The Empathy Exams

Jamison, Leslie

Primary Category: Literature / Nonfiction

Genre: Collection (Essays)

Annotated by:
Zander, Devon
  • Date of entry: Aug-02-2021


Leslie Jamison starts The Empathy Exams with a quote from The Self-Tormentor by Terence, first in Latin, then in English: “I am human: nothing human is alien to me.”  In beginning this way, she sets up the book to explore the human condition and what it means to relate to one another with caring despite the interpersonal complications that can often arise. Through a series of nonfiction essays (some initially published elsewhere) she explores how we express our feelings and process those of others. To do this, Jamison uses a number of different lenses, large and small, including ultramarathons, immigration, incarceration, a Morgellons disease conference, and more.  

The book takes its name from the first essay in which Jamison juxtaposes her experience as a standardized patient for students in medical school with being an actual patient. She specifically explores the ways in which empathy is created/manufactured and extended in medicine, both from medical professionals and loved ones.


The first essay, “The Empathy Exams,” was inspired by Jamison’s work as a standardized patient.  A standardized patient, colloquially abbreviated “SP,” is an actor who takes on the role of a patient with a specific health concern, so students in health professions can practice taking patient histories, doing physical exams, building rapport, and communicating health information in a setting that mimics an actual clinic. Though SPs grade students on many different aspects of their approach to patient care, Jamison focuses in on SP “checklist item 31”:  the “[voicing] of empathy for my situation/problem,” (p. 3) an action that is required of students to get a perfect score on their practice encounter. She compares her role as an SP with her own experience interacting with a boyfriend, family, and doctors while undergoing an abortion and heart ablation and what her expectations for checklist item 31 were for those around her.  Written in the form of the paperwork given to SPs to help them build a back story and act out their assigned illness, Jamison’s essay pulls back the curtain on the emotional labor it takes to “act out” not just another’s illness but express the feelings and pain around one’s own.  And, in doing so, she attempts to explain what pain is, “something actual and constructed at once,” (p. 10) and how we ask others to respond to our pain.

The subject of pain is expanded in her final essay, “Grand Unified Theory of Female Pain.”  In it, she attempts to explore how female pain has been expressed, romanticized, commented upon, and repressed.  Yet, her commentary in this essay sheds light on the first one.  Jamison quotes a friend who explains how “pain that gets performed is still pain” (p. 188).  While alluding to the ways in which the expression of female pain has been downplayed, this quote can just as easily be applied to the role of a standardized patient - an actor is being asked to embody the illness of another, to both separate their own experience from it and yet draw from their own life to make it genuine without “[exhausting] the students with… the side effects of our actual bodies” (p. 4).  On the flipside, and yet in the same way, Jamison’s collection questions whether empathy that gets performed is still empathy.  Does the medical student who uses a canned phrase express empathy?  Does the boyfriend sitting in the hospital waiting room?  Does a doctor with a prompted apology?  Though only touched upon in The Empathy Exams these questions prompt others outside the book; namely, can empathy be taught?  Can it be cultivated?

Ultimately, these two essays embody much of Jamison’s book and are not just explorations in the ways in which empathy is created and desired, but are arguments for the need to appreciate the ways in which others express empathy or express their need for it.


Graywolf Press

Place Published

Minneapolis, MN

Page Count