The Empathy Exams by Leslie Jamison
"How do we talk about [...] wounds without glamorizing them," Leslie Jamison asks. In The Empathy Exams, Jamison's prizewinning collection of essays, she probes the idea of human response to pain. Just how much does empathy ask of its giver? What does it give to the receiver? Are there inherent bargains made in the exchange? Do we take on one another's burdens with purpose? Why do we need others to acknowledge our pain? Jamison asks these questions and more as she encounters a variety of both sick and healthy people. She questions herself with the same intensity as the others, often subjecting herself and her inclinations to the harshest criticism.
The essays in Jamison's collection cover a wide range of topics, yet in each case Jamison monitors her response to pain and suffering -- both her own and others'. The result is a collection that examines the empathetic response in many situations. In the title essay, Jamison is a medical actor portraying a patient for medical students and rating their responses. In "Devil's Bait," she visits a gathering of people who believe they have Morgellons disease, an oft-doubted diagnosis many give themselves when science fails to categorize the mysterious eruptions of their skin. Jamison's travel also features in the collection, and she uses travel both as an opportunity to explore her own physical pain as well as her response to unusual circumstances. "Pain Tours I" and "Pain Tours II" detail her journeys (sometimes intellectual rather than physical) through different types of suffering. Jamison looks at why ultramarathoners in the Barkley Marathons push their bodies beyond sense or reason in "The Immortal Horizon," and in "In Defense of Saccharin(e)" and "Grand Unified Theory of Female Pain" she challenges ideas about what constitutes appropriate human emotional response and urges. Ultimately, her work, too is an exercise in empathy, as is all writing. Her collection seeks to quantify emotional response as a human contract, yet Jamison also asks that the reader enter into a similar contract by interacting with the book.
"[E]mpathy is always perched between gift and invasion," Jamison says of the empathy between doctors and patients. In that scenario empathy is a measurable quantity of the scientific process, scored by checklist item thirty-one. The participants of these exchanges walk delicately on either side of a line. Jamison establishes early that empathy is found in a balance of imperfect souls; that it requires agreement on both sides of the equation. When she visits a gathering of self-diagnosed Morgellons sufferers ("Morgies," she comes to call them), she sees also that empathy has the power to affirm:
When does empathy actually reinforce the pain it wants to console? Does giving people a space to talk about their disease -- probe it, gaze at it, share it -- help them move through it, or simply deepen its hold? Does a gathering like this offer solace or simply confirm the cloister and prerogative of suffering? Maybe it just pushes on the pain until it gets even worse...
In "Devil's Bait," as well as the rest of the collection, Jamison is hard on herself, examining her reactions to people and diseases; she notes the way she might reduce someone's suffering to a trite conclusion in an essay. Among the "Morgies" she feels the burden of not only their desire for belief and affirmation of pain, but also the burden of the human tendency to make things too neat in writing. Her essays are made better by this transparency. Often the difficulty Jamison describes in the writing becomes central to the essay's core.
This idea of pain (or suffering) giving value to both an activity and to the person undertaking it is raised again in "The Immortal Horizon," the tale of the brutal one-hundred-plus mile unmarked trail race that almost nobody finishes.
There is a gracefully frustrating tautology to this embodied testimony: Why do I do it? I do it because it hurts so much and I'm still willing to do it. The sheer ferocity of the effort implies that the effort is somehow worth it. This is purpose by implication rather than direct articulation.
Pain, in its way, acknowledges value. Some people in Jamison's essays -- like the marathoners -- seek pain as a measure of self worth. Others she meets elsewhere want confirmation of the validity of their illness. Her exploration of the interaction between pain and attention is fascinating, and deepens in scope with each essay.
In "Grand Unified Theory of Female Pain," Jamison takes on the images of suffering women in literature, and challenges the notion that female characters need be reduced to simpering hysterical beings because of their pain. But she also refutes the idea that if something is emotional, it is not academic or good. She explores our distaste for those who tip too far from needing into being needy.
A cry for attention is positioned as the ultimate crime, clutching or trivial -- as if "attention" were inherently a selfish thing to want. But isn't wanting attention one of the most fundamental traits of being human -- and isn't granting it one of the most important gifts we can give?
Here, as in "In Defense of Saccharin(e)," Jamison is able to hold two opposing thoughts in the same essay. As a society, we disdain those who are trying too hard to get attention, or that which is too sweet. Yet we all want attention, and we can't get our fill of sweetness.
Jamison's thoughts on the issue of attention-seeking and its relationship to suffering bring her to label modern women as "post-wounded":
The post-wounded posture is claustrophobic. It's full of jadedness, aching gone implicit, sarcasm quick-on-the-heels of anything that might look like self-pity. I see it in female writers and their female narrators, troves of stories about vaguely dissatisfied women who no longer fully own their feelings. Pain is everywhere and nowhere. Post-wounded women know that postures of pain play into limited and outmoded conceptions of womanhood. Their hurt has a new native language spoken in several dialects: sarcastic, apathetic, opaque; cool and clever. They guard against those moments when melodrama or self-pity might split their careful seams of intellect.
She challenges, then, both the impetus toward needing emotional attention and of using emotion to respond to a creative work.
Is the idea that feelings are not enough, that they will fail us if we rely on them too exclusively (for ethical decisions) or milk their excessive impact too shamelessly (for aesthetic value)? Or is the idea that our language is often not enough for feelings themselves, that sentimentality forces them into artificial vessels or cheap bulk-good volumes? Are there right and wrong ways to experience emotion in response to aesthetic work?
This is the question we have to ask ourselves as we read Jamison's book. And it raises the question of all reading, in general. We experience emotion as a natural response to aesthetic work, and yet that reaction is seen as somehow less worthy. Why is this? Jamison presses for an answer.
The Empathy Exams is polished, interesting, and compelling. Jamison pokes so deeply into the idea of empathy that she is able to raise questions about empathy we wouldn't expect. She puts herself on the examination table; her medical and intellectual wounds are here for our consideration. She writes with honesty and openness to critique. If empathy is setting our own discomfort to allow the feelings or symptoms of others to become our feelings, too, than entering into an empathetic contract with Jamison is a worthwhile exercise. These are essays that challenge and provoke, affirm and affect.
The Empathy Exams by Leslie Jamison