Dialogue Volume 14 Issue 3 2018 - Page 23

PRACTICE PARTNER was less affected by repetitive pain exposure than people who are not health-care profes- sionals. The evidence is all preliminary. Still, Profes- sor Jackson suggested that the longer health- care professionals practise, the more numb they become to the pain their patients feel. While the fMRI wasn’t an empathy detec- tor, Dr. Goldman questioned if he was fully attuned to the emotional state of his patients. When a patient is waiting anxiously for a bed or for a diagnosis, when they’re scared or in distress, are you on their wavelength? Empathy isn’t an add-on. Dr. Goldman explains that you can learn a lot about a word by looking at its opposite meaning. If you don’t think that empathy is important, con- sider its antonym: apathy. Of course, any doctor needs sound techni- cal skills. But nobody would argue that a doctor who lacked interest, enthusiasm or concern, who was indifferent or unresponsive to patients, was doing a good job regardless of their other competencies. The good news, says Dr. Goldman, is that most people are empathetic. But, time pres- sures and other work stresses can make it harder to show empathy all the time. So hang out with people who are good at it. It can rub off, he says. Stay mindful of basic courtesies. Minimize distractions. Be in the moment with your patients. Find out their stories. We may be hard-wired to be empathetic and kind. Yet empathy is not a biological obligation. “Empathy,” says Dr. Goldman, “is a choice.” MD Let Down Your Guard What gets in the way of feeling empathy with patients? One obstacle for doctors may be their worry about making mistakes, and the perceived repercussions. Many doctors, says Dr. Goldman, believe they have to be 100% perfect. That’s impossible. Still, that feeling can lead to defensiveness when they’re challenged, or shame when they make an error or are seen as not knowing everything. His theory? When doctors have their guard up, it becomes more difficult to connect with others. “Shame kills empathy,” he says. There’s a system issue at play. “You want your mistakes and you to escape detection. Obviously, that’s not good for making the system safer,” says Dr. Goldman. One solution, he says, is to foster a culture of empathy among health-care colleagues. “If you feel ashamed that you pushed the wrong drug or made the wrong diagnosis, tell someone you trust,” he says. “As soon as you talk about it, you remove the mystique of silence. You no longer fear having your mistake discovered; you beat it to the punch by revealing it. The person you tell needs to listen empathically. Studies on shame inform us that doctors who make mistakes want the person they confide in to state that you’re still competent, still deserve to be accepted as a doctor.” As Dr. Goldman writes at the end of The Power of Kindness, if you want to connect with others, the first person you have to connect with is yourself. If you want to be kind to others, be kind to yourself. ISSUE 3, 2018 DIALOGUE 23