The discussion of empathy in the patient–physician relationship is integral to any medical school curriculum. Fully grasping the meaning of empathy, however, is challenging for many students, as it requires a range of emotional and intellectual experiences that cannot be fully gleaned in an academic setting.
For first- and second-year medical students at the University of Michigan, the first opportunity to engage and develop the emotional and intellectual faculties of empathy occurs through their participation in the Family Centered Experience (FCE) program. Broadly, the program allows individual students to form longitudinal relationships with patients and their families affected by a chronic illness. Students regularly meet with their assigned FCE families to discuss topics related to stigma, hardship, and the everyday monotony that can accompany chronic illness management. Additionally, each student shadows his or her patient on routine clinic visits to gain a deeper understanding of the patient–physician relationship from the patient’s perspective.
After completing one year in the FCE program, students create artistic interpretations of the stories, emotions, and lessons that their patients and families have impressed upon them. A Patient’s Perspective depicts the patient–physician relationship as experienced by a patient living with a chronic illness. This piece, rendered graphically with visual-editing techniques from a still photograph, illustrates the often dehumanizing effect of chronic illness and the associated breakdown of the patient–physician relationship.
In the image, a young man is awaiting test results from his primary care physician. The patient’s body and countenance are overlaid with histological images of cells associated with the chronic illnesses experienced by the authors’ FCE patients. The indistinctness between the cells and the human shape of the patient represents the patient’s struggle to identify as an individual needing healing rather than a disease needing treatment. The posture and positioning of each individual serve to convey the breakdown of the patient–physician relationship. The physician remains detached and devoid of empathy. He stands beside the patient’s chair, engrossed in the patient’s medical charts, and avoids making eye contact with his patient. The patient gazes outward, representing the patient’s inability to fully engage his physician. The illustration ultimately conveys the patient’s feelings about his physician, who has lost the ability to develop human interactions and to empathize with his patient. The physician is more interested in managing the pathology of his patient’s condition than in recognizing the emotional wounds of living with a chronic illness.
Acknowledgments: The authors wish to thank their Family Centered Experience families for inviting them into their lives and for impressing upon them the importance of humanism in patient care. As they make the journey through medical school and beyond, the authors will leverage this experience to show empathy to their patients and provide the human-centered care they deserve. The authors thankfully appreciate Drs. Arno Kumagai, Ebony Parker-Featherstone, and Christina Chiang for their encouragement and support.
Peter Swiatek, Andrew Rizzi, and Michael Hortsch, PhD
P. Swiatek is a second-year medical student, University of Michigan Medical School, Ann Arbor, Michigan.
A. Rizzi is a second-year medical student, University of Michigan Medical School, Ann Arbor, Michigan.
M. Hortsch is associate professor of cell and developmental biology and of learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan; e-mail: [email protected]