Pretty much everyone I spoke to after I arrived back in North Carolina urged me to write about my experience on my blog. I know it’s good advice, but I put it off because (1) I am really good at putting off blogging, and (2) I really, really wanted to avoid one of those blog posts in which the well-intentioned writer describes how much fun it all was while the unwitting reader struggles to stay awake.

So here’s my alternative: It’s a quick story about the challenges inherent in developing empathy.

While rehearsing for our “panel discussion”, my wonderful and generous colleague Melissa commented that every time she had a question during my portion of the talk, it was immediately answered in the moments that followed. “How did you know exactly what I was wondering about?”, she asked. “It’s like you were reading my mind. Every time a question popped into my head, in the next few seconds, you answered it.”

So you can see why I describe Melissa as wonderful and generous. What an awesome compliment! And it meant a lot to me, because that’s what I am trying to do every time I create anything for patients, students, colleagues, or clients. I always want to “read minds” because that helps me create something that will actually make sense to the people I’m trying to reach.

But the truth is that it’s hard to “read minds”. It’s the essence of empathy, and I’d be a big liar if I told you I was always successful or even mostly successful at being empathetic. It’s something I strive for, but truly putting myself in someone else’s shoes is hard emotional and cognitive work. It requires careful listening and an incredibly active imagination. You have to pretend to be someone else, to imagine their experience. It’s a little bit art and a little bit science, and it’s easy to miss the mark.

Because I don’t always get it right, a compliment like Melissa’s means the world to me. So thanks, Melissa. I’ll keep working at it. And thanks for being so kind as to point it out when I get it right.

I’ve had a lot of “health care encounters” over the past few months. And while it’s been stressful, I’ve been lucky because my health problems have not been life-threatening – mostly just the “woman-meets-midlife” variety. There was the lengthy build up to surgery, the surgery itself, and now I’m recovering. It feels great to be (almost) done with this particular chapter in my life.
Not surprisingly, I’ve seen a lot of doctors and I’ve had lots of diagnostic tests over the past few months. After many of these encounters I’ve been asked to complete satisfaction questionnaires. “Your satisfaction is important to us”, they all begin. Sorry, but that’s a little like the now-infamous, “Your call is important to us”. You know the joke: After waiting on hold forever, you don’t really believe that your call is important to anyone. Similarly, after seeing the questionnaires I’ve seen, it’s hard to believe that my satisfaction is important to anyone. It’s clearly not important enough to measure it very well.
Before you assume that I was looking at the questionnaires with a critic’s eye, I swear I wasn’t over the top. True, I can be a little nit-picky when it comes to questionnaires (or so claim my kids, who have seen me dissect one too many restaurant surveys over the years). But even my kids were shocked at the health care questionnaires I showed them. I was asked to rate my satisfaction with a frequency response scale (oops!). I was asked to rate whether my physician spent enough time with me in the hospital. Well, I saw about ten physicians while I was there, so which one are we talking about? I was asked to rate “the nursing staff” on a number of attributes. I don’t know – I had one great nurse and one who was so-so. How do I rate them both? Take an average?
The sad truth is that I had a lot to say about my experiences – good and bad. I very much wanted a way to thank those doctors, nurses, and other healthcare workers who took the time to be friendly, compassionate, and thorough. And I also had a lot of constructive feedback for the encounters I had that were less than optimal. I guess it’s nice that the questionnaire asked if the food I was served was at the appropriate temperature, but honestly, that doesn’t top my list of what’s important. The only way I could have shared accurate and useful feedback would have been decidedly old-fashioned – with a letter.
A sage market researcher I once knew always told me to design any study with this thought: “Begin with the end in mind”. I think that’s basically what’s missing in this flurry of questionnaires. If health care administrators want to use the data they collect to “continuously improve”, the data must be meaningful and accurate. And the data have to really, really matter to whoever is in charge. Given the questionnaires I’ve seen, it’s a stretch to believe that the data – or my satisfaction – really matters at all.

My neighbor, a very friendly guy, asked an unexpected question. Was my intervention was really “just for women “or “more oriented to females”? He explained that he felt men wouldn’t need the intervention. Men would just set a goal and meet the goal.

Whoo-boy. Where to start? I explained that in general, gender differences aren’t necessarily the most important factors to consider when it comes to adapting to chronic disease. And when they are, they’re often proxies for other variables. Things like emotional well-being, family support, medication side effects, coping styles, etc. tend to be more important in predicting which patients are likely to have trouble adapting to life-changing illness. (For a great article on gender differences in general, you might want to read this paper by Carothers and Reis.)

But back to my neighbor: I think his question points to a common cultural assumption: Needing help is feminine. And being goal-oriented is male. Since women actually give birth to babies, some of which are very large babies, I’m not sure where this assumption comes from. But it does make me wonder what, if anything, those of us who are designing health interventions must do to accommodate “gender differences”.

It might just be a mistake to look at the issue through a gendered lens. Maybe the better idea is to design interventions so that they’ll appeal equally to those who see themselves as impervious to the typical willpower struggles most of us face, while also welcoming those of us who readily admit we could use a helping hand. A truly powerful intervention, like a truly powerful teacher, will somehow manage to speak to everyone.