work,” was the only question that my son’s father-in-law asked the surgeon.
The surgeon replied with a smile, “Many people take months; sometimes six months or more. You will be ready in four weeks.” We all laughed at the surgeon’s astute assessment of my son’s father-in-law.
I did the math. If a positive attitude can make that much difference to healing after major surgery, then the emphasis generally placed on emotion in medicine, is sadly lacking.
Some would say that when it comes to mental illness, we have come out of the dark ages. I would rephrase this and say: When it comes to mental illness, those suffering have begun to emerge from the dark ages. Speaking from my personal experience, and having suffered with depression and anxiety for most of my life, I now, at 54, am comfortable with who I am. The vast majority of people, and I include those that suffer and those that don’t, remain prisoners or gatekeepers. Either way, mental illness, or as I like to call it, humanness, remains compartmentalized within medicine.
My oldest son herniated a disc in his lower back three years ago. He had an MRI and a report was sent to his family doctor, stating that his herniation was mild to moderate. His doctor sent him for physiotherapy and when this didn’t alleviate the pain after some months, gave him painkillers and sent him for a series of nerve blocks. After eight months of suffering, both physically and mentally, his doctor became frustrated with my son and told him that he shouldn’t be feeling this much pain based on his MRI report and that he believed that the next step would be for my son to see a psychiatrist. My son felt helpless and desperate. A radiologist friend, who had himself suffered with chronic pain for years, decided to look at the original MRI. His conclusion was that the herniation was severe and that the nerve block that my son was receiving could not possibly reach my son’s problem area. My son had surgery and is doing well.
I tell this story for two reasons. Firstly, to demonstrate the either/or approach and the resulting separation of the physical and mental. Secondly, my son’s suffering was increased tremendously because of the lack of kindness and understanding that he received from his family doctor. My son wanted to feel understood and heard. He needed empathy.
Empathy is understanding how someone else feels and being able to put yourself in their shoes. Receiving empathy validates a person’s feelings and helps them feel understood and less alone. Empathy alone can diminish feelings of anxiety, fear or depression. You don’t have to have the same experience as someone else to have empathy. I explained it to my 12 year old daughter,who did not understand her friend’s fear of dogs, like this: “You love dogs so you can’t understand why someone would feel terrified. Are you afraid of something?” Of course the answer was yes. “Don’t look at what your friend is afraid of. Simply understand that she’s afraid. Think of your own fear to help you do this.”
Empathy in doctors is essential to effective medicine. It is not something that doctors should bring into play when they feel that a problem has become weighted on the side of mental illness. It must be in place during every interaction between a doctor and a patient. The absence of empathy makes doctors both less humane and less human. While the physical and emotional may be weighted differently in people, they are always integrally connected. To separate the two would be like severing your legs and believing that they could walk on their own. I find it so interesting that most of us understand that in everyday life, empathy is key. Our personal and professional relationships depend upon it. Why then does this knowledge not reflect the approach of many doctors? Could the fault lie in their training? Perhaps if they were giving the tools to incorporate their feelings and the feelings of their patients into their practice as doctors, things may be different. Without specific training in empathy, and appreciating the importance of emotions in healing, it is understandable why doctors would shy away from empathizing with their patients. No other profession carries the burdens that medicine does. Mistakes matter. Why would a doctor, even those with natural empathy, focus on anything other than what they have been trained to do? The consequences are too enormous.
The medical profession has assumed for too long that doctors will show empathy in their practice of medicine. It seems that there is a breakdown between this assumption and its translation into practice. The time taken to train doctors in empathy should reflect the value of empathy to a doctor’s ultimate goal – healing.
My final comment comes from a place of hope. My son was accepted this year into the Michael G. DeGroote School of Medicine at McMaster University. He began his year with some trepidation. He knew the school did not follow a traditional approach to medicine and was uncertain what to expect. He has enjoyed every moment but I believe of all the things that he has been exposed to thus far, the thing that has spoken directly to the heart of him, has been their human approach to medicine. The school’s emphasis on empathy, kindness and understanding in their future doctors define’s their difference from other schools. Hopefully this school will pioneer schools throughout the world. Hats off to them.