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Empathy and the Practice of Medicine: Beyond Pills and the Scalpel
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Howard M. Spiro, Mary G. McCrea Curnen, Enid Peschel, and Deborah St. James; eds. 208 pages. New Haven: Yale University Press; 1994. $20.00.
Hippocrates recognized the personal healing power of the physician when he wrote the following: "Some patients, though conscious that their condition is perilous, recover their health simply through their contentment with the goodness of the physician." An empathic connection allows the physician to better know the patient, not just to know about the patient. Too often today, medical education and even patient care emphasize information about the patient's condition and neglect the patient's thoughts and feelings. Discussions about computerized laboratory data, radiologic images, electrocardiographic tracings, procedure results, and disease pathophysiology are the focus of interest in classrooms distant from the patient's bedside and world. Empathy and the Practice of Medicine attempts to bring the patient's experience of illness and the physician's empathic understanding of the patient to center stage. This book should be required reading for all those involved in the diagnosis, treatment, and care of patients. Unfortunately, those who might gain most from this book are probably those least inclined to investigate its contents.
From the foreword by Richard Selzer, through a series of essays written by physicians, philosophers, and a nurse, this book challenges the reader to consider the role of empathy in medical practice. The varied perspectives of the authors regarding the practice, teaching, and theoretical underpinnings of empathy enrich and challenge shallow considerations of this subject. Two preliminary chapters by Howard Spiro, as well as his introductions to the three parts of the book, are reward enough for the time invested in reading.
The value of empathic connections with patients is conveyed through the presentation of personal accounts, philosophical considerations, and historical and literary tales. Examples of empathic physicians and their situations are drawn from opera (for example, Dr. Grenvil in Verdi's "La Traviata") and literature, notably from works by Shakespeare, Chekhov, Camus, Williams, and Moerch. Arguments and cautions against the iatrogenic effects of empathy are also presented, including William Osler's praise of the physician's quality of "imperturbability."
Those who require empirical evidence of the ways in which empathy and its effects can be quantified and validated will be disappointed by the absence of experimental data in the collected essays. Perhaps these readers will be motivated to conduct investigations into the benefits and risks of empathic behavior by physicians in medical encounters.
The Russian writer Ivan Turgenev recognized that "illness isn't the only thing that spoils the appetite." This book validates the physician's need to gain an empathic knowledge of the patient to better diagnose, treat, and counsel.
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