Empathy – a Foreign Language for Doctors?
(see also appendix 5)
It seems that most doctors literally
cannot bring themselves to utter even the most basic
and commonplace empathic phrases
in response to a patient’s presentation of his or her symptoms –
even though these can have an immediately beneficial and healing
impact. Indeed they are even taught in their medical training empathy
as such is a hindrance to maintaining clinical ‘objectivity’ in
doctor-patient communication. In reality it can be the magic key to
affirming – rather than defending themselves against – the
patient’s lived, subjective experience
of illness. In this way it can
give an immediate sense of being recognised as a human being and with
it an immediately enhance sense of well-being. In contrast,
maintaining a stance of ‘clinical distance’ is a form of
communicative pathology in the most literal sense– a ‘sick’
(pathos)
use of language (logos).
Yet since empathy is clearly a ‘foreign language’ for most
biomedical doctors and clinicians what follows can be likened to a
elementary language phrasebook, not in ‘English as a Foreign
Language’ (EFL) but in ‘Empathy as a Foreign Language’ (EFL)
one so basic it is quite
extraordinary that it should be needed at all.
Note: feel free to distribute or put a copy of it up for doctors in
your local clinical practice or hospital!
1. Opening empathic phrases in
response to patient’s presentation:
For example, how about simple phrases
like:
I’m sorry to hear that. / I’m
sorry to hear you’ve been feeling that way/so bad.
That sounds very
unpleasant/distressing/painful.
How has that been making you feel?
I can understand why you feel so
worried/upset/concerned/distressed.
I can understand why you wanted to see
me.
How have you been coping?
2. Some simple closing phrases to end
a consultation:
How are you feeling now?
How do you think you will cope?
Do you have any other worries?
Is there anything else that you’d
like to tell me about/ that is bothering you?
Do let me know how things go.
(which the patient could do by leaving a note for their doctor by
phone)
The common failure to use this type of
empathic language is itself
symptomatic of a larger
problem – namely the almost total lack of interest on the part of
clinicians in the patient's lived
experience of illness and its
effects on
their life rather than just
their presenting symptoms.
“One unintended outcome of the modern
transformation of the medical care system is that it does just about
everything to drive the practitioner’s attention away from the
experience
of illness. The system thereby contributes importantly to the
alienation of the chronically ill from their professional care-givers
and, paradoxically, to the relinquishment by the practitioner of that
aspect of the healer’s art that is most ancient, most powerful and
most existentially rewarding.”
Arthur Kleinman M.D. The
Illness Narrative: suffering, healing and the human condition
No comments:
Post a Comment