Empathy in clinical practice
In 2009, while conducting research on the practice of empathy, Dr. Howard Spiro wrote: “Empathy has always been and will always be among the physician’s most essential tools of practice” (Jeffrey, 2016).

Clinical empathy can be defined as the act of correctly acknowledging the emotional state of another, or a patient in a physician’s case, without experiencing that state oneself (Halpern, 2003). It goes without saying that physicians cannot fully experience the suffering of their patients, but can try to cognitively understand what they’re going through in order to be moved by their experiences and act accordingly in the most appropriate manner (Halpern, 2003). It is also important to differentiate that empathy is more of an intellectual rather than emotional form of knowing and thus cannot be influenced by the feelings of sympathy. Recent studies have in fact shown that physician empathy increases patient satisfaction and improve clinical outcomes (Jeffrey, 2016).

In contrast to the view of Spiro on empathy in clinical practice, Mattingly (2008) suggests that some doctors view empathy in clinical practice as ‘nice’ and not essential due to the medical culture that does not consistently support the practice of empathy. Physicians are often so rushed to get through their day that they don’t take the time to listen and interact with their patients and justifies this act by agreeing with Mattingly that clinical empathy is not essential (Jeffrey, 2016). In order to have empathy with a patient, understand their state and pick up important information which could promote their health and treatment, physicians must make time to listen to their patients and interact (Jeffrey, 2016).

During my last block of my final year, I encountered a serious dilemma where a patient was failed by a multidisciplinary team of physicians who did not empathize with the state she found herself in. This was due to a lack of interaction and interest in a patient who seems like she was being “over-dramatic” and eventually led to her death, causing the hospital to find itself in the middle of a big court case. The patient initially came in with back pain and a disk lesion and was awaiting neurosurgery. In the meantime she was referred to physiotherapy to participate in active rehabilitation, while as a matter of fact she had cauda equina syndrome. The patient had all obvious signs and symptoms of the condition, yet no doctor picked it up and nurses continued to be irritated by her complaints and put her in an all-fours position as that was the only possible way she could urinate.

Although this was not a patient of mine, I was present in the gym when doctors were called to come and observe how she was unable to control her bladder and urinated all over the floor once she got into standing. I saw her every session when she came down to physiotherapy and cried of the pain she was in and how physicians and nursing staff rolled their eyes once she started crying and complaining. I eventually became irritated by how she acted every time she was in the gym without even knowing why she was crying or taking the time to find out what was wrong. Every single doctor, physician and nursing staff failed that patient because none of us took the time to approach her in a compassionate manner to try and understand the state that she is in which would have led to diagnosing the life-threating condition much earlier which eventually claimed her life.

Out of an experience as straight forward as this one, I completely agree with Dr. Howard Spiro that empathy in clinical practice is essential to the diagnosis and humane treatment of a patient. No physician showed this patient any form of empathy, no one understood her pain or tried to uncover the reason behind her symptoms, and in essence due to a lack of empathy a young female died too soon. In an article by Toombs (2001), he again states that clinical empathy helps physicians to see a patient as ‘a living body and not merely as a physical body’ and aid them to make treatment more appropriate, active and humane. He continues to suggest the importance of medical educators to develop students’ capacity for empathetic understanding and in the article note several ways in which the task might be accomplished (Toombs, 2001). If this can be achieved by means of following his guidelines, it could be a start to reducing incidents as I experienced and eventually prevent something like this from ever happening to an undeserving patient again.

References
Halpern J. (2003). What is clinical empathy? Journal of General Internal Medicine 2003; 18(8): 670-674

Jeffrey D. (2016). Clarifying empathy: the first step to more humane clinical care. British Journal of General Practice 2016; 66 (643): e143-e145

Mattingly C. (2008). Health, illness and culture: broken narratives, stories that are ready to break, eds Hyden L-C, Brockmeir J (Routledge, New York) pp 73-98

Toombs S.K. (2001). The role of empathy in clinical practice. Journal of Consciousness Studies 2001; 8(5-7): 247-258