Interview with an emergency doctor about his search to find his empathy again – a humbling read

Dr Brian Goldman, an emergency room physician, at Toronto’s Mount Sinai Hospital, always felt himself to be a thoughtful doctor, that was until, 30 years into his career. Goldman, accused by the loved one of an elderly patient, of being unkind, found himself in the position of wondering if this was the case? He subsequently did some very honest thinking, analysing of his behaviour and perceived attitude; had he really lost his ability to have or at least demonstrate empathy?

This led Goldman on a 2-year global journey and subsequent book The Power of Kindness: Why Empathy Is Essential in Everyday Life. The below interview by The Star shows some of the deeply human experiences that have empowered Goldman to not only ti use his clinical skills in his work but utilise that human connection, of which empathy plays a powerful role in.

Much study is done on burn-out, with often conclusions stating that the more empathic the health professional is, the quicker they burn out. What often is overlooked though, is the empowering benefits us human beings get from connecting with others. Whether this is in a clinical role or everyday personal life. The problem arises with no support is there for us, when long working hours deplete our energy levels and resilience, when a lack of empathy shown back to us from those in leadership roles is evident, and when  systems and sometimes even patients and loved ones, yes, fail to show us empathy and kindness, then of course, any human being, including any nurse or doctor, can get burn out.

When I train in empathy, one of the things I draw attention to is the need for it to be two way. Whatever our job role, or gender, age or race, we all have the need for empathy and kindness, compassion and care (self-care too!). Burn out occurs from giving too much and not getting enough back, allowing for an imbalance and depletion in our empathy levels. Let’s be honest, we can even get burn out with our own children (particularly teenagers) when we are giving so much and they fail to empathise with us! And we love them!! Dr Goldman, however, listened to someone’s assessment of him and asked himself some honest questions and as a consequence has empowered himself professionally and personally in doing so.

Having lost my child in a hospital and challenged the lack of empathy shown towards me in the aftermath, (forming part of the training I now do with healthcare professionals and complaints teams now), if I was one of the relatives that spoke so honestly to Dr Goldman, on reading the below article I would feel not only empathy for him and kindness but uplifted also. A humbling read.

Original article: 

brian_goldman_cred_christopher_wahl_The emergency room physician, Dr Brian Goldman,  knew he was a thoughtful doctor and a caring husband and father. But he wondered whether his 30 years of treating patients in a busy downtown hospital had worn away his empathy.

Those brooding thoughts turned into a two-year search for kindness that took him across Canada and around the world. On his travels, Goldman, who is also the host of CBC Radio’s White Coat, Black Art, interviewed top neuroscientists, hung out in laboratories and underwent psychological testing to determine his own capacity for kindness.

But even more important to his pursuit, he says, were the extraordinarily kind people he met along the way.

Goldman has turned his journey into a book that describes these encounters and details his own reflections on what it means to be kind.

In , readers get to meet, among others, a woman from Sao Paulo, Brazil, who reunites a homeless poet — a man she calls her soulmate — with his family, the bar owners in New York City who have created a safe space for 9/11 first responders and Mark Wafer, who owns six Tim Hortons restaurants in Scarborough and who has made it a priority to hire people with disabilities.

You tell us at the beginning of the book that you worry you have lost your kindness, that the empathy you remember having as a kid is no longer with you. Is there one particular moment that sticks with you from your career as a physician or from your family life that made you think that you had lost your kindness?

Yes, indeed. It happened when I saw an elderly woman in the emergency department who was in the advanced stage of a degenerative disease. The family had brought her to the emergency department because, though they had been doing their level best to care for her at home, they felt they could no longer do so. She had no acute medical issues that required immediate admission to hospital — she wasn’t dehydrated, she didn’t have pneumonia, she didn’t have a fever — but they were at the end of their rope. They wanted her to be admitted. In fact, I did that. But I wasn’t kind about the way I did it. There was something begrudging in my attitude. At one point, one of the family members asked if I had done the referral and I snapped at this person. A few months later, the woman had passed away and the husband wrote me a letter, inviting me to meet with the family. He told me flat-out in the letter that he thought I was unkind, and the reason he wrote the letter was because he thought I was salvageable, that there was a human being under that moment of unkindness. Eventually, I met most of the immediate family and we all had a good cry in that meeting. It was that encounter, more than any other, that set me on this road and made me want to look inside myself — and also around the world to try to figure out what kindness looks like.

Kindness is the most important thing we learn in kindergarten. As we get older, it seems to matter less and less in our institutions. Why is that?

That’s a tough question. There are many reasons. Christian Keysers (co-director of the Social Brain Lab at the Netherlands Institute for Neuroscience in Amsterdam) told me that we are all hard-wired for empathy, but we also have this giant frontal lobe (in our brain) in charge of executive function. Keysers said to me that empathy is a choice — not including psychopaths and Machiavellians and narcissists — but for all the rest of us, empathy is choice. And for the rest of our lives we will have these competing interests in our daily priorities. So, you’re running to catch the bus for an important job interview and you see a child who has fallen off her tricycle. At that moment, you have to weigh your important job interview against this child who needs you. We are constantly weighing what it is to be kind in the moment. I think the reason why it gets more difficult to be kind is because we have so many competing interests that it taxes our ability to do the right thing at the right time.

You work in medicine, so data and double-blind studies are kind of your thing. But for this book, for the most part, you chose to write about individual people. Why did you focus on stories, rather than studies?

