Dr. Brian Goldman, a Toronto ER doctor and host of White Coat, Black Art on CBC Radio, wrote a book on kindness. In The Power of Kindness, he defined cognitive empathy as the ability to imagine a patient’s experience, put yourself in their shoes, and act accordingly.
Specialists have compassion for those with brain injury, that is, concern and sympathy for their suffering. Some go beyond compassion to have empathy, the ability to understand and share the feelings of their clients or patients. However, having compassion and/or empathy and acting on them are two different things. I believe that’s what differentiates cognitive empathy from regular empathy and compassion.
Specialists have compassion for their clients. Many exhibit empathy. They respond to eye-watering stories of suffering, with kindness in their eyes, concern in their furrowed brows, softness in their voices. But that doesn’t usually lead to truly putting themselves in the shoes of those with brain injury and acting accordingly. If it did, standard medical care would encompass all the objective diagnostic tests that are appropriate for the various kinds of brain injury and it would provide treatments that effect significant or complete healing of the injury. If it did, standard medical care wouldn’t downplay the major losses like the loss of reading nor the presence of brain injury grief. If it did, standard medical care would acknowledge that in the 21st century, the ability to read, concentrate, remember, communicate effectively, be able to act on the knowledge of interpersonal skills that are required in order to socialize and prosper. And that acknowledgement would move specialists and clinics out of the model of standard medical care of strategies and rest into a 21st-century neurostimulation medical model within a collaborative framework that encourages support from all quarters.
“Up until a few years ago, the question of kindness was way down on my bucket list. I had what I believed were much more important things on my mind, such as being a competent emergency room physician. Like many of my colleagues, I worried about every mistake I made on the job, big and small. Medicine is a profession where every error carries the risk of serious consequences.”The Power of Kindness: Why Empathy Is Essential in Everyday Life. Dr. Brian Goldman.
The problem with staying with what’s familiar for fear of making errors, is that it creates the far more serious consequence of consigning clients and patients to permanent disability with catastrophic destruction to every facet of their lives and forcing them to accept that like a medical version of Stockholm Syndrome. The familiar standard medical care of strategies and rest and waiting to see what happens is the more serious error.
It’s true that cognitive empathy would lead specialists and clinics to be out in front of the pack, a position that leads to conflict with colleagues and probably family and friends of the injured, a position that’s uncomfortable since most people, no matter their profession, are followers and not leaders. But without being prepared to tolerate discomfort, specialists, hospital concussion clinics, and private clinics will not be able to help their clients and patients reach their full healing, their full potential. In the end, we all suffer the loss of their contributions in our personal lives and community lives.
The start of effective brain injury treatment begins with cognitive empathy.