Empathy's Limits

Has your mother died?

When I heard the words, a strange memory popped into my head. My wife and I had just been married and were sitting on an airplane. As we prepared for the flight, a family of five bungled by and occupied the seats directly behind us. I gave my wife a knowing look. There were three children and the eldest appeared to be about seven.

I sunk down in my seat, and placed the headphones over my ears to no avail. The next few hours were filled with screaming, crying, and pushing on the back of my chair. I was livid.

I couldn't understand how adults could have so little control over their children. That is, until I became a parent myself and had to negotiate the perils of travel.

There are just some things you have to experience to understand.

*

Mrs Jones was dying. After years of dementia, she suffered a catastrophic stroke. Instead of rushing her to the hospital by ambulance, I asked the family to meet me at the nursing home to discuss her situation.

I entered the room and marveled at the number of family members stacked like sardines into such a small space. I introduced myself, and shook their hands individually. Mrs Jones daughter stood at the front of the crowd, and faced me as I began to talk.

I explained the prognosis was particularly poor for someone who was in the end stages of dementia. Heads shook in agreement as I continued. I discussed the different options and finished with my personal opinion.

If this was my mother, I would opt for comfort care only.

Upon hearing the last sentence, I sensed a change in the daughter's stance. Her lips pursed and her shoulders hunched forward in anger. She turned and talked to her family for a moment, and then calmly asked if I would speak to her outside the room.

*

Has your mother ever died? Because if not, you may not want to recommend withdrawing care so strongly.

I took a moment to think about what she just said. Although I had watched many patients pass over the years, I have never once walked in their loved ones shoes. Of course, my father and grandparents died. But each relationship is special and unique.

And in this way, empathy has its limits. I can't truly know what it feels like as they preside over such difficult situations. All I can do is remind the family that I have accompanied many patients and families through similar situations.

Often the acknowledgement of my own inabilities,

provides comfort in itself.