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Do I Know How You Feel?

David Epstein, MD, discusses the misconception that doctors can feel what their patients or their families feel during times of severe illness.

Sometimes you say things that you wish you could take back.

I experienced that feeling as a new attending physician a number of years ago. I was rounding on patients in the pediatric ICU and came to the bedside of a child with a mother who was upset with the care that was being delivered and the plight of her child. I stepped forward to comfort her and the words, “I know how you feel”, escaped my mouth. I would immediately regret my statement.
The child’s mother instantaneously looked at me in disbelief. She said, “You have no idea how I feel!” A wave of nausea and extreme uneasiness washed over my body, as she admonished me on the spot. I had no response, no defense, and no explanation for what I said. My intention was to de-escalate the mother’s dissatisfaction, calm her, and show compassion towards her due to the unfortunate and unfathomable situation that she was experiencing because of her critically ill child. My single statement unintentionally made a bad situation so much worse.
As the day ended and I returned home, the interaction continued to weigh heavily upon me. I sat down with my wife…who happened to be a social worker. I relayed the story to her and she responded with, “you said what?” Her response was not demeaning or condescending. The response was more steeped in surprise and curiosity. She followed by asking me questions to essentially see if I had ever experienced anything like what that mother was experiencing with her child. The bottom-line result of the investigation was “no”. I had not experienced anything like what that mother in the pediatric ICU was experiencing.

“My single statement unintentionally made a bad situation so much worse.”

She made me see that I could not know how this mother was actually feeling. I had not experienced her specific situation. There was no malice behind my initial remarks, but there was a lack of insight. I had seen many critically ill children in the pediatric ICU with some who would make a full recovery and some who would not fully recover or even die. I mistakenly thought that my experiences enabled me to understand how others felt during these situations. However, my experiences did not translate to those of the parents of the children in the ICU.
So, as I reflected on the situation, I found that I could not know how the parents of these critically ill children were feeling. I was not the parent thinking about the fate of their child and what life would be like without their child. I was not the parent thinking about how they could relieve their child’s discomfort. I was not the parent desperately thinking that they needed to find a better treatment for their child’s failing health than the medical team. I was not the parent worrying about what would happen to their child if they were to leave their child’s bedside to sleep, eat, or take a break from the bedside vigil. I was not the parent of the child in the ICU and I could not know how they felt.
From that moment going forward, I never uttered those words again. I realized the mistake that I made. I wish that I could take back the words that I spoke to that mother so many years ago. But, it helped me learn an important lesson. While speaking to parents and empathizing with their situation in the pediatric ICU, I now always start the conversation with “I can’t possibly know what you are going through or how you feel.” I can only try to understand what parents of critically ill children are experiencing, but I cannot actually feel what they are feeling. This simple, yet crucial, insight has ultimately prevented me from making a bad situation so much worse.
How do you empathize with families or patients without making the mistake of giving them the impression that you think you know how they feel?

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2 Responses

  1. Hello once again Dr. Epstein. I loved your article. As a CPNP, I totally understand what you were going through. As a parent of a now grown 30-year-old and successful son who has had IBD (UC) since age 12, I can relate to being that parent who stayed 24/7 while he had lost half of his blood supply. I can say this… I, too, had made that same statement “I know how you feel,” to a parent of a child in peds ICU while working as an RN early in my career. It’s a statement we can never take back. However, I believe that is how I learned from that experience, especially when reflecting back on my own (future unborn) child’s illness. I haven’t made that mistake again. As healthcare professionals, we “live and learn” (hopefully) knowing we will never be perfect but can support our patients the very best we can. I now do have some empathy for parents that are going through these chronic illnesses but can never be in their shoes. Shoes (like people) come in so many different sizes and hopefully, we can try to embrace our patients without bias but with a true heart for them. Thank you for reminding me that we all make mistakes because we’re human but I’d like to say we can forgive ourselfs so we can continue to grow everyday with open hearts and do our very best medicine!

    1. Suzanne, thank you so much for your thoughtful and personal comment. You expressed yourself beautifully and I really appreciate your perspective. We make mistakes (hopefully, not too many), so we can grow!

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