Fighting Holmes- Heart over Brain, Empathy over Sympathy
I have always wanted to be Sherlock Holmes. So when it came to choosing a field, I chose medicine. The idea of solving problems that haunted and scared others was appealing. He seemed like the most useful person ever.
I wanted to be useful like him. To reach the root of misery and attack it. The disease seems like the cause of the misery and I want to bring an end to diseases. When I entered Medicine, I was swept away, like many others, in an endless rut of reading and learning and just catching up.
But accidents happen. So do miracles. And one day, I found myself, stumbling through the grounds of Jinnah Postgraduate Medical Center, a connected teaching hospital, along with my friends. We were on the path to becoming doctors, and we felt giddy in our crisp new white coats.
The moment we entered the hospital, an old lady ushered us to direct her to the medicine ward. Although we looked like we belonged to this place- we were new, and we were clueless. Yet, our desire to help outmatched our uselessness and we began asking around with her. After following directions from various other students in white coats, we finally found the medicine ward.
More excursions followed. At times, we knew the answers; at others, we found out. Rarely did we ignore the person seeking help. Rarely do we help them out now.
I do not want to be Holmes anymore. Holmes wasn’t very careful about feelings. He only cared for bits that helped him solve the present case, which is important, too. It was not that he ignored the clients’ feelings deliberately.
It was just that his art of solving cases was pure scientific and evidence-based, and it had no place for human emotions, just like modern medicine. All around me, I see Holmes in different skins, hustling and bustling in crisp white coats. It’s an inevitable fate, unless it is intervened. Empathy decreases significantly over the years of medical education.
Significant decline occurs during the first basic science year as well as the initial clinical years when we, medical students, are exposed to patients . The experiences leave us baffled. We don’t want to talk about them, and when we do, there’s no one to listen. We harden our cores, and shield our hearts.
We make them cases to be solved, instead of patients to be treated. Our relationship with them deteriorates. Empathy is one of the three core values needed to establish an effective physician–patient relationship and the rapid erosion of empathy in medical students calls for immediate attention. Medical education needs to be transformed to ensure preservation, if not enhancement, of empathy.
The current medical education system needs an intervention that allows students to share their experiences in clinical clerkships to help preserve their empathy. Since interventions at such a level are hard to achieve, especially in Pakistan, the only way to save ourselves is to help save each other. We should talk about our experiences. We should listen to and learn from our peers. If we remove the heavy and dark curtain of competition, we are not as different as we thought.
We need each other, and if we want to remain our true selves, we must support each other. We’re constantly molding ourselves into doctors of tomorrow. I am constantly changing myself to fit into the definition of a doctor. I am slowly, but surely, becoming one of them.
I need you to stop me. I need you to help me. If you don’t, no matter how I try to keep my compassion intact, one day, I’ll be Holmes.
1. Newton BW, Barber L, Clardy J, Cleveland E. Is there hardening of the heart during medical school? Acad Med. 2008; 83:244–249.
2. Rogers CR. A Way of Being. Boston, Mass: Houghton Mifflin; 1980.
3. Rosenthal S, Howard B, Schlussel Y, et al. Humanism at heart: Preserving empathy in third-year medical students. Acad Med. 2011;86:350–358.
About the Author: Urooj Imdad Memon is a 2nd year medical student at SMC, Pakistan. She’s interested in Psychology and Genetic Engineering and hopes to make a lasting contribution in these fields one day. Currently, she is a member of Sehar Welfare Society and can be reached at email@example.com
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