A Prescription for Empathy

Empathy is essential to humane health care practice, yet it can be difficult to teach. While there are many strategies for teaching empathy to medical students and practitioners, most of these methods are thinly veiled attempts at instilling sympathy in the listener. Sympathy doesn’t suffice because it’s often feigned pity; true empathy requires a touch of experience to inform the sympathy.

We have a suggestion. Imagine walking into a lecture hall for first year medical students about to start their cancer unit.The desks each have a pill cup with a powerful emetic and a barf bag. Students file in and find seats in the room. As the lecturer stands up to begin teaching the pharmacodynamics and kinetics of chemotherapy they begin with these simple instructions: “Take the pill. Keep the barf bag close. Let’s get started with alkylating agents.”

Now a room filled with vomiting medical students may not provide the best pharmacology learning environment, but would even this short-lived experience not instill a touch of empathy in the retching student? Imagine working through all the side effects of chemo in the same resolute way.

Our suggestions for developing empathy for one’s patients, however tongue- in-cheek, are inspired by a teaching moment of the late 19th century’s great physician and teacher William Osler who, according to legend, taught empathy to his medical students one day while rounding. In teaching about patients’ experiences with bedrest (which was commonly prescribed in those days and which he strongly supported), Osler pointed at random to one of his medical students and said “You. Bedrest. 2 weeks.” In the spirit of Osler and to remedy the dearth of empathy in aspiring medical providers we recommend the following treatments:

For your cancer patient undergoing chemotherapy we recommend not only taking the emetic you first had in the lecture room at least 3 times per day for the following week, but also to be sure to shave your head.

For the COPD patient, we recommend breathing only through a straw or oxygen-depleting mask for a minimum of 12 hours per day.

For your dermatology patient with intractable skin rash we recommend an itch-producing ointment applied liberally to your own skin.

For your wheelchair-bound patient, we recommend spending a week in a wheelchair, 24/7, no This won’t tell you what it’s like to spend ten or twenty years in a wheelchair, but you will discover lots of obstacles to getting around.

Do you have a patient with a high spinal cord injury? Spend a week motionless in bed, with all your bodily functions attended to by others.

How about a patient with a feeding tube? You can see the presentation of what you plan to eat, smell the aroma and even put it in your mouth, but you must spit it Your entire nourishment must come only from bland, tasteless gruel that you must eat exclusively for a week.

For diabetic neuropathy, consult a neurologist and try to replicate numbness, tingling or serious nerve pain.

You may have patients addicted to It may be difficult to simulate the craving – although you should give up whatever brings you the most intense pleasure — but you can certainly simulate the intense constipation caused by opioids by taking Imodium continuously at the maximum dose.

For your schizophrenic patient, you must use your earphones to project voices into your head for 24 hours per day, for one nonstop week.

To truly understand the dementias, especially later stages, you could begin with going without sleep for 48 hours and trying to function in your normal Of course, that’s only the beginning.

These suggestions are merely a start and we encourage the reader to consider further strategies for enhancing empathy in the situations of more complex patients. Keep in mind the great William Osler and that hapless medical student consigned to bed rest as you develop the trait of empathy. And if you’re really serious about becoming a great physician who truly understands what your patients are going through, try all of these exercises, one after another, for the entire time you’re in med school. Of course you’ll never really know what it’s like to be the patient in these difficult situations, but at least you’ll be a lot closer than many physicians ever get.

Rubor Participation
2018 Contributing Essay

A distinguished professor of philosophy and medical ethics at the University of Utah. She has authored, co-authored, edited, or co-edited some twenty books during her career.

Rubor Participation
2018 Contributing Essay

A member of UUSOM Class of 2021. She graduated with a degree in Physiology and Developmental Biology from BYU. She enjoys trying new foods, reading, and cuddling her cat.