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Surgeons, empathy, and Shakespeare

Expose thyself to feel what wretches feel,
King Lear Act III scene iii

Surgeons, amongst doctors in general, sometimes distance themselves from patients. This engineered distance is partly pragmatic. Distance from the human with the disease may allow a clear head for executing the necessary procedure on the disease.

It is perhaps also protective, for when things do not go well. French surgeon René Leriche is often quoted: “Every surgeon carries within himself a small cemetery, where from time to time he goes to pray – a place of bitterness and regret, where he must look for an explanation for his failures.” Such reflection is hard – and harder yet without some distance.

Other facets of contemporary medicine drive depersonalisation in different ways. Biomedical mechanistic approaches and evidence based medicine pay little heed to the emotional and moral aspects of the patient:doctor relationship. Telemedicine, the utility of which has rightly exploded in pandemic times, has (quite literally) enforced a greater distance between the patient and surgeon.

In this environment, how do we try to enhance empathy? David Jeffrey, a palliative medicine doctor here in Edinburgh, suggests we look back to Shakespeare.

O, I have suffer’d with those that I saw suffer.
The Tempest Act I Scene ii


Shakespeare’s works are compelling because of his empathy. Human relationships are essentially unchanged from Shakespeare’s time, whilst the stage upon which they play out has changed. He existed in a world not yet complicated by the Scientific, Industrial, and Digital Revolutions. Looking back at his fundamental portrayals of human interaction may help us to be more empathic surgeons today.

Jeffrey writes: “Human relationships are constrained by the inaccessibility of other minds, any conclusions about another’s mind must rely on human interpretation. Shakespeare’s defining gift is his empathic approach: each of his characters speaks in their own voice, generating a narrative composed of multiple individual perspectives, while suppressing his own ego.” This sounds like a good starting point for a surgical consultation.

Mark Hughes
Consultant Neurosurgeon and Honorary Senior Lecturer, Edinburgh
Director, eoSurgical

Email: mark.hughes@eosurgical.com
Twitter: @eosurgical


* Jeffrey DI. Shakespeare's empathy: enhancing connection in the patient-doctor relationship in times of crisis. J R Soc Med. 2021 Apr;114(4):178-181.