“Sure, some news is bigger news than other news. War is bigger news than a girl having mixed feelings about the way some guy fucked her and didn't call. But I don't believe in a finite economy of empathy; I happen to think that paying attention yields as much as it taxes.”

The Empathy Exams: Essays by Leslie Jamison
My rating: 5 of 5 stars

I have wanted to read Leslie Jamison's The Empathy Exams for a very long time because the questions she grapples with are ones that I, too, often try to answer: what is empathy? What kind of territory do I find myself in when I empathize with someone? And what do I make of my own emotional response to the pain of those with whom I empathize? 

The Empathy Exams is a fitting title that captures the nature of the eleven essays in it. The title essay traces Jamison's experience as a medical actor, a job that required her to play the role of sick patients in simulated scenarios and speak to medical students whose performances she would later evaluate via a checklist: how well could they assess her condition? Did they give the right advice? And, checklist 31: how well did they express "voiced empathy" for her "situation/problem?"

For the medical students, the 15-minute session was simply an exam they had to take. Yet an "empathy exam," like all tests, takes work, and can herald disastrous consequences if failed. What distinguishes it from a regular exam is that passing is not simply a matter of getting over half of the questions right:

“Empathy isn’t just remembering to say that must really be hard—it’s figuring out how to bring difficulty into the light so it can be seen at all. Empathy isn’t just listening, it’s asking the questions whose answers need to be listened to. Empathy requires inquiry as much as imagination. Empathy requires knowing you know nothing. Empathy means acknowledging a horizon of context that extends perpetually beyond what you can see ”

“Empathy isn't just something that happens to us - a meteor shower of synapses firing across the brain - it's also a choice we make: to pay attention, to extend ourselves. It's made of exertion, that dowdier cousin of impulse. Sometimes we care for another because we know we should, or because it's asked for, but this doesn't make our caring hollow. This confession of effort chafes against the notion that empathy should always rise unbidden, that genuine means the same thing as unwilled, that intentionality is the enemy of love. But I believe in intention and I believe in work. I believe in waking up in the middle of the night and packing our bags and leaving our worst selves for our better ones.”

The parts of the book with which I resonated the most strongly were those in which Jamison looked at empathy from a self-analytical (and sometimes criticizing) standpoint, discussing what one might call the 'problems' of empathy:

“When bad things happened to other people, I imagined them happening to me. I didn’t know if this was empathy or theft.” 

When does empathy actually reinforce the pain it wants to console? Does giving people a space to talk about their disease -- probe it, gaze at it, share it -- help them move through it, or simply deepen its hold? Does a gathering like this offer solace or simply confirm the cloister and prerogative of suffering? Maybe it just pushes on the pain until it gets even worse, until it requires more comfort than it did before. 

This is the anxiety of the empathizer, a self-consciousness that Jamison - and I, honestly - have never been able to escape. Is empathy still empathy when we "trust the fact of suffering, but not the source?"  

How do I inhabit someone’s pain without inhabiting their particular understanding of that pain? This anxiety is embedded in every layer of this essay; even its language—every verb choice, every qualifier. Do people have parasites or claim to have them? Do they understand or believe themselves to have them? I wish I could invent a verb tense full of open spaces—a tense that didn’t pretend to understand the precise mechanisms of which it spoke; a tense that could admit its own limits. As it is, I can’t move an inch, finish a sentence, without running into some crisis of imputation or connotation. Every twist of syntax is an assertion of doubt or reality.

While it is only in "Pain Tours" that Jamison examines empathy in specific geographical locations, she conveys the territorial nature of suffering in all her essays. After all,

“Empathy comes from the Greek empatheia - em (into) and pathos (feeling) - a penetration, a kind of travel. It suggests you enter another person's pain as you'd enter another country, through immigration and customs, border crossing by way of query: What grows where you are? What are the laws? What animals graze there?” 

In some ways, we can derive a sense of self-gratification from such travel: we are often inclined towards sentimentality, just as "we like who we become in response to injustice: it makes it easy to choose a side." Yet the foray into "another person's pain," of course, also hurts: "empathy bleeds." Jamison's geographical analogy works so well because visiting a troubled country and trying to help it is a lot like taking a tour of somebody's broken emotional landscape: the journey may not be pleasant, but the traveller must always strive to remember the purpose of the visit and the people for whom it is made. Throughout her book, Jamison approaches the subject with a critical eye, an often-innovative form and piercing introspection to convey that empathy is difficult, demanding - but also indisputably important.


View all my reviews