In an essay about essays, Jonathan Franzen writes about the power of the essay to expand one's mind and viewpoints. Franzen is a self-described pessimist, but his sardonic tone nevertheless sheds light on the value of reading: "literature at its best...invites you to ask whether you might be somewhat wrong, maybe even entirely wrong, and to imagine why someone else might hate you." More optimistically, consider Ray Bradbury: “Fiction gives us empathy: it puts us inside the minds of other people, gives us the gift of seeing through their eyes. Fiction is a lie that tells us true things, over and over.” These are general ideas, but it is my purpose here to suggest that this value can be applied specifically to doctors. David Foster Wallace: "But if a piece of fiction can allow us imaginatively to identify with a character's pain, we might then also more easily conceive of others identifying with their own." If true, this seems a valuable practice for a physician.
If you are of a more academic bent, consider this research that poetry develops empathy in readers, or this paper arguing that poetry builds emotional intelligence, or this Scientific American article highlighting the finding that reading literary fiction improves empathy. The above quotes and these research papers point help articulate this idea, but we know this intuitively as well. Writing, especially good writing, is one of the oldest methods we have of expressing our humanity in all its glory and all its struggles. Reading allows us to engage with another's message and give thought to the story placed in front of us. This is not all that different from what we do every day as doctors. We aren't always good at this, but like all skills, we can improve if we practice deliberately. I propose reading as one way for doctors to practice and develop this skill.
I am certainly not the first to suggest the value of reading, particularly as it relates to empathy, nor for physicians. Readers of nearly any genre can attest that there is subjective value in the act; it offers an opportunity to expand the mind, draw new connections, learn new information, clarify existing knowledge, engage new patterns of thinking, and build skills such as attention to detail, problem-solving, and making predictions.
For this article, though, most significant is the ability of reading to place oneself in another's shoes and to consider the world from his or her perspective. There are three primary reasons this is valuable for physicians. First, generally, is how this practice can engender empathy for real people. Reading a variety of stories, fiction or nonfiction, forces the reader to engage with a viewpoint that is necessarily different from the reader’s. It may be a similar viewpoint, but expressed differently, or it may be a radically different viewpoint that calls on the reader’s imaginative capacities. I submit that this practice of imagination is exactly what we need to develop when we speak with patients. There is palpable value in being able to say to someone, "I can imagine that this would be difficult for you," if we are truly able to imagine it. Aligning ourselves with someone else, with their story and perspective, makes us more attentive to what we say, how we say it, and thus makes us more compassionate and effective physicians.
Second, reading increases our vocabulary for how to talk about the world, specifically the world of health and disease. Every essay, poem, and story has the potential to surprise and captivate us with new ways of expressing the same ideas. Poetry is especially valuable for this, with rich language and careful attention to how words are put together. As physicians, we are tasked with talking to people at some of the darkest and most vulnerable parts of their lives. It is a component of our sacred duty to think carefully and critically about the words we say. Reading may help us practice that by seeing it in action; it may also directly help by introducing us to new words, phrases, metaphors, analogies, or other examples that we can use to better express ourselves to patients.
Third, most specifically to doctors, is the reading of books and poems that fall into the genre of health or medical memoir. These run the gamut of styles, from high literary fiction to short essays to poorly written attacks on the medical community to lovely poems. This is a wide genre because the health of the body and mind are such central concepts to what it means to be human. Reading can help remind us of that, and help us specifically to understand what our patients might be feeling, thinking, wondering, worrying about, wishing or hoping. Putting ourselves into the mind of a patient in this way can increase our capacity to remember that each patient is an individual who needs our attention and treatment as such. This can be so very difficult for us, who see five, 10, or even 30 patients in a day and thus start to forget that for the other person, our visit may be the most important part of their day. Empathy can only occur if we take a moment to allow it; reading closely the stories of others is one straightforward way to develop this ability.
It seems clear that reading more and reading more broadly can make us better doctors. Importantly, I'm not a purist; I think reading just about anything can be helpful. Thus I wouldn't suggest laboring through something that bores you or bothers you simply to make you better. The Brothers Karamazov may have a lot to say about humanity's struggles, but if you don't like it, find something else more interesting. Perhaps poetry has never interested you (though you should really consider reading this one by Philip Levine and this one by Raymond Carver); if so, don't let that stop you from reading something else. Though there can be value in laboring at something challenging to increase the reward, there are so many things to read, each with something to teach us, that the most important thing, I think, is to just begin.
(If you're wondering where to start, here's an excerpt on grief and death by Joan Didion, from her book "The Year of Magical Thinking"; if that doesn't interest you, maybe one of these will.)
Brent Schnipke, MD is a writer based in Dayton, OH. He received his MD from Wright State University in 2018 and is a first-year Psychiatry resident at Wright State. His professional interests include writing, medical humanities, and medical education. He is also a 2018–2019 Doximity Author.
Image: jiris / shutterstock
