"Everything about a medical setting from it's unequal power relations, the racial makeup of who the doctors are, the gender makeup, everything about it suggests that there will be a lack of empathy for your very common patient" Kelsey Crowe, PhD.
Kelsey Crowe, PhD is the Founder of Help Each Other Out, Co-author of There Is No Good Card for This
Kelsey Crowe, PhD & Help Each Other Out
I'm Kelsey Crowe and I am the founder of the social venture, Help Each Other Out and I also teach social work. Help Each Other Out is about giving people tools for human connection when it's really difficult to do. Often it's really difficult to do when someone is going through something really difficult that you don't understand. So, if you know someone going through illness, loss, miscarriage, infertility or depression you may not feel that you can fully relate to that experience and back away. Help Each Other Out is about making it easier to lean into somebody's difficult experience and not be afraid to actually find how much joy it gives you to have connection on deeper levels. It actually gives you more energy rather than less. I started this work because I was somebody who shied away from people in a difficult time.
I was often afraid that I would say or do something to make the situation worse. I reached kind of a dead end with that behavior when my friend was diagnosed with breast cancer and I didn't reach out and I could no longer console myself, but that was because I was doing her a favor. I realized it was because I was simply afraid. I had experiences in my own life growing up that was very isolating and filled with a lot of pain and suffering and others didn't reach out to me. I recognized that I was inflicting the same pain of isolation that had been afflicted upon me, I don't think it's because people don't care. I think, in fact, many of us do care. I think we just often don't feel equipped to do something with that care that can support somebody else.
Connecting Empathy tools to the healthcare environment
It's funny, when I first did this work, I didn't expect it to infiltrate the medical community at all. I really was looking for your average person that's looking for a yoga class or an empathy class, and really wanting to take it out of the hands of professionals and put these kinds of skills into everyday skills like we have around how to eat at the dinner table. Just basic kind of regular etiquette practice. I started getting more calls from medical providers about doing my empathy bootcamps with them and I recognize that what is so valuable in that community are two things;
The very simple practical tips I give around communication that doesn't dismiss somebody else's experience that honors somebody else's experience, makes them feel respected, but doesn't have to add a whole lot of time to your encounter that many, as you know, medical professionals do not have. So how can we help people feel seen in their condition? By just the way we have presence with them, and not necessarily give them one more hour of our usual to do's business that we do by the computer. I guess this kind of practical approaches has appealed to medical providers.
Also, I talk a lot about how, what we can be, who we are and what we can do. How to help us see that as being so full and complete, and ultimately enough. I think it's in our striving to be perfect, that we wind up layering on a level of stress to connection that makes us resistant. So my goal in the medical community is that doctors feel empowered as human beings to be who they are and to offer their best self, but to not expect to be everybody to all things. Because, when we go that route of trying to please everybody all the time that's when we get to the burnout and fatigue, the resentment and the cynicism. So that is my goal, to help medical professionals really recognize who they are as natural empaths, identify ways to be that full self and to feel like it's a joyous thing.
Jeopardizing Empathy in the provider patient relationship
I think we jeopardize it when we blame patients for their situation, which on the one hand can easily happen because we all have our traits that make us blameworthy. That can bring us into the hospital. I think we also need to see our patients for who they are, which are people with families or people without family, people with failed dreams and with dreams. People who bring a whole host of fears, denial, worry, and to not wall ourselves off from those because they get in the way of doing the medical work and in fact somehow figure out how to work with these aspects of human beings. That is part of the work, I think we'll all be so much better at it.
Social Determinants of Health & Empathy
All Studies, on empathy have shown that people in power have less empathy for people not in power. That people who are more powerless tend to have more empathy for others because they've had to put themselves in the shoes of somebody else to sort of navigate and understand their treatment. Everything about a medical setting from it's unequal power relations, the racial makeup of who the doctors are, the gender makeup, everything about it suggests that there will be a lack of empathy for your very common patient. Even the research studies who's being studied are we studying different populations and genders for different impacts of drugs and on and on and treatment outcomes. So it's, it's inherently bias. And then also who comes into the system because of lack of access to preventive care.
