The Most Empathetic Doctor in the World

An early look at a Pacific Standard story that's currently only available to subscribers.
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Joel Salinas. (Photo: Mark Ostow)

Joel Salinas. (Photo: Mark Ostow)

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Join us next Thursday, July 16, for a live Q&A on Reddit's Ask Me Anything forum with this story's subject, Joel Salinas.

A rare condition called mirror-touch synesthesia causes neuroscientist Dr. Joel Salinas, profiled here, to experience other people's emotions and sensations. When Salinas performs a spinal tap on a patient, he can feel the needle going into his own back; when a psychotic patient goes into a rage, Salinas feels himself getting worked up. Is mirror-touch synesthesia a superpower or a curse?

Erika Hayasaki's Pacific Standard feature story is currently available to subscribers and will be posted online on Monday, July 13. Until then, an excerpt:

There are many ways in which mirror-touch synesthesia probably makes Salinas a better doctor. In recent years, there has been a lot of talk in medical circles about the decline of doctors’ observational powers; as more and more diagnostic work is done by machines, the fear is that physicians are becoming worse at paying close attention to patients with their own eyes and ears. Some hospitals have even taken to offering doctors modified classes in art appreciation, in an attempt to revive their atrophying skills of pattern recognition and awareness.

Salinas’ condition arguably makes him unusually gifted at these tasks. For part of the morning on the day I shadowed him at Massachusetts General Hospital, Salinas led a group of medical residents on a set of hospital rounds. The team wheeled their laptops on rolling desks through the halls. At one point, one of the residents yanked an electrical plug out of a socket and accidentally electrocuted himself in the process. Instantly, a shock raced up his arm and his head slammed against the sharp edge of a chart bin on a wall.

Salinas not only saw the accident, he felt the jerking movement in his own arm, and felt his head hitting a wall. He tuned into the situation immediately, rushing to the resident’s side and asking, “Are you OK?” (The resident was fine.) Few others in the hallway had even seemed to notice the mild shock.

Empathy itself is another quality that modern doctors are said to lack in sufficient doses. Here, too, Salinas’ mirror-touch synesthesia gives him advantages, particularly his heightened facility for reading people’s facial expressions and emotional states. He says he usually zeroes in on a person’s mouth, more than any other body part, when reading emotions. In one patient’s room on the day I visited, a man with severe dementia lay sprawled and smiling on his back on a bed encircled with rails and padded floors. Just the day before, he had been so agitated he had to be put in restraints, but medication had dramatically changed his demeanor, and he cheerfully waved his right hand to greet Salinas when he approached. But the patient’s wife and daughter were not in high spirits.

“There’s not going to be much change ever, is there?” the wife asked Salinas and his supervisor.

“It’s the nature of the disease,” the supervisor said. “It tends to be progressive.”

How much longer did he have left to live?

“A week or six months; it’s hard to say.”

The doctors were about to leave, but Salinas noticed the daughter’s mouth. “She had thin lips, and they tightened at the edges,” he recalled. “She furrowed her brows.” Salinas knew that the daughter was not satisfied with this answer, so he interjected to keep the consultation going until the mood shifted. By the time their interaction finally ended, the corners of her mouth had softened—an expression Salinas felt as relief.

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