"In short, empathy can be learned but not taught." Perhaps not, but honesty and humility can be - most effectively by demonstration. And empathy is learned through honesty and humility. Any physician working under you is profoundly blessed by having that example.
Such a heartfelt and unforgettable piece — helpful for both clinicians and patients to read. Thank you, Dr. Cifu, for your keen awareness, your willingness to share, and your strengthened empathy.
Beautiful, sensitive piece, thank you for your open honesty. It's refreshing to see in a physician....no offense intended!
As a seasoned RN that has taught many new nurses, I used to think to myself how do we teach compassion? I came to the same conclusion as you, we can't. We can model it, we can discuss it, but nurses will have to learn it through experience in the field. And frankly, some get it and some never do....sad but true. We can only hope the ones that do acquire empathy and compassion are the ones who stay in the field and model it to the next generation of healthcare providers. Please God. :)
So honest and true...I too considered myself adept in the empathy department, but a few years ago when I returned to ER work after escaping DV abuse, the shift in my empathy was bittersweet. Realizing with all the “empathy” I thought I had for the patients suffering in abuse dynamics, I never really connected with them before I walked that path of suffering myself. I also saw where I used empathy to connect with people but didn’t have the emotional maturity to understand how much space people need to truly be seen and heard. I think your point about balancing empathy and “practical” decision-making describes a time where your process filled that space...and for me, my “processing” the traumas has yielded space to hear more fully what patients need most. I’m grateful you are sharing your stories awareness to students, patients, and readers
I don't believe empathy can exist without a big picture. Throughout my specialty I have taken baby steps in learning to look through, around, under, over my patient. Gender, career or career left, family, spirituality, finances, mental capacity molds what is in front of you right now. To be able to see the forest for the trees is a coveted skill. I say that as I often find myself still slogging through the minutia. And, yes, of course, that fine line between close and too close. This is a journey I'm glad to be taking.
Learned empathy is where you understand the more subtle issues a patient may have regarding there problem or diagnosis. At the top of the list would be educating a right handed person to start practicing toilet hygiene with their left hand before their shoulder surgery. Or vice a versa for left handed patients.
Just supplying a little of that inappropriate healthcare humor you mentioned in your prior post.
Wow this was so perfectly placed. I am so thankful that this was written and that I read it- it is such a delicate balance between emotions and practicality- and the story of this dance was so well articulated. I also appreciated the end where strengths and weaknesses were called out- something to be aware of and bring self awareness to!
I feel this in my soul! Before I became a nurse, I worked as an office manager. I have a history of days-long migraines. Occasionally, I'd get a migraine that was so bad I would have to call out of work. My boss (who was also a close friend) was never happy when that happened because in his mind, it was "just a headache". One day, he came down with a debilitating migraine and when he came back to work the next day he told me he would never discount my need to call out for migraines again!
I'm a NICU nurse by trade and I became one because my first son was born at 32 weeks. I had such good, caring nurses with him and I wanted to pay it forward. I'll be the first to admit that my son didn't know he wasn't supposed to be doing the things he did (e.g. drink from a bottle at 32 weeks, so much has changed in NICU nursing regarding developmental feeding over the last 35 years!) and fortunately his stay was only a couple of weeks. I know acutely the pain/heartache a mother feels when she is discharged from the hospital and has to leave her baby behind. I am thankful I have been able to walk many mothers (and fathers) through their NICU journey and I know my own experience helps me be a better nurse to our families.
Jan 20, 2023·edited Jan 20, 2023Liked by Adam Cifu, MD
Thank you Dr. Cifu. I've certainly seen a shift with oncologists before and after they've experienced cancer firsthand. I like the concept "empathy earned and learned".
The old "If it were your parent would you want this?" is what came to my mind reading this piece. I often repeat things to patients that I have told myself inside my head. "try and be a soldier, and hold still. You can do it". I suppose I agree that it is learned. Because younger people often just say "don't move".
I had repeated ear infections as a child, and to this day, I rank those as the #1 most painful experience I've ever had (worse than when I had a crushed a fingertip or natural childbirth) So when my daughter was little, I would take her to urgent care or ER when she had ear infections. Mostly we got the "you shouldn't be here; this isn't urgent" song and dance. But one night, a doctor said to us "Have you ever had one of these as an adult? Ear infections are PAINFUL!" He was right, and I've been forever grateful. I wished there were more like him! He knew she was in pain and wanted to help.
I won't bore anyone with the details, but am dealing with the awfulness of my mom's "discharge to rehab" at present. For a doctor, or anyone in the U.S. giving advice to elderly parents, advise them 'do anything you can to KEEP YOUR HOME and use up your savings for in home care until medicaid takes over' unless there is absolutely no alternative. To be faced with possible end of life in a nursing home or any place that was never home (like unassisted living) is truly heartbreaking for the patient and the family and contributes to depression, hopelessness and anxiety for all of them. Even with a debilitating medical condition, keeping parents together and even just sitting with the parent who is failing, is preferable to many medical interventions. As far as empathy, there's minimal quality of life after a nursing home takes a vacuum cleaner to your bank account.
Thank you for your writing. I’ve followed you for several years now and you are a singular voice filled with compassion. Not that you are the only one but that you bring a unique perspective, kindness and grace to this somewhat cold and brutal healthcare table. Can I mention financial empathy? This behemoth System batters patients with its money club when we are at our most vulnerable and the people who do it have no agency or relationship with us. Doctors unwittingly push the boulders down the hill and the billing folks, thousands of them with endless tools resources and weapons that brutalize patients take over. Doctors may think they know what we’re going through but as your colleague the ophthalmologist found out after his heart attack you can’t know until you’ve been victimized yourself.
