The Empathy Exams

Jamison opens her essay by explaining that she works as a medical actor, which means for $13.50 an hour she is given a script and pretends to have the conditions outlined in it. It also includes how and when to express symptoms, with rules in place for revealing information. Jamison then shares a portion of her specialty case script, written about a woman named Stephanie Phillips, who is experiencing seizures after the death of her brother.

Jamison then describes the process of the exam itself. The actors will wait in an examination room for the arrival of a second- or third-year medical student. The student and actor will interact with each other, exchanging information based on the behavior of the student. Following the exam, each actor is given an evaluation to gauge whether the student discovered all pertinent information, including whether they “voiced empathy for my situation/problem” (3). Jamison then describes the preparation suite for the actors, listing the different medical scenarios and the props associated with them.

The students themselves, Jamison notes, are often awkward. There is an unwritten contract between actor and student that involves a willingness to participate in fictitious small talk. She notes the difference between overeager students and business-like students, finally discussing the students who showcase humility as a proper step towards empathy. She uses this moment to spring into her working definition of empathy, which is “figuring out how to bring difficulty into the light so it can be seen at all” (5).

Jamison then provides a script of her own medical history when, at the age of 25, she terminated a pregnancy at six weeks. She compares this to a heart surgery she had a month later, contrasting the procedures and the feelings associated with them. She then discusses her partner, Dave, and their love leading up to the pregnancy. Jamison lingers over the pain of the decision and her desire to share that pain with her partner while simultaneously knowing he will never relate to the decision the same way she must.

The reader is then given another partial script from Stephanie Phillips, and Jamison discusses the difficulty in performing her correctly. Because the fake patient’s condition is directly tied to grief, it requires Jamison to walk the line between grieving and denial. The “patients” with physical pains are easier to manifest, and Jamison brings up the connection between a visible injury and an invisible one.

Jamison then transitions into discussing her heart condition, a supraventricular tachycardia, which is a condition where there is an additional electrical node in the heart that sends out unnecessary signals. Jamison’s mother pressures her into telling her doctor about her abortion before the procedure to make sure her heart condition will not be a problem. The doctor is skilled at her job but is very curt, and her bluntness drives Jamison to tears when she does not express and empathy or concern about the abortion. Jamison then describes the experience of her abortion, which was simple, and her heart surgery, which was unsuccessful. Her heart doctor explains they can try again, but the process may cause Jamison to need a pacemaker.

Jamison’s doctor records notes on a tape, which she then uses as prompts when she interacts with the author. She speculates what a tape might sound like if it is from the doctor who performed her abortion. Following her heart procedure, her partner tells her about when the doctor explained to him that they had to tear through the muscle of her heart to continue burning away excess tissue, causing him to pray at the hospital chapel for her to live. Jamison compares this concern to actual empathy, leading her to speculate on the connection between empathy and theft because of the time and emotion that someone else’s pain can cause someone else. She discusses her brother’s diagnosis of Bell’s palsy and her subsequent obsession with the condition. Jamison provides commentary on empathetic studies, using them as support for the feelings people experience when seeking empathy. She highlights that even though there are physical responses to the feeling of empathy, to be empathetic is a conscious decision that must be made.

Jamison ends the essay by writing a second script for herself in the context of her abortion. This script includes the complexity of emotions she experiences as she gets ready to undergo the procedure, and it outlines some of the events leading up to the pregnancy. In this, Jamison makes connections to past choices and relationships that, in small ways, contribute to this moment she is experiencing.