The Power of Kindness: Why Empathy Is Essential in Everyday Life

216 Pages·2018·1.3 MB·English

by  Brian Goldman

Dedication
To my partner, Tamara, and all the kind people I’ve met
who make this world a better place.
Contents
Cover
Title Page
Dedication
Chapter One: A Question of Kindness
Chapter Two: Hard-wired
Chapter Three: Psychopaths, Narcissists, and Machiavellians—The Dark Triad
Chapter Four: The Donut Shop
Chapter Five: The Bar at Ground Zero
Chapter Six: Games of Empathy
Chapter Seven: Homeless in Brazil
Chapter Eight: The Kindest Robots
Chapter Nine: Teach Me
Chapter Ten: Soul Whisperers
Chapter Eleven: Epiphany
Acknowledgements
Index
About the Author
Also by Dr. Brian Goldman
Copyright
About the Publisher
Chapter One
A Question of Kindness
Am I a kind soul?
As an existential question, it’s right up there with Why do I exist? and How
do I know if I’m doing the right thing?
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. I worried that my lifelong battle with insomnia, coupled with
unnatural shift work, would eat into my competence. I worried about being an
older physician in a young person’s environment like the ER.
To those worries, add being the host of a national radio show. It’s prestigious
and exciting, but it’s another place where getting a fact or an attitude wrong can
cause instant disapprobation. Sometimes, my main comfort is knowing that even
my worst mistakes on the air are not immediately hazardous to anyone’s health.
At home, I was preoccupied with being a good partner to Tamara and father
to my children, Kaille and Alexander. Over the years, I have focused my
energies on being a solid provider to my family. For my kids, I was preoccupied
with things like making sure they had the technological tools and the tutors they
needed to succeed. I always remembered to encourage them to talk about their
feelings, especially the ones that troubled them.
As the son of aging parents, I saw it as my duty to make sure they got astute
medical care. When my mother was admitted to a long-term care facility with
end-stage Alzheimer’s disease, I visited her as often as I could. When she could
no longer feed herself, I took turns spoon-feeding her with my sister Joanne.
When my dad felt crushing bitterness at having to move his wife of nearly 60
years into the nursing home, I tried to comfort him while absorbing some of his
pain.
My parents are both gone now. And that has left me with time to ask the
question: Am I a kind soul?
From what I’ve told you about myself, I sound pretty kind. So how come I’m
asking? Because doubt has crept into me. I have felt this way for a long time.
That I’m too stressed, too busy, too preoccupied with the errors I make at work
and in life, too anxious and too self-absorbed to think enough about others to be
kind to them.
And I’m not alone. As I look around me, I see the same problem everywhere.
You order a decaf latte. The barista repeats your order word for word. A
minute later, he’s forgotten it and asks you to repeat it. When you finally pick up
your beverage, one sip tells you he got it completely wrong.
A beleaguered woman struggles to lift a heavy printer onto the service desk
of a store that sells computer equipment. The printer doesn’t work. The manager
looks relieved when he points out that her service contract has expired.
An unaccompanied minor on a commercial flight misses a connection. For
several panic-stricken hours, the child is missing. The ending is happy, but what
the parents remember most about the ordeal is the call centre representative
advising them not to worry.
What these and many stories have in common is lack of empathy.
It seems everyone has a painful story or two to tell. A recent study by
University of Indiana psychologist Sara Konrath found empathy among today’s
college students has declined by about 40 percent compared to their peers 20 or
30 years ago, with the biggest drop after 2000.
There’s sympathy and there’s empathy, and many people confuse the two.
Sympathy is a gesture of acknowledgement or commiseration for someone
experiencing misfortune, ranging from a business setback to the death of a loved
one. Think cards, flowers, or the oft-used phrase “Sorry for your loss.” To
extend sympathy, you don’t need to know what people are going through, and
you don’t need to feel what they feel. Empathy, on the other hand, is the ability
to use your imagination to see things from the point of view of another person,
and to use that perspective to guide your behaviour.
Jean Decety, a cognitive neurosciences researcher at the University of
Chicago, says that empathy is made up of several components. One is affective
or emotional empathy, which refers to the capacity to feel the emotions of others.
A mother who winces when her toddler trips and falls is feeling her child’s pain
physically. But you don’t have to be a mother to experience the emotions of
others. Anxious people make me feel anxious; it’s as if their mood is transmitted
to me like a virus. Researchers refer to this phenomenon as emotional contagion.
Emotional or affective empathy is an instinctive capacity that is baked into
our DNA. It exists inside the most primitive centres of the brain, and it appears
early in a child’s life. “By the age of 12 months,” Decety writes, “infants begin
to comfort victims of distress, and by 14 to 18 months, children display
spontaneous helping behaviors.”
Emotional empathy is what motivates us to help others. On September 2,
2015, the body of Aylan Kurdi, a three-year-old Kurdish boy, washed up on a
Turkish beach, and the photo of his lifeless body caused outrage around the
world. Aylan was only one of more than 3 million refugees trying to flee
persecution and sectarian violence in Syria. Yet somehow people who saw that
one photo empathized so profoundly with the boy’s fate that thousands of people
donated money and sponsored refugees.
For a surgeon, emotional empathy is a double-edged sword. You want the
surgeon who takes out the cancer in your chest to be motivated to help you; you
do not want the surgeon to be so wracked with empathy for your pain that she
hangs up her scalpel.
The second component is called cognitive empathy, which means having a
sense of how another person is feeling. Cognitive empathy is also referred to as
perspective taking because it involves the ability to see things from the
perspective of another person. Unlike emotional empathy, which originates in
the primitive brain, cognitive empathy comes from the brain’s higher centres
where, as Decety puts it, “motivation, memories, intentions, and attitudes
influence the extent of an empathic experience.” Developmental psychologists
