Empathy

I have always tried to understand what my patients are feeling. Why are they depressed? Why are they anxious or afraid? What keeps them from getting out in the world and working or traveling or visiting with families or going to church? It is very hard to put yourself into someone else’s body or mind, or to walk a mile in their shoes, but the practice of mental health treatment almost demands this thing called empathy. Since March of this year, our mental health center has been sorely tested, forced to rearrange schedules, send people home to work, see patients for injections outside under a tent in the open air, and really think outside the box to continue to provide socially distanced, medically safe, efficacious treatment to those who suffer from mental illness in Aiken and Barnwell counties.

So what is empathy? The ability to understand and share the feelings of another. I alluded to the first part of the definition in the first paragraph, but did you catch the second part? To share the feelings of another. Now, I would argue that understanding and sharing the feelings of someone who is hurt, ashamed, fearful, depressed, angry, or suicidal would normally, at least in my field, be a voluntary action. It would be something that I would choose to do, as I care about my patients and what they are feeling and want to figure out how best to help. I would go so far as to set up regular appointments, ask questions, learn about family history and listen to the hopes and dreams of the person, all in the service of understanding and trying to feel just a little of what they feel.

The coronavirus pandemic has forced us all into an involuntary state of misery. The CDC tells us that stress during an infectious disease outbreak can sometimes cause the following:

  • Fear and worry about your own health and the health of your loved ones, your financial situation or job, or loss of support services you rely on.
  • Changes in sleep or eating patterns.
  • Difficulty sleeping or concentrating.
  • Worsening of chronic health problems.
  • Worsening of mental health conditions.
  • Increased use of tobacco, alcohol, or other substances.  

We stay isolated from each other, but we try our best to connect through Zoom, Teams, FaceTime, and Skype. We communicate in real time but we cannot hug or touch or shake hands. We work together as teams, but do so virtually, knowing each other only from the neck up. It is very hard to be empathic if you sit in a locked office, maybe somewhere out of state, talking to a person who is hurting as they walk around their back yard swinging an iPhone that gives you an intermittent view of first their face, then the ground, then the sky.

One would think that this pandemic era would be extremely hard on anyone with preexisting mental health issues, and as plenty of evidence has shown, you would be right. However, I was amazed to learn something new from one of my patients a few weeks ago that made me rethink how empathic I had really been over the last few months. I had asked him how the pandemic had affected his life and if he was more depressed or upset because of it.

“No, Doc, not at all. And you want to know why?”

I did.

“Because now everyone else knows how I feel every single day.”

You see, this man had felt loneliness, social isolation, anxiety about being in close proximity to crowds in stores, fear about getting ill or dying, worry about being able to find and hold a job and pay his bills, lack of transportation, and most of all, the stigma that is associated with an illness that is completely out of his control. He had been living with these very difficult issues for many years. We had just been dealing with them for a few months at most.

“You know, Doc, staying at home, playing with my dog, playing a game on my phone, watching TV, listening to music, it’s not so bad really. It relaxes me.”

Profound words from one of the folks who teach me more than any expensive textbook I ever bought. We have all been forced by the coronavirus to feel what some of our most vulnerable feel and live with every day. We have experienced the social isolation. We are anxious about our health, or jobs, keeping our homes and putting food on our tables. Maybe one positive effect of this pandemic is that we will learn to be just a little more empathic towards our fellows, knowing that only in staying together even as we are apart is the only way we will survive this.