While I was on a gig this last weekend, Paul went camping on Mt. Whitney with a group of our friends. One of them – a highly fit, healthy guy – suddenly felt unwell on Friday afternoon, and within minutes he was having what looked like a seizure. Paul and our friend’s wife rushed him down the mountain, meeting the ambulance halfway. Turns out it was vasovagal syncope, which might have been a result of dehydration and/or altitude.
He’s going to be fine. But his wife was really shaken. I reached out to her, letting her know I wanted to support her in any way I could; as my spouse recently went through an acute and life-changing health scare, I have a good idea of some of the tumultuous emotions and anxious projections she may be processing. But that’s all I have; a good idea.
I often think about empathy – the recognizing, understanding and sharing of thoughts and feelings of another person. It’s the foundation of relationships, enabling prosocial/cooperative behaviors to emerge from within ourselves, rather than a behavior forced externally. By shifting the focus to the internal state of another person, it helps us make moral decisions; by assuming the cognitive state of another, we’re able to see their perspective and thus create deeper connection.
Which is all profoundly necessary and a cornerstone of society, but I am cautious about the notion of “walking in someone else’s shoes”.
My wariness is twofold. The first applies to situations like the one I described above. When Paul went through his acute health crisis earlier this year, I was initially bombarded by a sense of terror and a loss of control. Watching a loved one in what was a near-critical situation can reframe the present and the future in an intense way! I, like so many, live my day-to-day with the underlying assumption of a modicum of stability, and a projection of a long future in which things go basically as planned. One could argue that this is totally unrealistic – we can’t ever discount the possibility of surprises/disasters/scares (Covid has re-taught us of this). But constant fear of possible negative events would certainly gobble up immense amounts of psychic space and be a barrier to living fully and well. So we try to live in the present and hope for the best.
When the worst happens, it is truly earth-shifting, because your sense of what is happening, and what can happen, is suddenly jarred off-kilter; the precarious balance of our sense of reality is threatened, and we’re forced to reexamine our own images of our lives, both now and in the future. And that’s HARD. As Paul’s hospital stay extended on and off for months, the learning curve was steep.
That’s all to say, I have experienced a spouse’s acute health crisis, and so I have a good grasp on the kinds of emotions my friend is now going through.
That is not to say, however, that I “know what she’s feeling”, because I can’t possibly completely put myself in her shoes. To me, empathy comes with the suggestion that we’re able to enter another person’s cognitive state – to actually feel what they feel – and I don’t think that’s reasonable. Even if we went through absolutely identical experiences, we are both separate entities that are an amalgam of our unique genes and experiences. While we may have a better idea of each other’s feelings than someone who doesn’t share our experiences, we can’t feel the same emotions. So you can understand that I’m a bit cautious when anyone uses phrases like “I empathize”.
Sympathy is more accurate. Sympathy indicates that we understand what the other person may be feeling rather that feeling what they’re feeling. This seems a better representation of what I felt for my friend – I appreciated her experience, and could grasp the nature of her feelings, but not try to feel them.
But better still than sympathy is compassion, because it requires neither mutual feeling nor understanding. It’s simply the willingness and desire to relieve the pain and suffering of another. And so
I find the idea of compassion to be the most useful, because we needn’t try to enter into that suffering, and we don’t need to analyze or try to comprehend another’s experience. We merely need to extend a hand. When I’m in pain or grief, the thing I most want to hear is “how can I help”, because even if there is no way to change the situation that’s causing me pain, simply knowing that someone wants comfort me and try to alleviate the pain is enough to ease my grief.
A final thought about empathy. When my dad died, we were all devastated, none more than my mom (at least outwardly). She had never imagined life without a spouse, and on top of reeling from the loss of a loved one, she had little about many of the practical facets of life (she didn’t know anything about health insurance, or where the fuse box was, for instance). She was mired in confusion and desperation and disbelief and anguish. Instead of staying within myself, so that I could extend compassion to her, I took it upon myself to take on her emotions, because it felt like the only way to understand her. That lasted many years, as I kept feeling her anger and sadness, not as an observer, but as someone who was as mired in her emotions as she was. And of course, that interfered with my ability to help her in any way, as I was too wrapped up in her feelings. Empathy, in that situation, was harmful.
And so while empathy may have some place in trying to see another’s perspective from inside of them, in the end, it has it’s limits. “I know how you feel”? Probably not!

Hi Sarah, Paul & Pinkerton.
You brought up good points of view. I’m seeing sometimes some colleagues at work (lpn, rn, sw, md, …) who burn out themselves with empathy. You must take a distance but you still can have compassion toward your patients.
Your story with your friend reminded me of a tragedy. Last July 27, 2014 I lost my colleague rn. He was in the Adirondacks, NYS. He had a heart attack on top of mount Giant. Philippe was from Bordeaux, France. He arrived in Québec in 1966. I was born in 1967 so he was saying he was more Québécois than me. Lol ! We had 20 years difference of age. He would have been 75 this September the 5th. Hiking was his passion. Men are a minority in my profession. Our colleagues were calling us the Tango&Cash of nursing. Then on August 2014 I lost brother Jesus Camàra (the one who was friend with CC). C’est la vie.
Take care to all of you.
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I can only imagine how burned out some of your colleagues feel – watching Paul’s nurses and the enormous responsibilities they shouldered has renewed my respect for your profession!
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