To me, kindness isn’t found in studies. It’s found in the one-on-one relationships between partners, between a therapist and a client, between a mother and a newborn baby, between two friends in a coffee bar who are matching each other’s hand gestures and speech patterns. I included some studies, where they were pertinent, because there is fascinating research into empathy and kindness. But I knew that if I wanted to become a kinder person, I needed to learn from the examples of other people who are kind, by finding out their stories. And I also know that in the emergency department, when I’m seeing patients, it’s not studies that count, it’s me and how I interact with the patients that count.

On your journey, you met many extraordinarily kind people. Is there one person who sticks with you, one person who you think of more than others, even now that your book is complete?

I think most often of Naomi Feil, the woman who pointed out to me, for the first time in my career as a health professional, that people at the end-stage of dementia who say things repeatedly and seem agitated are doing and saying those things for a reason. And, if you give them an opportunity to express what they are feeling, and not try to pull them back into the here-and-now, you can help them by validating their feelings, so they can release those feelings and be less agitated. No one taught me that.

That would be a useful lesson for a physician, but also as a human. Have you had an opportunity to use that lesson since meeting Naomi?

Yes. Since then I’ve had loved ones with dementia, including my father-in-law. Whenever I would see him, I made a point of never testing his memory to see if he seemed disoriented. I wanted him to know that I loved him for who he is and not for what he remembers. And I’ve used that kind of approach, thanks to Naomi Feil, in the emergency department as well.

What steps are you taking to bring back your kindness?

First, I breathe. I breathe into a count of six. I hold my breath to a count of six. And I exhale to a count of six. I’m breathing, I’m feeling air entering my lungs, it helps to centre me. Second, I clear the clutter in my heart and in my head. I try to let it float by like a balloon or a float in a parade. Any intruding thoughts — a bad memory, a conversation that didn’t go well, somebody who doesn’t have nice thoughts about me — I don’t judge them, I just let them float by until they’re gone. I try teleporting myself to the ceiling. I try mentally floating over to a spot above the person that I’m trying to be kind to and I float down right beside them. I imagine I’m with them. How are they feeling? How is life going? What’s bugging them? And finally, I remember to smile. Not smirk — smile.

What is the one thing we can all do today to make the world more kind?

The sweetest kindness in the world is the unexpected kindness. It often comes from people who you believe to be your enemy. You can’t control how they think about you. But you can certainly change things. And the way to change things is be unexpectedly kind to them.

This conversation has been edited for length and clarity.



5 tips to embed empathy into an organisation and health/social care and medico-legal specialist empathy training

5 tips to embed empathy into an organisation from a study by Business Solver, a USA based organisation. 

Click on this link for health/social care and medico-legal specialist empathy training, or see details below.

Mind the Gap Recognize the challenges facing job roles and levels, and how the gap between what employers think about workplace engagement versus what employees actually think could be causing problems.

Embrace Differences Across Your Organization Create more empathy in the workplace by embracing different backgrounds, genders, age groups, and working styles — the result can be a stronger patchwork of engagement.

Build Empathy Muscles — and Leadership Mindset Learn how to put empathy in practice through words, actions, and business policies/offerings. Even more importantly, learn how to practice it in day-to-day activities and interactions. Gain a clear understanding of where your organization currently stands in terms of empathy (seeking out professional assistance here may be a good idea to get an objective opinion), and then develop a plan to execute empathy training.

Walk the Walk…Over to Your Co-worker’s Desk Understand the ways to exhibit empathy — through 1:1 interactions and personalized communications, and practice what you preach through daily interactions with others.

Keep Your Eye on the Prize The ultimate goal of an empathetic workplace is a more engaged employee and, therefore, a stronger bottom line. It’s not an approach or process that happens overnight, but it has the power to transform a business

The “Reverse Golden Rule” tells people to “treat others how they want to be treated.” This well-known adage might just be the key to connecting people through a shared workplace culture. Empathy impacts the way we experience the world around us and how we interact with others. At a time when empathy is at the forefront of conversations on a global scale, it’s more important than ever to understand the practical applications of empathy in daily life and how to reap the benefits of empathy in the workplace.

CarolynThis is based on multiple organisations. My company C&C Empathy Training, concentrates on the health/social care sector and medico-legal and works with these organisation and their very valuable staff on how to use empathy in leadership roles, in complaints and serious incident situations and patient safety. I believe, at the heart of any learning, each organisation and each individual must have the desire to wish to learn, and if not present before the training takes place, then leave with that desire to from feeling engaged in the training they have just received.

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That’s what people who attend my training feedback to me, their desire to be more empathic from attending my session. That’s the key, that personal motivation. Hearing examples of the real life effect of the absence and presence of empathy weaved throughout any conference session, or full day creates this desire. With 100% recommending my courses and 100% rating them as relevant to practice, I have no doubt of the positive impact empathy and empathy training can have on people’s professional and personal growth.

Click on image for an overview of services offered by Carolyn and C&C Empathy Training

Example comments:

  • I found it a really powerful session, which made me reflect on how processes and systems can block empathy and also how we sometimes think we are listening to someone but we really are not
  • Very powerful message – will always remember
  • I hung onto every word as it was relevant, important and well presented. The points touched upon will help me as I support individuals and families to obtain answers to questions regarding care and treatment of their loved ones.