The Empathy Exams. Leslie Jamison.

Jamison, Leslie. The Empathy Exams. Gray Wolf, Minneapolis, 2014. NF; 12/18.

I Met Fear on the Hill is a recent essay by Jamison published in Paris Review (227). Some of its insights caught my attention. A former husband of her mother was an American hippie trying (or at least giving the appearance to himself and others of trying) to be “unfettered by norms, absolutely free”, and also “interrogat(ing his)… obsession with coolness”. But this interrogation was according to Jamison really a quest for “an utterly authentic self”, which she refers to as a fantasy.

An escape in other words, from what we really ought to be doing. But (all excited by Jamison’s insight) I wondered what, according to this very smart lady, that would be? So I looked her up and downloaded this collection of essays. I was impressed but my feelings ended up mixed, and I couldn’t identify with her dark vision of femininity, never mind finding a definition of an alternative to a phoney authentic self.

(Apropos: a quick digression about the Paris Review recently. There is a new editor, one Emily Nemens. She is a relatively unknown young former editor of another literary review. It’s going to be interesting to see how she and the Review respond to the alleged sex behaviour of the former editor Loren Stein. I hope the reaction to that and to the party culture of this old and influential periodical will be measured, avoiding a right-versus-left safe-places train wreck.)

Jamison is an interesting character, a Harvard undergraduate, Iowa Writers’ Workshop alum, and Yale literature PhD. But also a sometime alcohol addict and subject in her writing to unsparing self-analysis and -criticism. This set of essays focuses on empathy, drilling down through its idea of feelings for others into an analysis of feelings about oneself and finally exploring female pain.

In the title essay Jamison, apparently needing to take on a badly-paying job, works representing illnesses in live examinations of medical students. I’ve experienced those examinations, and agree that especially lately the examiners on the other side of the two-way mirror are looking not just for the student to get the right answer, but also to somehow exhibit… empathy. Dr Seamus O’Malley in his lovely book The Way We Die Now  says that showing suffering patients kindness is a “private mystery that only many years of practice teaches”, and recent clumsy attempts to teach that mystery to rote-oriented young students is ridiculous. I agree. You don’t have to be an experienced doctor but you usually need to be an experienced person to share bitter experience and encourage people to feel you understand.

But Ms. Jamison’s experience of staged empathy introduces us to the idea that like an old doctor we don’t just have feelings, we also create and express them. So they are represented, not just experienced, and that’s okay, kind of. Jamison lets us know that that little problem is moral and dealing with it doesn’t come easy:

… confession of effort chafes against the notion that empathy should always rise unbidden, that genuine means the same thing as unwilled, that intentionality is the enemy of love. But I believe in intention and I believe in work. I believe in waking up in the middle of the night and packing our bags and leaving our worst selves for our better ones.

I believe in intention and work too, and find I’m able to make use of her idea of leaving a bad self for a good one. Bravo.

In In Defence of Saccharin(e) we get a treatise on sweetness and (or as) sentimentality. At what point is pleasure (and what kind of pleasure is) gratuitous: too easy and undeserved? We are reminded that this is a probably-reformed alcoholic speaking. Again no easy answer. If we’re going to deal with empathy we have to deal with misery, and in her to me obscure Pain Tours (II) Jamison dances around the phenomenon of misery and how you can’t have it, live it, or access its meaning by describing it. Feelings may be made up in part of representation but that doesn’t necessarily apply to representing someone else’s misery. Or, as we see in a later essay, even your own.

The topic range of these essays is wide: imaginary diseases that may not be imaginary, uber-extreme wilderness competition, murders and false conviction, and life in prison. The last essay, Grand Unified Theory of Female Pain, is the longest. A friend or advisor tells our author that “the problem with an essay can eventually become its subject” and that idea and the original meaning of “essay” is operative in this one. Surveying and personally participating in self-mutilation, ugliness, wounds physical, spiritual, and metaphoric, and a lot of bleeding leads us to a strange paradoxical take on feminism. Is it or isn’t it okay that being female somehow identifies with pain? Well it is but for that to be true you have to deal with feeling sorry for yourself along with the suffering and hemorrhage.

A lot of critics (and I guess a lot of men) would wonder about a woman’s worry that pain she talks about at great length is going to characterize femininity, when there is such a thing as being characterized by pain that you have to carry as if it wasn’t there.

Leslie Jamison has a wonderful education, is I think a fine writer, smart, and relentlessly self-critical. She’s a force to be reckoned with and admired. I’m familiar from reading authors like E. M. Cioran and Emmanuel Carrere with wondering if it’s okay not to agonize over and internalize other people’s unhappy experiences because they are beautifully expressed and obviously real. I think I have to see if I can sense whether what Jamison is talking about is real for any of the women I know.

I guess it’s ??/8.9 if I have to be numerical.

About John Sloan

John Sloan is a senior academic physician in the Department of Family Practice at the University of British Columbia, and has spent most of his 40 years' practice caring for the frail elderly in Vancouver. He is the author of "A Bitter Pill: How the Medical System is Failing the Elderly", published in 2009 by Greystone Books. His innovative primary care practice for the frail elderly has been adopted by Vancouver Coastal Health and is expanding. Dr. Sloan lectures throughout North America on care of the elderly.
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