Hanging on to our better selves

First, a confession about how this particular blog post came into being.  It all starts with an image of a panda bear that was included in the Tweet that Nick Kristof posted, linking to his NY Times piece on how we can increase empathy.  Chances are that I would have found my way to the essay anyway, but the panda…well, who can ignore a panda, right?  And I didn’t.

I’ve shared this great (short) video before in which Brene Brown (one of my personal heroes for her wonderful work on shame) explains the difference between empathy and sympathy, and the importance of connection.

What we know:

  • Empathy has been described as an essential capacity of physicians, impacting doctor-patient communication, patient engagement in their care, and the effective care of patients as a whole.
  • Empathy is also essential to maintaining physician emotional and mental wellness, including avoiding burn-out, depression, and suicide.
  • Student empathy scores (using a validated measurement tool) decline during medical school, specifically once students enter the clinical years.
  • We are ineffective in teaching students how to balance the presence of suffering with the maintenance of empathy, probably because we have historically relied up on the “hidden curriculum” to do this (and many of us do it poorly).

So how do we do this better?

Maybe the answer is in having a wellness curriculum for our trainees. Of course, there is the critical issue of getting our own houses in order as well- burnout has become a prevalent topic, particularly in the surgical literature, and we know that emotional exhaustion and depersonalization are predictive of burnout.  In the absence of much formal training, we just plain make it up as we go…so we practice yoga, we read literary fiction, we learn about meditation (and try mightily to sit still!), we look at pictures of cute animals.

Gratuitous Olivia Photo

Gratuitous Olivia Photo

Most importantly, we have to be brave when it’s not easy to be brave.  Our “culture” teaches us to chin up and keep going and sometimes that’s not the right answer- we need to pause to process, we need to talk to a colleague about what happened.  And we need that colleague to sit with us and say, “I know what it’s like down here, and you’re not alone”  No, “At least…”, and no offering of sandwiches.  Because, really, we’re all in this together, aren’t we?