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When we hear about a person’s ill fortune, the essence of good communication is for both parties to feel that they are connecting—that is, ‘on the same wavelength’. The way we act is underpinned by our attitudes and reflects our personality. Sometimes, especially when faced with unfamiliar circumstances, we are unsure of how to respond. After all, attitudes are complex, being influenced by diverse factors including life experiences, our inherent idiosyncrasies and prevalent societal values. They are therefore vulnerable to criticism when we fail to connect. With my experience of permanent paralysis from a spinal injury sustained a few years ago I have had an opportunity to reflect on these matters.
One way of responding to a person’s bad news may be to express empathy. But what is empathy all about? When is it appropriate to empathize and is this something that we can learn to do? Is empathy an innate quality or does it stem from acquired notions of how we should behave towards others? First and foremost, we need to find out how the person has been affected by events. Having gauged their perspective, we need to form our own perspective of events and, in order to empathize, feel touched by what has happened to them. This is inevitably coloured by our own previous experiences; disruptions to our own ‘normal life’ can give insight into the hardships of others. However, it is less the extent of our own hardship than how we have coped with it that affects our behaviour towards others. And, of course, we can learn much from the ways other people react to our misfortune. Those who communicate well—with that magical gift of acting comfortably and saying the right things at the right time—can teach us a great deal. So can those who get it wrong. After becoming paralysed, I was among patients who, although proceeding through a rehabilitation programme aimed at similar skills for independence, were reacting in very different ways. Some patients were deeply angry, others were resigned. Observing the responses of those around me, I could see the futility of anger and bitterness. A phase of grieving for what has been lost is unavoidable, but my own adaptation was to concentrate on the capabilities that remained. Moreover, returning to medical practice, I found myself in some ways stronger. I have learned from my own experience and those of others that growth through hardship is possible, and that the worst fate is to acquire the destructive baggage of a hard-done-by victim. People rarely come to terms with extreme hardships; they simply adapt and find different ways of living. In this process health professionals, I can testify, can provide crucial support that goes far beyond their technical skills. The key is empathy. When a person’s hardships seem beyond verbal communication, a simple acknowledgment of the inadequacy of words can be the most powerful statement of caring and support.