1. Bolwell, Brian J. MD, FACP

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People who have careers in health care generally say they entered the field because they wanted to help people. Implicit in such a statement is that they possess high levels of empathy. Empathy is a character trait that many aspire to obtain and is frequently lauded as a quintessential characteristic of emotional intelligence. For those of us in oncology, the ability to be empathetic to those with cancer is an essential part of the job.

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I recently came across an article in Wired magazine by Robin Wright entitled "Empathy Is Tearing Us Apart" that caused me to reevaluate my one-dimensional view of empathy. Previously, I thought you either possessed it or you did not. The backdrop of the article is that current animosity between political parties across the country is a real issue, and the author examined potential drivers that intensify it. Wright quotes a recent study that found "empathetic concern does not reduce partisan animosity in the electorate and in some respects even exacerbates it."


The study found that Americans who scored high on an empathy scale were more likely to score higher not only on the favorability rating of their political party of choice, but also in the degree of negativity rating towards the opposing party. So, a high level of empathy was polarizing, as highly empathetic people also had high negative feelings towards the opposing group.


Clearly, people do not deploy empathy indiscriminately. People are selective in how they utilize empathy. Wright describes evidence that empathy is deployed tactically. But more importantly, the study showed that highly empathetic people view the out-group more unfavorably (relative to their own group) than low empathy people. Therefore, their feelings of empathy vanished when they viewed those with opposing political views.


When you ask people about empathy, they naturally reflect on times when they do indeed feel empathy, and not on the political partisanship of the world. The fact that highly empathetic people have heightened negative emotions toward the out-group then strengthens the opposite feelings that the out-group has towards them. It becomes a vicious cycle. This essay certainly can explain some of the current polarization of American politics today.


This is an obvious contrast to being an empathetic physician. In health care, we are supposed to care for everyone, regardless of background, socioeconomic status, or beliefs. We have to deploy empathy towards everyone we treat. But we cannot choose who receives our empathy. As learned, kind, and caring individuals, it's our duty to apply our knowledge and compassion to everyone. And yet, all of us, to some degree, deploy our reservoir of empathy quite discriminately to those we like and agree with, and withhold it from those we oppose. It's important to be aware of the psychological tendency to treat with heightened negativity those you disagree with.


Nobody's perfect. But being aware of our tendencies and unconscious bias is an opportunity to self-reflect.


As a leader, it's important to evaluate and self-reflect to ensure you are able to learn and grow. I talk about empathy all the time yet previously had not given thought to how I tactically deploy it. Rather than having it or not, I now look at the scope and direction of my empathy.


Leadership is about supporting others. Generally, they are part of your team or organization. A limited leader defines their organization narrowly. This could mean the individuals they interact with every day or only the people who agree with them. It's much harder to use your influence and support those who do not immediately touch your team. It's even more difficult to support those who you do not agree with or who don't agree with you. But that is what a true leader must do.


Ask yourself what type of leader you aspire to be. A leader who is limited, or one who can take on the challenges and lead those who are difficult, and even more importantly, a leader who can inspire and elevate others from afar.


The path forward may be self-reflection. Living your values or speaking empty words? If you believe in the value of empathy, check yourself. Are you empathetic towards those who share your views and those who oppose them? Are you exhibiting empathy to all? Can you practice servant leadership to those outside your immediate chain of command? Can you affect those on the fringe of your organization?


Give this some thought, as you witness behavior of our leaders nationally, and as you yourself grow as a leader. Tolerance for those who you oppose may be something to consider. As a leader, using your authority to support not just the favored group but also others may be an opportunity to display wisdom as well as real empathy. Most importantly, constantly self-reflect. Examine not just what you think but what you do-every single day. What you do is who you are. We all think we are empathetic. But reflect on how you behave. That will define how much empathy you truly possess.


BRIAN J. BOLWELL, MD, FACP, is Chairman of the Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner School of Medicine. Cleveland Clinic is a top 10 cancer hospital according to U.S. News & World Report.


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