Dan Perrault, MD

When you work in the emergency department (ED) on a regular basis, you can lose some of your empathy for patients. 

 When a child vomits and complains of pain, his or her parent may have just heard a story about someone who waited too long before seeking treatment. They rush to the ED as the  child gets better on the way in, but they also fear what they do not know. 

Parents do not know what we know. We have seen more sick people than they have. We know what to look for because we do this all the time. It can look so simple and obvious to us in the ED, and we may question why a patient doesn't know that it's not a big deal. But the fear and concern 

Fear is universal. I write this article in the family waiting room while my daughter is having surgery. When the phone just rang, I had a twinge of fear that maybe something was wrong. But it's a minor surgery and my rational brain seemed disengaged for a moment as I worried. I was relieved when my name wasn't called; it was too early for her surgery to be finished. 

We provide patients relief when we inform them that they are okay. It is easy to forget the power of a reassuring word. 

Diminished empathy is infectious. It's like a common cold. When one person says, "He doesn't look that sick to me," it taints the next person's attitude. Instead, we can say the same thing with the phrase "well-appearing" added. These two phrases mean very similar things, but the connotations are different.  

Other physicians may say, "That is just the way I talk," or, "I am only describing the patient." But if that is the case, then fix it. Realize that the words we choose can have a negative connotation. Our connotations are as important as the words we say. 

The ED is a fun place to work. I see interesting sick people and enjoy the opportunity to intervene and make them well. Healthy, worried people can take us away from what we are there to do, but allying fear and treating minor illness is also what we do. Reassuring patients and relieving even mild pain is an important aspect of our job. 

Save your apathetic rant for home. Or better yet, don't even say it at all. Vocalizing it just makes it stronger and a battle for all of us in the ED to maintain our empathy for others. 

The author is an emergency department physician/family practitioner in Berlin, Wisconsin. Send your feedback to 

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A physician looks at how doctors communicate with their patients and urges his colleagues to think about how their actions might affect patients.

Author | Dan Perrault, MD

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Viewpoint: Why empathy is necessary in medicine