Why healthcare providers need this superpower
I woke up one morning, looking over toward the bathroom of my apartment. I took a glance at an object that wasn’t supposed to be there: a wheelchair. My overstudied brain suddenly recalled that on that day, I was supposed to be a paraplegic.
The simple task of getting out of bed and bathed without using my legs was daunting. I kind of cheated, taking a shower the night before, bypassing the need to fully bathe in the morning before embarking on my journey to the downtown campus of my school. But I tried my best otherwise to play the part.
It was my first year in grad school. As part of my training as a physical therapist, we participated in two important activities that initial year, both designed to develop empathy, an essential trait of good caregivers.
The first? Disability day. We drew cards with various scenarios. Half the class was “disabled” at a time, that way, our classmates could help out each other. For 24 hours, we had to be that person.
You can probably guess that my scenario was life as a paraplegic. I was to navigate my world from a wheelchair in a second-floor apartment, and I could not drive my car. We also had to go to the store and purchase an item from the top shelf.
The logistics of this were challenging. I had to allow my neighbor and roommate bump me down the stairs in the wheelchair. 2 flights, mind you. I had to ride in a wheelchair van, strapped to the floor by my chair. A lady at the grocery store watched in horror as I used a wooden spoon I found to slap an item down from the top shelf. She actually wailed in disgust. Would it have killed her to ask me if I needed help? Apparently so. I also ordered a coffee from the coffee bar. The barista treated me as if I were not only physically disabled, but mentally as well. All humbling experiences.
This day did the trick. I thought I was empathetic to people who rely on wheelchairs for mobility. But spending a day in a chair taught me much more than I ever imagined. I was eager to surrender the chair at the end of the day.
The second task? We read a book called Bed Number 10. It’s about a woman who developed Guillian-Barre syndrome, and she temporarily lost all mobility, including her ability to mobilize her diaphragm to breathe. Her story was extraordinary.
The author so carefully documented her discomforts, her fears, and her frustrations during her care. Her story impacted my everyday practice, and it still does to this day. Every time help a patient back to bed, I recall the pain she described caused by a wrinkle in her sheets. I have developed little tricks over the years for reducing wrinkles in bedsheets for my less mobile patients. And it all goes back to this book.
I have no doubt that these tasks were added to our curriculum to help us understand what our patients go through on a daily basis, not only as someone with a disability navigating an abled world, but also how our patients feel when they are at their most vulnerable.
With how I’ve been treated as a patient at times, I wish that medical schools had some of this same training. Like playing out scenarios where they had a list of ailments, went to a doctor, and had the experience of the doctor telling them it’s because they are stressed. Or that their pain isn’t that bad or entirely in your head. Or write you off as an over-anxious mom or a drug seeker.
How many of you have had this experience? It’s frustrating and humiliating, and it delays appropriate treatment.
It’s happened to me often enough, even as an educated healthcare provider myself, that I do things to prove that my story is real, like wearing multiple layers of marathon gear to a doctor’s appointment. In my mind, if I wear a badge of proof that I intentionally put myself through pain for fun, perhaps they will believe that my symptoms are real.
This mistreatment happens more frequently than you may think, and there are multiple layers that factor into this problem, including implicit bias. I have so many stories of patients who were written off and not taken seriously:
- A Black man who had back pain was documented as drug-seeking in his chart. After several trips to the ER, he finally presented with the red flag symptoms of inability to ambulate and the loss of control of his bowel and bladder. He actually had a tumor in his spine that progressed to the point of causing paralysis by the time they did any diagnostic testing. I literally wept while writing his evaluation. It was a horrible injustice.
- A Black woman who fell off a ladder at work, but her employer “lost” the tapes. They denied that the accident even happened, and only allowed her to see doctors approved by their workman’s comp policy. She was also written off as drug-seeking, but actually had a serious spinal injury. Her physical recovery was prolonged significantly because of the time between the injury and proper intervention, but she also experienced emotional turmoil in this process. In addition to our medical team properly addressing her diagnoses, I also unlocked that trauma response and was able to refer her to our mental health practitioners for additional care.
- My own father. A white man who doesn’t necessarily fit into the “alpha male” persona. He was in a car accident and presented to the ER with left shoulder pain. They x-rayed his shoulder, and it was fine, so they sent him home. He had been told that the pain was in his head and that he needed to take a vacation. That advice nearly killed him. Left shoulder pain is also a referred pain pattern from the spleen. It had ruptured, and he became septic a couple of weeks later.
The above scenarios demonstrate not only a lack of empathy from multiple parties involved in the care of these patients, but also a gross lack of curiosity on the part of practitioners to get to the root of the problems. Certainly, bias played a role here as well. But in order to be curious, you must first have empathy and take the time to actively listen to your patients.
Surely those of us who have chosen to enter the field of medicine do so because we desire to help others. But when we get into practice, sometimes this desire gets diluted by the expectations from corporations and insurance companies.
We are so quick to judge in this society, especially in our healthcare world. Bias and stereotypes unfortunately still affect patient care. And our system is designed to reward procedures, band-aid fixes, and high productivity. These issues are systemic and repeatedly reinforced, including biases toward certain patient populations.
As unfair and distressing as this is, we can change this. Even just a little empathy from a provider can change the experience of our patients seeking healthcare. It is possible for future and current healthcare providers to foster these skills, both during their medical training and through continuing education. Empathy can help us look at patients more holistically. And it can definitely help us be better clinicians. That’s the power of empathy.
I’m publishing this as I sit in the ER with a family member. I’m here to advocate. That’s what I do.
As always, I hope you all are safe and healthy.