Then the way that those patients are judged, "you've let this tooth decay this far. Why didn't you go for regular checkups? Do you not care about yourself ?". Lack of information that patients have about various medications and their side effects. Not everyone is easily going to turn to Google and look up web med, or have friends that they can talk to or to get referrals for the best practitioner. The networks that people move in and sort of the professionals within their social circle and family circle that they have access to. It's just so different. That really allows you to prepare for your calls and to field your providers. There's so much room for disparity, and it's a tremendous ask of doctors and nurses in there wanting counter to try to overcome that huge societal weight of disparities.
The Feel and look of empathy for the everyday patient
I think for a patient empathy feels like someone understanding your frustration form the minute you get into the door with how cold the reception area is. How uncomfortable the seats are, to how anxious you are about waiting and not understanding why you're there for two, three, or four hours. To getting into the doctor's office and not waiting in your gown for an hour, for shivering. To meeting your doctor and not have them immediately turned to their computer and start typing in notes. To having your doctor ask, how are you feeling about this today? And hearing your experience with what you're going through.
To then asking what do you already believe you know about this condition? And respecting the knowledge, what you believe to be knowledge that you bring to it, and to have open ended questions about any concerns that they have with coming home or with anyone in their community and genuinely wanting to know not just ticking it off of a form.And then the larger system in terms of its practice of sharing medical records and communication between medical providers that they try to facilitate a lot of communication around some basic data so that the patient doesn't have to keep repeating over and over again, some of their basic information, because it's really dehumanizing.
Deploying empathy towards vulnerable populations in the healthcare setting
So many vulnerable populations, let's say call them vulnerable at the same time, sometimes act the toughest and it's because they're afraid to be vulnerable. They don't want to be victimized, they don't want to be disrespected. So they may not share all of their stuff, all of their worries. They may not actually and often do not have a lot of trust in their medical team.
I think that doctors need to build rapport with their patient that's based on trust. And Trust always, always begins with an interest in who somebody else is. If you don't have that interest, then you're just another doctor who doesn't care about me. So you, you have your own stereotype as a medical professional to overcome. Even if it's, Oh, I noticed your hair is different today. Anything special going on? Any way to sort of acknowledge or shared humanity.
There's No Good Card For This
What inspired me to write the book; There Is No Good Card For This is getting the hands of as many people as possible, some basic tools and practices that help people connect to others. It was rooted in a firm belief that, we so much lack compassion as we lock confidence in how to be compassionate. So the book provides real guidelines for what empathy and compassion can look like and feel like. And also illustrate ways in which what we see as benign comments can actually seem very hurtful to somebody else. So it kind of illuminates what caring connection looks like. It doesn't try to tell somebody to be somebody who they aren't by any means. It just helps round off the rough edges a little and I'm really pleased that It's gotten into a few people's hands for sure and may it get into more.
Impacting Societal change through empathy
What I do is teach and help others teach each other some basic tips for having more effective communication and connection. My hope would be that people have the conversations that they want to have because they've learned these things. They don't want to have dead end conversations, where you don't get all the health data that you need to make your medical decisions. And you don't get all the feelings updates from your spouse or your family member that you need to be a good spouse, good parent, or good sibling. There are ways that we can practice talking to each other that bring out more and make our relationships really worth while. My hope would be that people learn these simple tools, and they have access to them, however is best for them whether it's in a book ,workshop or online.
I would like to see empathy education in every classroom, the way that you see sex education. I'd like to see it in every wellness studio in the way you would see yoga. I'd like to see it as just part of adulting, that we take relational health based classes. That would be my legacy that, that happened. That somebody would just join that course as freely as they would join any other course.