The Power of Empathy

By Francis v Adams, MD

In many ways, our healthcare system is in turmoil. Surveys of patients and physicians reveal widespread dissatisfaction. Patients are dissatisfied with the failure of their physicians to communicate. As a private practitioner it is common for me to encounter patients who are searching for “someone who cares” and especially, “someone who will listen”. To many, medicine appears to have lost its humanity.

A recent example is Bob Hewitt, a middle-aged man I treated for asthma who experienced the sudden onset of chest pain and lost consciousness. He was rushed to a local emergency room where his electrocardiogram (EKG) showed an irregular heart rhythm and signs of a lack of blood supply to the heart. With evidence of an impending heart attack he underwent a procedure known as cardiac catheterization in which a thin catheter is inserted into a blood vessel in the groin and threaded through the circulation to reach the arteries that supply the heart. Dye is then injected to outline the vessels and pinpoint blockages. A cardiologist identified the area of vessel narrowing in Bob’s heart and inserted several tiny stents to restore the blood flow. Bob was congratulated on the success of his procedure and actually sent home the next morning.

The impact of his near-death experience struck him after he left the hospital and he had trouble sleeping for several nights following his discharge. The next week he saw the cardiologist who greeted him as “Mr. Stent”. When Bob said he wasn’t sleeping and had no appetite, the cardiologist took an EKG, assured him his stents were working, and prescribed Zoloft, an antidepressant.

I saw Bob in my office the next day. “I just need to know what happened to me. Could I have died? Did my heart stop? Everyone is so happy about those damn stents, but I almost met Saint Peter. I think I saw that bright light everyone talks about. What would have happened to my family if I hadn’t been taken to the ER?”

It was clear he needed to talk and I said very little for several minutes as he recounted his experience. When finished speaking I explained that the irregular heartbeat had lowered his blood pressure which produced the fainting spell and that his heart never stopped beating. I then shifted the conversation to how he might prevent further problems and suggested a rehabilitation program where he would receive conditioning exercises, as well as instructions in diet and nutrition.

My patient needed someone to listen. He enrolled in the rehabilitation program and never filled the prescription for Zoloft.

Medicine is both an art and science. While science of medicine has advanced with many wonderful technological breakthroughs, the art of medicine has been diminished and may be disappearing. The rushed, impersonal physician of the 21st century tends to rely more on what technology tells him about his patient rather than what he can learn firsthand at the bedside. Surveys of physicians also reveal widespread dissatisfaction largely due to managed care, reduced fee schedules, and rising overheads. The end result—less time for a physician to spend with his patient.
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