Leslie Jamison’s The Empathy Exams


Karen Craigo

When you love nonfiction, sometimes the perfect book just finds you, exactly when you need it most.

That was precisely the case with Halitosis: Bad Breath Causes and Natural Treatment Solutions by Alyson Rodgers.

Just kidding—it’s April 1, after all. But the book that really brought me face to face with my own troublesome life force is Leslie Jamison’s much-talked-about The Empathy Exams (Minneapolis: Graywolf, 2014). I’d heard a lot of buzz about the title before I finally got around to checking it out for myself.

I have been thinking a lot about empathy. I recently lost my job—I was a full-time non-tenure track English instructor whose three-year contract was non-renewed—and I’m not proud to admit that I’ve been ping-ponging from deep shame to blessed relief to the most delicious schadenfreude. (My disappearing job is with a rather unremarkable and rather expensive liberal arts college that is dying a slow death from its inability to justify its own steep price tag. Still, it was home.)

The thing is that my colleagues at this university are pretty amazing. They’re brilliant scholars and energetic teachers and amazing supporters—and where a granite wall of schadenfreude is erected, empathy has a hard time finding a crack to spill through.

In The Empathy Exams, Jamison takes on the subject of empathy very directly, with essays that explore the lives of Bolivian coal miners, gangbangers-turned-tour guides, extreme racers, and even herself, viewed through the clinical lens of the professional patient.

The eponymous first essay in the collection is my favorite of the bunch. Jamison offers the unusual perspective of a medical actor—a person hired to present scripted complaints and personal details to medical students so that they can be tested on their diagnostic acumen and, more importantly to Jamison’s narrative, their demonstration of empathy.

It is not enough for the students to give a kind look or a warm smile; to get credit for empathy, the students must say something that demonstrates it. One of the questions on the medical actor’s evaluation sheet specifically asks about “voiced empathy.”

Jamison includes an example of part of her dossier/script, and she also invents one for herself by way of comparison. She has perhaps more empathy for her invented psychiatry patient, Stephanie Phillips, than she does for herself (“CASE SUMMARY: You are a twenty-five-year-old female seeking termination of your pregnancy” …).

The author points out the dagger-end of empathy, a word that comes from the Greek em (into) and pathos (feeling). Empathy requires penetration, Jamison astutely notes: “It suggests you enter another person’s pain as you’d enter another country, through immigration and customs, border crossing by way of query: What grows where you are? What are the laws? What animals graze there?

Empathy feels pretty natural, I suppose, until you lose it. As I cheer on the slow death of my institution, I have to remind myself of what grows there—the students I love, the faculty who have supported me without ceasing, my very special chair whose love of language has kept me energized.

Jamison, who endures the double-whammy of an abortion and heart surgery in the same month, looks piercingly at her own need to hear the right words from her boyfriend, Dave. She wants empathy.

He understood my pain as something actual and constructed at once. He got that it was necessarily both—that my feelings were also made of the way I spoke them. When he told me I was making things up, he didn’t mean I wasn’t feeling anything. He meant that feeling something was never simply a state of submission but always, also, a process of construction. I see all this, looking back.

Jamison shows in this remarkable book that sometimes the breath of empathy is fetid, rising as much from care as from the need of the empathetic one to connect and to be validated. Empathy can be surprisingly selfish.

And in Halitosis, Rodgers notes that bad breath doesn’t always have its origins in the mouth. Sometimes it’s the throat or the nose or even the stomach—a place unexpected, but when you acknowledge the possibility, then you can begin to pinpoint a cure.

Karen Craigo is on the Advisory Board for Assay.