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Reconstructing the concept of empathy: an analysis of Japanese doctors' narratives of their experiences with illness

Morishita, Mariko 京都大学 DOI:10.14989/doctor.k24793

2023.05.23

概要

‘Doctors who have suffered from an illness and experienced pain understand patients’ suffering’ (Murakami and Hinohara, 2003, p. 31).
The quoted text is by Hinohara Shigeaki (1911–2017), a renowned Japanese physician
(Stafford, 2017) who became ill with tuberculosis in his twenties. When experiencing illness, the doctor is also a patient; thus, they are in the position to acquire a deeper understanding of the patient’s experience (Rosenbaum, 1991). This is poignantly portrayed in the
film ‘The Doctor’ (directed by Randa Haines in 1991), where a skilful but arrogant surgeon
becomes cognisant of his patients’ fragility and anxiety after developing laryngeal cancer.
His experience of being a patient led him to become a more compassionate and understanding practitioner (Rosenbaum, 1991). In terms of formal research, previous studies of
doctors’ illnesses have revealed how doctors gained awareness of patients’ perspectives
after experiencing illness and how doctors who returned to work felt greater emotional
empathy (or vicarious empathy)—considered the same as sympathy—and cognitive empathy towards patients, showed improved communication skills and became more proactive about patient care (Fox et al., 2009; Hahn, 1996; Ingstad & Christie, 2001; Klitzman,
2008). Published narrative accounts of doctors’ illnesses indicate that doctors learn much
about medical practice by being patients (Jones, 2005; Mandell and Spiro, 1987; Murakami
and Hinohara, 2003; Takaku, 2007). These experiences contribute to the improvement of
their medical practice and, consequently, the health care system (Haver, 2010; Jones, 2005;
Murakami and Hinohara, 2003; Onji, 1989; Takaku, 2007).
The central premise of this body of literature has been that experiencing what others
have lived through increases empathy; the idea is that once wounded, a person can understand the pain of others’ suffering. This has been termed the ‘wounded healer effect’ (Jackson, 2001). The notion of a wounded healer is not new; it dates far back to the ancient
Greek mythological figure, Chiron, a wounded healer centaur and teacher of Asclepius,
the God of healing. In the nineteenth century, Carl Jung noted that a psychoanalyst’s selfunderstanding and their own experiences of pain result in the capacity to accept others’
suffering; he used the expression ‘a wounded physician’ (as cited in Jackson, 2001) to
describe this phenomenon.
This notion of the ‘wounded physician’ has appeared in previous studies referring to
doctors who have experienced illness (Hahn, 1996; Klitzman, 2008). Hahn (1996) analysed
doctors’ illness narratives and reported similarity between shamans and physicians turningpatients, both of whom had a deeper understanding of others’ pain and suffering because
of their own personal experiences with illness. By interviewing doctors with experiences
of illness, Klitzman (2008) documented that the doctors gained wisdom through illness;
he also suggested possibilities for using doctors’ illness narratives as educational tools to
nurture doctors so that they improve their practice.
Based on the idea that the ‘wounded healer effect’ (Jackson, 2001) has use in medical education for developing empathy, Hojat (2016, pp. 224–225) introduced studies in his
literature review highlighting that hospitalisation experiences helped nurture empathy in
medical students. For example, Wilkes et al. (2002) conducted a study wherein healthy
second-year students at the University of California-Los Angeles Medical School participated in pseudo-hospitalisation and concluded that the experiences enhanced students’
understanding of patients’ problems. Another literature review determined that experiential
learning interventions increased empathy in medical students (Batt-Rawden et al., 2013). ...

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Reconstructing the concept of empathy: an analysis of Japanese doctors' narratives of their experiences with illness

概要

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