Empathy can be described as demonstrating kindness, understanding, and feeling for the suffering of others.

We tend to expect these attributes from care practitioners.  This is often not the case.

During a recent hospitalization for severe covid symptoms, I was told by a doctor that my life was at risk.  A “DNR” (Do Not Resuscitate) band was slapped on my wrist. This was performed without an understanding word or comment.

I felt horrified and frightened at that moment.

Later, I was angry and mystified.  Why was this doctor unable to show emotion?

Do I expect a degree of sensitivity from doctors? Yes, I do!  As an occupational therapist, I learned and practiced, “therapist use of self.”  This means the modeling of behaviors that promote empathy.  It means that a frightened, paranoid client may benefit from the therapist sharing moments when he or she was frightened.  It may mean spending extra time with a client to express an understanding of the client’s needs.

I continued to question: what factors and experiences might influence doctors to show empathy?

Are Some Doctors Born with a Capacity for Empathy?

I remembered previous doctors who have cared for me as though they were born with empathy.

These doctors consistently gave generously of their time, discussed treatment options, and easily expressed a “sorry”, when observing discomfort.  With these qualities in mind, I recalled one sensitive, caring physician who personally and immediately phoned my lab results to me.  I was grateful, knowing most practitioners may have waited days for me to receive my computer-generated copy.

In a gene study (BBC, 2018), author Therrien indicated that empathy can be inherited.  In this study, 46,000 participants were given a questionnaire and DNA testing for “empathy quotient” (EQ). Varum Warrier, from the University of Cambridge who led this study, stated that at least 10% of the participants were born with empathy.  This study indicates that genes may have a role in the development of empathy.

Can Social Experiences Influence Empathy?

I recalled a veterinarian, one of few in a small town, who once seemed cold, with little compassion for his animal patients.  Once with a business-like demeanor, his personal illness changed his ability to feel.  He dramatically changed to become a kind, understanding practitioner after his personal illness and lengthy treatment for cancer.  When my Yorkie was very ill, he spent extra time and demonstrated an understanding of my loss and grieving.  He shared his personal trauma experienced as a patient with an uncertain health outcome.

It may also be possible that a doctor’s long treatment of a patient may add to an in-depth caring of this patient.  The severity of the illness could also add to empathy development.

Lesley University (2024) has also theorized the “simulation” theory.  Empathy is possible when we see another experiencing an emotion.  We simulate or represent that same emotion in ourselves.  There may be “mirror” neurons that fire when humans observe and experience emotion.

Thinking beyond our environment, is it possible to consider empathy training for doctors?

Can Doctors Be Trained to Feel?

Empathy and compassion are part of the practice of medicine, according to Patil et al.(2019).  They reported positive results in training empathy skills.  These skills include mindfulness (acting with awareness); reflective listening (non-judgmental understanding of another); and eight weekly hour sessions with hand-outs and practice sessions.

In this study, improvement in doctor eye contact, empathy and support, and understanding of patient fears and experiences were reported.

In a similar manner, Cleveland Clinic’s Lerner College of Medicine (2020) reports empathy has been on the curriculum since the college opened in 2002.

Can We Be Hopeful About Contact with Empathetic Doctors?

Can an awareness of innate and social/environmental factors, as well as empathy training, tend to increase the numbers of caring doctors?

The answer seems to be a positive, enthusiastic, and welcome, YES!

Kathleen Noonan, OTR/L (“Kate”) is an occupational therapist and health care writer.  She has worked in mental health and pain management settings with adolescents and adults.  Her publications reflect current issues in psychiatry, that include suicide, trauma experiences and treatment, and challenges with hyperactivity.  Her current project is a book that expands a fiction article she wrote about believing in miracles.  Kate did survive COVID!

References

Therrien, A. (11 March 2018) “Genes Have a Role in Empathy, Study Shows”. BBC Health. https://www.bbc.com/news/health-43343807

“The Psychology of Emotional and Cognitive Empathy.” Lesley University (2024). Cambridge, MA. lesley.edu/article/the-psychology-of-emotional-and-cognitive-empathy

Patil, S; Pelletier-Bui, A; Smith, S; Roberts, M; Kilgannon, H; Trzeciak, S; Roberts, B; Lamm, C. “Curricula for empathy and compassion training in medical education: A systematic review.” National Library of Medicine (2019, August 22).  ncbi.nlm.nih.gov/pmc/articles/PMC6705835/

Cleveland Clinic (16 July 2020). consultqd.clevelandclinic.org/priority-teaching-empathy-to-medical-students.