Tele-empathy is not being empathetic over the phone. It is not crying in the sad parts of your favorite TV show. It is not beaming empathetic thoughts magically across time and space. No, tele-empathy is a technology. I should rather say, it’s a group of technologies recently being created to increase the empathy of health care providers. “This is rich,” you might say coming from an industry that brought us electronic medical records, automated “help desks,” and robocallers.
Sandeep Juhar, a writer for the New York Times, tried out one of these devices, one that simulates the uncontrollable shaking suffered by Parkinson’s patients, and describes tele-empathy as follows:
“tele-empathy”: using technology to improve insight into the patient experience. Movement disorders like Parkinson’s are one aspect of this work, but there are others. Engineers are studying the airflow patterns of patients with emphysema to replicate their shortness of breath in others. A virtual-reality program is being developed to misalign sound from video, a technique called dephasing, in ways that mimic the experience of disordered thinking in psychiatric illness. Gadgets are being made to numb the feet to reproduce the symptoms of diabetic nerve disease.
Makers of medical devices are usually not motivated by empathy themselves, so they must think there’s a market for this sort of thing. Why? Because empathy is in short supply virtually everywhere you look. The GOP health care bill showed a remarkable inability to walk in the shoes of the less fortunate. The Charlie Gard tragedy demonstrated how little we understand the emotional consequences of our actions on those who actually have to care for terminally ill patients and on the patients themselves. The entire Middle East is a black hole into which sympathy, empathy, and compassion have vanished without a trace. Juhar asserts that “Lack of empathy in caregivers — doctors, nurses, even loved ones — is one of the most widely voiced complaints in the health care field.” If true, (Juhar gives no references to back up this statement), then why?
Empathy has been studied fairly extensively. Some of the things we know are fairly obvious. For example, empathy has been shown to be lower in people in positions of power and in personality disorders like psychopathy and narcissism, findings that will spectacularly fail to surprise the likes of Sean Spicer and Reince Priebus. It is also true that our own emotional state can distort our understanding of other peoples feelings, as Tania Singer and her colleagues found in their work with an area of the brain called the right supramarginal gyrus. Empathy seems to suffer when we have to make very quick decisions. It is harder for us to empathize with people who are very different from ourselves. Empathy decreases in people who are in pain or otherwise stressed.
Ninety-eight percent of us (excluding psychopaths and narcissists) have the built-in ability to empathize, and this skill can be enhanced by specific training. You can show emotionally charged videos to people, teach them about visual cues and body language, raise emotional awareness, and yes, simulate Parkinson’s. But what it really takes to be empathetic is the ability, and willingness to, engage with people. Some researchers believe that empathy is actually a choice that we make. They contend that we choose to feel more empathetic when the object of empathy does not require sacrifice on our part and that we may choose not to interact with certain groups because we do not want to feel empathy towards them. It is pretty well known now that empathy decreases in medical school, particularly in the clinical years. This is because being empathetic is hard emotional work, and requires the sacrifice of our own comfort and well-being. It requires that we slow down, understand our own feelings, ignore our own pain and stress, and confront our differences.
Empathy is the work of a lifetime.
Shirie Leng, a former nurse, is an anesthesiologist who blogs at medicine for real.
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