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A Piece of My Mind
April 21, 2020

Empathy Revisited

Author Affiliations
  • 1NYU Winthrop Hospital, Mineola, New York
JAMA. 2020;323(15):1447-1448. doi:10.1001/jama.2020.3790

The phone rang in the middle of the night. Like during so many other sleep-interrupting calls, I cleared the cobwebs in my brain and prepared to speak with the fellow about a new consult. Acute myocardial infarction? Ventricular tachycardia? Acute systolic heart failure? This call would be different. It was Bellevue Hospital. “Your wife and father-in-law have been in a serious car accident. Come to the hospital as soon as possible.” Life would never be the same again.

As I drove to Bellevue my mind raced. Was I still dreaming? Was this reality or a nightmare? I was somewhat comforted in knowing that she would be in excellent hands at a leading trauma hospital. Whatever needed to be done, would be. However long a recovery was required, I would never leave her side. When I arrived, I was escorted into a private room. Word would be coming soon, and I could only hope for the best. When would I be able to see her? A trauma surgeon walked into the room, paused, and said, “I am sorry for your loss.” Scripted words of sorrow from a surgeon who never knew my wife, a punctuated phrase, and a frame captured in time, created a before and an after, and changed everything you thought might be.

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    1 Comment for this article
    Beyond Empathy to Compassion
    Barry Kerzin, M.D. | University of Pittsburgh
    The recent article, 'Empathy Revisited' by George Gubernikoff, MD, in the April 21, 2020 edition of JAMA, was deeply personal and moving. The courage to share his deeply personal loss and pain while questioning whether empathy is possible, resonates deeply.

    Stepping in the others' shoes may indeed not be possible, yet we try. And so doing, it can get us in trouble. Much of the burnout, so prevalent among healthcare professionals, comes from trying to take on others' pain through empathy. When we take on others' pain, we tend to own it. It stays with us and builds up.
    Unwittingly, empathy can turn become overwhelming. Then with the wish to help, what can we do?

    Moving beyond empathy to the wish and action, when possible, of helping to relieve others' pain is a healthier approach. We might listen without judgement. We might offer a smile. We might utter the words, "I am here for you when you need."

    Compassion is the wish, and the action when we can of relieving pain and misery. We take an emotional step back, which buffers us from taking on the others' pain. Yet we are concerned about their suffering. A half-step back emotionally allows us to assess the situation more fully. This puts us in a better position to be effective with our compassionate intervention.

    When we have the intention to help, but lack the knowledge of what to do, this is o.k. This intention gets us ready for the next time. It keeps our heart open and prepares us for the next opportunity to help reduce suffering. We can only do the best we can, not more.

    When our actions with good intention backfire, we learn how to respond more effectively for the next time. There is no need for guilt. In fact, acting compassionately, brings inner peace, and a sense of wellbeing. Acting out of love or compassion makes us feel well. It makes us feel that we are connected to humanity. Love is similar to compassion. It is the wish, and action when able, to bring happiness. The end result of compassion and love are the same, but the approaches are a little different.

    When I was a 3rd year medical student my mother died of ovarian cancer. When I was out of residency and starting private practice, my wife died of ovarian cancer. While devastating experiences initially, both experiences later broadened my capacity to love -- the silver lining.

    Being a Buddhist monk living in Dharamsala has also nurtured my ability to love and act compassionately. Having the great fortune of providing medical care to His Holiness the Dalai Lama has exponentially deepened my love and feeling of interconnectedness to all living beings. Sometimes I pinch myself feeling that this all is a dream.

    Thank you deeply, George Gubernikoff, for sharing your pain, growth, and reflections on empathy, with the permission of your boys.

    With love and respect,
    Barry Kerzin, M.D.
    Founder and President
    Altruism in Medicine Institute