also refer to cognitive empathy as theory of mind, a term coined in 1978 by
David Premack and Guy Woodruff to describe the ability of humans and some
primates to predict the motivations and intentions of others.
Simon Baron-Cohen, professor in developmental psychopathology and
director of the Autism Research Centre at the University of Cambridge, refers to
theory of mind as mind reading. He says that humans “mind read all the time,
effortlessly, automatically, and mostly unconsciously.” Baron-Cohen has
devoted much of his career to studying people with autism, a condition in which
the ability to construct a theory of mind is greatly impaired—a condition that the
eminent psychologist refers to as mindblindness. People with schizophrenia and
attention deficit hyperactivity disorder (ADHD), and cocaine and alcohol users,
may also suffer from mindblindness. They have abnormalities within the
structures or the circuitry of the brain that account for this deficit.
These days, it seems that many people with decidedly normal brains behave
as if they were incapable of imagining what it’s like to be in another person’s
shoes.
Take this example: A 47-year-old woman walks up to a government service
kiosk. Her husband, a recent arrival from another country, has died suddenly of a
brain aneurysm. The woman wants to take her husband’s body back to his
birthplace, a process complicated by the fact he and his wife have applied for
permanent resident status but haven’t yet received it. Far from showing
kindness, the clerk acts irritated. From the clerk’s point of view, each encounter
is supposed to take a fixed number of minutes, and this one could take an hour or
more to sort out, which will drag down her productivity rating. At that moment,
she seems unable to imagine the pain that the grieving widow is going through.
The third component of empathy is called affective concern. Some call it
compassion empathy or empathic concern. Daniel Goleman, psychologist and
author of the 1995 book Emotional Intelligence, writes that “with this kind of
empathy we not only understand a person’s predicament and feel with them, but
are spontaneously moved to help, if needed.”
Affective concern is what motivates a group of bystanders to help a person
who falls in the street, or a firefighter to run toward, instead of away from, a
burning building. It’s what motivates a teacher to spend extra time helping a
pupil with ADHD understand a challenging concept in mathematics. And it’s
supposed to motivate the people who care for you at hospitals and clinics:
nurses, pharmacists, social workers, and doctors like me.
We expect health professionals to be competent at what they do. If they’re
über-competent at knee replacements or minimally invasive heart valve surgery,
we might cut them some slack if they come up short in the bedside manner
department.
An elderly man spends five days in a hospital corridor in the ER waiting for
a bed on the ward upstairs. He is never told when the bed will be available, and
his only access to personal privacy is one of two bathrooms he shares with all
the other patients in the ER. A woman recovering from a double knee
replacement spends the night in a urine-soaked bed—after warning her nurse to
use two hands when removing the overflowing bedpan the woman depends on to
relieve herself. I’ve heard and witnessed thousands of stories like these in health
care and in the outside world. Each is different, but they have one thing in
common: people in close contact with others who have no idea and little interest
in what it’s like to be them.
That is the very definition of a lack of empathy.
I keep referring to health professionals as if I’m talking about someone else.
But I’m talking about me. There have been singular moments in my professional
and personal life when I too have failed to imagine what it’s like to be the other
person. There’s the time I didn’t acknowledge the cataclysmic grief felt by a
disbelieving son when I told him that his father had died, because I was worried
he would accuse me of failing to save his dad. And there’s the time that I
grudgingly admitted an elderly woman to hospital and could not see the distress
her partner felt at no longer being able to care for her at home.
I wasn’t always this way. By all accounts, I arrived in this world as a smart,
loving, bright, and precocious baby. I’m told I spoke in full sentences when I
was 18 months old. When I attended a summer day camp as a four-year-old, my
counsellor told my mother that I was like a breath of fresh air.
What became of that little boy?
In the past few years, many books have been written about empathy, both inside
and outside of health care. They are helpful and important, but only up to a
point. They tend to analyze empathy in terms of brain circuits and behaviours.
Knowing whether or not you possess those circuits is helpful because it gives
you some hints as to what gifts or burdens nature has bestowed upon you. But to
expect to be more empathic by analyzing empathy is like hoping to become
funnier by deconstructing jokes.
If lack of empathy is the problem, what is the cure? In his 2017 book Against
Empathy: The Case for Rational Compassion, Yale psychology professor Paul
Bloom argues that empathy based on emotion motivates people to help in ways
that are counterproductive. He writes that our brains are programmed to enable
us to empathize with one person at a time, which dooms us to ignore the needs
of the many. Bloom says that whom we empathize with is biased in favour of
those who look and act like us, which motivates us to assist people who may not
be in the greatest need of our concern and our help. Instead of empathy, Bloom
advocates for what he calls rational compassion, dispensing with emotional
involvement in favour of helping others based on an objective calculation of
costs, benefits, and risks.
As a call to social action, Bloom makes a compelling case. But it doesn’t
help me understand what I seem to be lacking as a physician. Perhaps there’s a
better word to describe it: kindness.
Michael Stein is an internist, an author, and the chairman of the department
of health law, policy, and management at Boston University. In an opinion piece
published in 2016 in the Washington Post, Stein tells the story of a woman who
went to a walk-in clinic with neck pain and a fever. The woman told Stein she
almost had to beg the young doctor—who was convinced the woman just had a
cold—to do a test for strep throat. The test came back positive. Stein writes that
the woman was angry with the doctor, calling him incompetent and lazy and
accusing him of trying to save the health care system money. However, it was