(or, why knowing it all isn’t enough)
I was listening just the other day to a radio interview with Dr. Eric Topol, who authored several books about how AI is changing medicine. He mentioned that AI can enable doctors to spend more time being actual human beings. In a few years, doctors could leave AI to make differential diagnoses based on volumes of clinical data, and themselves spend more time listening to patient narratives. As we can all agree, patient visits are nasty, brutish and short, with little time to reach the root cause of an ailment, but I hope that this does not continue to be the norm.
And this idea has several implications for us medical school wannabes. While the road to medical school today is all about MCAT scores and GPAs and critical thinking, that paradigm is short-lived. Once technologies like AI begin to aid clinical diagnosis with near-perfect accuracy, medical know-how becomes less important for a physician. A human with knowledge gaps will be replaced by a cold, calculating machine that can find patterns with great accuracy. Future doctors will need empathy—the best doctors will be those who can make a patient feel heard, those who can resonate with their patients.
Here’s a link to a great review on Eric Topol’s new book: https://www.nature.com/articles/d41586-019-00708-7
Empathy is one of the most important skills in medicine, but it’s one of the most severely lacking. In college and medical school, we place so much emphasis on learning cellular pathways or mastering sutures that we often lose sight of the experiences that make us most human. And this is a reason why patients mistrust their physicians and why doctors’ passion for medicine evaporates halfway through their careers. Empathy isn’t easy, and sometimes the emotional baggage you carry can truly weigh you down.
I think that the only way to “learn” empathy is to seek it out in the real world. Volunteer in the community—but don’t just volunteer at the affluent nursing home next to where you live. Find people who live completely different lives from you and figure out how to make positive change. Listen to people and reflect.
I volunteer at a hospice facility in a largely under-served area in Austin, and I recently found out that many of the patients here would be homeless without this facility. And I quickly learned to stop talking on my visits here and simply listen to the incredible stories that people told me. One of my patients was homeless for eleven years prior to a pancreatic cancer diagnosis, but I listened to him describe those years as the best in his life. He told me about the people he met while living in a housing project in Brooklyn, and the vibrant community he found there. I listened for hours about his perspectives, priorities and experiences and thought about how different we were.
I don’t consider myself an expert on empathy by any means. But I found that one of the best ways to practice this skill was to describe in words how someone else felt at a moment in their lives. Or even describe it in a melody or painting—the more abstract the better.
I never really understood it until recently, but art and literature and music tell us so much about the human experience. Hearing someone sing about the pain of heartbreak or reading an oft-cited story of star-crossed lover remind us that these things are ultimately human. And we shouldn’t forget that, especially when caring for real human beings.
Ultimately, medicine is about people and the lives they lead, and as technology paves the way for better diagnoses, we shift our focus to caring for the patient rather than caring for the disease. Sure, there’s a lot of work to be done to combat high burnout rates and sterile, dehumanizing clinics, but I’m optimistic that we will rediscover ways to bring humanism back to medicine. In the meantime, it’s about building experiences with other people and realizing that before we are doctors or patients, we are humans.