The dangers of selective empathy

I go to medical school with a girl who is universally disliked, perhaps more than anyone I’ve met before. It began innocuously enough: She was too active in the group chat, too pushy about ordering class jackets, this and that.

In lecture, she barked out obscure answers like “Saturday Night Palsy” with physical force; her petite body careening forward in her chair, her class-jacketed hand spearing into the sky. But did you know she failed the second anatomy exam, we whispered in the halls, but did you know she got the lecture answers from a second year, just to impress?

By August, we were speculating – not without some evidence – that she’d faked having COVID-19 for clout, and that her “best friend” was a bodyguard, hired after she sued an orthopedics resident.

It was around this time that I threw a dinner party and invited her roommate, who happened to be moving out, who happened to not be able to take it anymore. By dessert, all conversation had turned to her: “I’m legally not allowed to confront her about anything in-person,” the roommate said, “only over-text; she had it added to the lease!”

What else, we begged, our mean streak bubbling and boiling, flaring oxblood.

“She has seven or eight lamps in her room, and she burns them through the night, like she’s scared of vampires, and oh yah, she once yelled at me for trying to make small talk over dinner.” We cackled, shooting our absent friends the details, the juicy he-said she-said.

I met her just once, early in the year when the rumors were circulating but not so big. We were having a picnic, and she and the later-rumored bodyguard were the first to arrive, a large pepperoni in-hand. “Hello!” we waved, pointing to the blanket we’d laid out, “Come join, that pizza smells amazing; by the way, what was your name?”

I remember her ambling over slowly, eyeing me coolly as she nibbled her pizza, shifting her eyes to the bodyguard anytime I asked her a question. It was like she felt bad for me: a new girl who still felt the need to make conversation, to impress.

I never see her anymore, with anatomy lab over and our lectures live-streamed to us. But I think about her more, cold and roommate-less, with seven or eight lamps burning and no one to split the bill, or a late-night pint of ice cream, with.

In medical school, we learn a lot about empathy: There are no “bad patients” in the hospital, just “good patients in difficult circumstances.” We’re quick learners; after six months in school, I’ve heard my classmates describe “stressed” and “challenging” patients, but character judgment remains strictly off-limits. This prompted me to wonder: What makes us so willing to extend circumstantial grace to our patients, but not to our peers?

The answer might lie in how we conceptualize the medical school admission process; a trauma that, as first years, we still talk about a lot. For every person that was admitted to medical school, most of us know half-a-dozen more who didn’t make it. The statistics tell the same story: Only 17 percent of U.S. will earn admission at an accredited medical school.

This rigorous selection process means we have high hopes for our classmates. When someone acts up, we wonder how they could have “slipped through the cracks,” how admissions didn’t see right through them. There is danger in this logic: It implies that admissions selects for “good” people, and that anyone who acts poorly is “bad,” a bruised apple that escaped admissions’ discerning eye. In short, we forget the relevance of circumstances.

This moral assumption leaves little room for empathy: Show-off, we mutter, when she hurtles forward to answer a question; manipulative, we gossip, as she tries to convince her roommate to stay. Meanwhile, the lamps burn in her room, the only light spot in a very dark apartment.