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Empathy: How Should We Care About One Another?


Author Leslie Jamison says that as an emotional response, empathy is always perched precariously between gift and invasion. Her new book of essays is called "The Empathy Exams." In it, she writes about prisoners, medical students, extreme runners and ex-boyfriends. It's all part of her quest to understand how others feel empathy and how she can feel it, too.

Leslie Jamison joins us now. Leslie, welcome to the show.

LESLIE JAMISON: Thanks for having me.

MCEVERS: The title essay is about actual empathy exams - how you got a job posing as a patient, to test how empathetic medical students are. What was one role you played that you remember?

JAMISON: Well, the role that sort of started to feel like my specialty - like, my wheelhouse - was a mid-20s woman who was in the throes of a huge loss. And instead of processing her grief, her grief was actually turning into seizures that she was having. So she came to the doctor asking for help, kind of getting better from these seizures. And the role that the medical student was supposed to play was to figure out that it was actually this unresolved grief that was giving rise to them. So my job was to kind of let my grief leak out in little pieces, but not know that that was the actual cause behind what was happening.

MCEVERS: And then this gave way for you to write about yourself and some of your own medical troubles. How did that happen?

JAMISON: I actually ended up feeling a kind of greater amount of empathy for doctors and medical students because I saw how many variables they were juggling every time they were encountering a patient, and that let me think about my own encounters with doctors. I was going through a series of medical struggles of my own, in my mid-20s. And so I was thinking about, well, what's happening in these encounters when I'm the patient and they're the doctor, and we're both thinking about kind of how to be good to one another in these situations.

And it was liberating for me, as a writer, to take the form of these scripts that I was working with as a medical actor and think about, well, what would it look like if I was going to turn my own life into a script. How would that script play out?

MCEVERS: Another really moving essay in the book is about people with something called Morgellons disease. First, can you just tell us what that is?

JAMISON: Yeah. So Morgellons disease is this controversial skin disorder. Patients who identify as having Morgellons report a variety of symptoms - sort of itching, sores, lesions. But the most remarkable and distinctive is, they report having these inexplicable fibers coming up out of their skin. And a lot of doctors just don't believe that there actually are inexplicable fibers. They think it's a kind of more complicated, psychosomatic reaction.

And what I was interested in was not thinking about, OK, are the fibers real or not. But I wanted to know what this community of patients, sort of how they understood what they were experiencing. And they have an annual conference every year in Austin. And so, I went to that conference to see, well, what the community like that's built around this pain? And so, I kind of wanted to penetrate what it feels like when you feel like your pain isn't being recognized.

MCEVERS: Right, because one thing that defines them is that no one, basically, believes them. You go there. You listen to them. You write about them. You give them their due. Do you end up believing them?

JAMISON: I did end up feeling that many of the patients at that Morgellons conference, there was something going on that was much more complicated than sort of, you know, actual fibers although I didn't - you know, I wasn't -I wasn't behind a microscope and so I was constantly trying to acknowledge, you know, I'm not an expert and I'm not totally sure what's happening. But I went really wanting to give them something different from what the doctors had given them.

And I'd like to think that even if I didn't end up feeling that the fibers were always real, that I was able to offer a different kind of listening, in so far as my main feelings throughout was like, whatever these fibers are or aren't, these people are going through something. And I feel like holding that in mind; like, whatever I don't know or understand about what you're going through, I can respect that you're going through something - and try to keep listening, and keep showing up, for that something. That was kind of my guiding imperative.

MCEVERS: In the final essay in the book, you talk about this idea that women are, nowadays, expected to be post-pain. You cite a scene from the TV series "Girls," where two main characters shout at each other: You're the wound!


MCEVERS: You know, this idea that women are sort of wary - because they're wary of melodrama, they feel like they're supposed to be funny and clever, and detached from pain. Can you explain that?

JAMISON: Yeah, that essay arose from a kind of nebulous feeling that I'd been having for many years; that I felt a certain amount of shame talking about painful experiences because I felt afraid that I would be seen as - you know, the phrase I use, the wound dweller or wound monger; that, you know, it's sort of a cheap way to construct an identity, or a plea for sympathy from other people. But that was a very nebulous feeling that I had - that there was some kind of shame around being a woman talking about your pain.

One of the challenges was trying to turn this very vague, nebulous feeling into something that I could actually talk about. I end up focusing, at one point, on this medical study about how women who report pain are more likely to be given sedatives, whereas men are more likely to be given actual pain relief. And that, to me, was - it sort of was putting something more solid or concrete around this fear that I'd had that it was hard to have your pain taken seriously, as a woman.

And I also - when I was in the process of writing that essay, I ended up, you know, I had this moment where I was like, God, I wish I could just ask every intelligent woman in my life what they think; whether they've ever felt this shame. And so I ended up just writing an e-mail to like, 40 of the women in my life, asking exactly that question. So their voices become part of the piece as well, to kind of examine that question from as many angles as possible.

MCEVERS: Can you give us an example of one of the responses you got from one of these women?

JAMISON: Yeah. I mean, one of the e-mails that was most provocative to me was a friend who was really upset by the trope of the wounded woman. She actually said that she had gotten my note and had slept on it because she felt sort of charged-up in her response - I think not necessarily upset at me, but sort of upset by this how familiar this figure had become of a kind of self-destructive woman who slept around or drank too much, or was sort of deeply enmeshed in pain but not totally articulating that pain. And that anger was really interesting to me. I wanted to find a way to talk about that anger - how women have become angry about the image of the wounded woman that kind of attends them or haunts them.

MCEVERS: Leslie Jamison is the author of a new collection of essays, "The Empathy Exams." Leslie, thanks so much for talking with us.

JAMISON: Thanks for having me.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.