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Promoting Empathy: What's Troubling About a Celebrated Hospital Video

Empathy can distract. It misleads, causing us to act counter to the greater good.


Empathy is a noun meaning “the ability to understand and share the feelings of another person,” according to an online Oxford English dictionary. This resonates with what I learned, or was reminded of, nearly 30 years ago in a medical school classroom. Empathy is when you perceive what it’s like to be someone else—when you can imagine, or maybe know, what it’s like to walk in their shoes. So to speak.

Sympathy, also a noun, involves affinity between two creatures. You might feel, for another, sorry or pity or love—though that word didn’t come up. We were receiving instruction in a mandatory medical ethics seminar. A list on a sheet of paper provided terms we needed to know: autonomy, beneficence, paternalism, consent, sympathy, empathy, etc.

The teacher, a professor in medicine, suggested that sympathy was appropriate to a physician’s good character. His point was that we should care for our patients, that we should get to know them by establishing rapport, of course, and by being genuinely concerned for their well-being. Duh, I thought. It was pre-Simpsons. But empathy gets tricky. As I recall from that session: Be careful with your emotions. You don’t want to get too close. You might lose your objectivity regarding the patient’s best interests. Or something like that, he said.

The problem with the film is that it patronizes the viewer, implying that we benefit by its ethical and psychological  insights. It promotes a religion of kindness that’s stupefying and, ultimately, meaningless.

The distinction, and empathy itself, gets blurry now, between new and old Oxford English dictionaries. Perhaps our conception—and use—of empathy has changed.

Fast forward to 2013. Empathy is all the rage. Why just this week the term wound its way into the title of a Scientific American post on Chicago maps, a New Yorker satire on New Jersey’s governor and, most truly, NBC’s version of the heartbreaking story of a computer programmer who copes with his young son’s illness by creating an empathy-oriented, moving video game, That Dragon, Cancer.

Don’t get me wrong. Empathy is beautiful. We need more of it, and not less.

So I’m not sure why when I first viewed Empathy: The Human Connection, it rubbed me the wrong way. The video was commissioned by the Cleveland Clinic’s “Chief Experience Officer” and produced by Cleveland Clinic Media Production, according to the NPO’s Health Hub page. The short, sweeping film has moved plenty of physicians, nurses, journalists, patient advocates, and hospital administrators to tears. And rocked us to our feet: after a big-screen showing at the convocation of the American College of Physicians last April in San Francisco, most of the hundreds of doctors in the audience around me stood up and applauded, loudly. How could we not?

The video opens with a quotation from Henry David Thoreau, of Walden in 1906. The words appear in slim white font on pitch black, asking, “Could a greater miracle take place than for us to look into each other's eyes, even for an instant?” Slow, sad music plays in the background of the voiceless production. A camera frames a hospital entrance where electric sliding glass doors open to reveal an older, bearded man in a wheelchair. He’s looking downcast while pushed forward, gently, into the medical facility by a younger man with a large ID and short red jacket. Sensitivity is on display as the transport worker pats the older man’s shoulder. A caption says that the man has been dreading his appointment, fearful that he’s “waited too long.” All of this, and we’re just 20 seconds in.

It’s hard not to be affected. In one scene a tired-looking man brings coffee, or some other beverage, to a tired-looking woman in a cafeteria. She’s got long, painted fingernails and hair pulled up, imperfectly, by a large clip. She is grimacing. The caption says their 19-year-old son is on life support. In another scene, a plump woman and her matching daughter in sneakers, tweenish with a bright peace sign on her T-shirt, are walking in a corridor. As the pair stops to pet someone’s aide dog, we learn that the woman’s husband—the girl’s father—is terminally ill. You get the idea. The film is loaded with waiting room scenes, an elevator scene, an escalator scene, a neonatal ICU scene, scenes with patients attached to IV poles, waiting, and scenes with patients struggling to walk, to listen, or to comprehend what’s happening.

But empathy can be destructive. It counters reason, as Paul Bloom writing in the New Yorker considered in “The Baby in the Well.” Bloom offers a partial case against the psychological construct: “it is parochial, narrow-minded, and innumerate. We’re often at our best when we’re smart enough not to rely on it.” Empathy—whether it’s a feeling evoked upon seeing the image of a needy child or an alcoholic beggar—can distract. It misleads, causing us to act counter to the greater good.

Maybe the best thing about the Clinic’s production is that it doesn’t offer false promises or hope, at least not in the usual way. The video is refreshingly bleak, in a sense, if you compare it to hospital commercials featuring smiling patients leaving and living well. There’s no pretense of terrific outcomes or doctors’ rare capabilities to heal physical ailments.

In the health care setting, I value empathy. Deeply. One-hundred percent. No doubts. But I’m wary of a slick video suggesting that a particular hospital’s employees are nicer, or above-average in their capacity to recognize and act appropriately in response to the feelings of their patients, colleagues, and visitors. The problem with the film is that it patronizes the viewer, implying that we benefit by its ethical and psychological  insights. It promotes a religion of kindness that’s stupefying and, ultimately, meaningless. A moral Disneyland.

I reject the notion that we need a video to teach us about empathy, to celebrate or sell it. Some studies support that empathy, like medical ethics, can be taught with good results. That may or may not be true. But for sure, it’s not a marketable commodity. Real empathy comes from within. You get it, or you don’t.