"In short, empathy can be learned but not taught." Perhaps not, but honesty and humility can be - most effectively by demonstration. And empathy is learned through honesty and humility. Any physician working under you is profoundly blessed by having that example.
Such a heartfelt and unforgettable piece — helpful for both clinicians and patients to read. Thank you, Dr. Cifu, for your keen awareness, your willingness to share, and your strengthened empathy.
Beautiful, sensitive piece, thank you for your open honesty. It's refreshing to see in a physician....no offense intended!
As a seasoned RN that has taught many new nurses, I used to think to myself how do we teach compassion? I came to the same conclusion as you, we can't. We can model it, we can discuss it, but nurses will have to learn it through experience in the field. And frankly, some get it and some never do....sad but true. We can only hope the ones that do acquire empathy and compassion are the ones who stay in the field and model it to the next generation of healthcare providers. Please God. :)
Oops! ...stories, awareness and wisdom with...;)
So honest and true...I too considered myself adept in the empathy department, but a few years ago when I returned to ER work after escaping DV abuse, the shift in my empathy was bittersweet. Realizing with all the “empathy” I thought I had for the patients suffering in abuse dynamics, I never really connected with them before I walked that path of suffering myself. I also saw where I used empathy to connect with people but didn’t have the emotional maturity to understand how much space people need to truly be seen and heard. I think your point about balancing empathy and “practical” decision-making describes a time where your process filled that space...and for me, my “processing” the traumas has yielded space to hear more fully what patients need most. I’m grateful you are sharing your stories awareness to students, patients, and readers
I don't believe empathy can exist without a big picture. Throughout my specialty I have taken baby steps in learning to look through, around, under, over my patient. Gender, career or career left, family, spirituality, finances, mental capacity molds what is in front of you right now. To be able to see the forest for the trees is a coveted skill. I say that as I often find myself still slogging through the minutia. And, yes, of course, that fine line between close and too close. This is a journey I'm glad to be taking.
Learned empathy is where you understand the more subtle issues a patient may have regarding there problem or diagnosis. At the top of the list would be educating a right handed person to start practicing toilet hygiene with their left hand before their shoulder surgery. Or vice a versa for left handed patients.
Just supplying a little of that inappropriate healthcare humor you mentioned in your prior post.
Wow this was so perfectly placed. I am so thankful that this was written and that I read it- it is such a delicate balance between emotions and practicality- and the story of this dance was so well articulated. I also appreciated the end where strengths and weaknesses were called out- something to be aware of and bring self awareness to!
I feel this in my soul! Before I became a nurse, I worked as an office manager. I have a history of days-long migraines. Occasionally, I'd get a migraine that was so bad I would have to call out of work. My boss (who was also a close friend) was never happy when that happened because in his mind, it was "just a headache". One day, he came down with a debilitating migraine and when he came back to work the next day he told me he would never discount my need to call out for migraines again!
I'm a NICU nurse by trade and I became one because my first son was born at 32 weeks. I had such good, caring nurses with him and I wanted to pay it forward. I'll be the first to admit that my son didn't know he wasn't supposed to be doing the things he did (e.g. drink from a bottle at 32 weeks, so much has changed in NICU nursing regarding developmental feeding over the last 35 years!) and fortunately his stay was only a couple of weeks. I know acutely the pain/heartache a mother feels when she is discharged from the hospital and has to leave her baby behind. I am thankful I have been able to walk many mothers (and fathers) through their NICU journey and I know my own experience helps me be a better nurse to our families.
Thank you Dr. Cifu, you wrote what I am experiencing on myself and what I have been a part of for years as an RN.
Thank you Dr. Cifu. I've certainly seen a shift with oncologists before and after they've experienced cancer firsthand. I like the concept "empathy earned and learned".
The old "If it were your parent would you want this?" is what came to my mind reading this piece. I often repeat things to patients that I have told myself inside my head. "try and be a soldier, and hold still. You can do it". I suppose I agree that it is learned. Because younger people often just say "don't move".
I had repeated ear infections as a child, and to this day, I rank those as the #1 most painful experience I've ever had (worse than when I had a crushed a fingertip or natural childbirth) So when my daughter was little, I would take her to urgent care or ER when she had ear infections. Mostly we got the "you shouldn't be here; this isn't urgent" song and dance. But one night, a doctor said to us "Have you ever had one of these as an adult? Ear infections are PAINFUL!" He was right, and I've been forever grateful. I wished there were more like him! He knew she was in pain and wanted to help.
I won't bore anyone with the details, but am dealing with the awfulness of my mom's "discharge to rehab" at present. For a doctor, or anyone in the U.S. giving advice to elderly parents, advise them 'do anything you can to KEEP YOUR HOME and use up your savings for in home care until medicaid takes over' unless there is absolutely no alternative. To be faced with possible end of life in a nursing home or any place that was never home (like unassisted living) is truly heartbreaking for the patient and the family and contributes to depression, hopelessness and anxiety for all of them. Even with a debilitating medical condition, keeping parents together and even just sitting with the parent who is failing, is preferable to many medical interventions. As far as empathy, there's minimal quality of life after a nursing home takes a vacuum cleaner to your bank account.
Thank you for your writing. I’ve followed you for several years now and you are a singular voice filled with compassion. Not that you are the only one but that you bring a unique perspective, kindness and grace to this somewhat cold and brutal healthcare table. Can I mention financial empathy? This behemoth System batters patients with its money club when we are at our most vulnerable and the people who do it have no agency or relationship with us. Doctors unwittingly push the boulders down the hill and the billing folks, thousands of them with endless tools resources and weapons that brutalize patients take over. Doctors may think they know what we’re going through but as your colleague the ophthalmologist found out after his heart attack you can’t know until you’ve been victimized yourself.
Beautiful essay, dripping with truth. As an old practitioner myself I can so relate.