Actor teaches clinicians to communicate

Allison Gandey

doi:10.1503/cmaj.1040618

Many patients have horror stories about their doctor's hurried standoffishness and seeming indifference. Actor Megan Cole learned this first hand while starring as Vivian Bearing, a professor dying of cancer, in the Pulitzer Prize winning play Wit. Cole encouraged the audience to talk about their own experiences and recognized a gap between how patients and physicians experience the doctor–patient relationship. She also realized that, as an actor, there was something she could do to help.

Figure. Actor Megan Cole learned about the gap in patient–physician communications from her role in Wit. Photo by: Courtesy of Compassion in Dying

Working with the US-based Compassion in Dying Federation, Cole developed a program in medical ethics and communication. Her course, “The Craft of Empathy,” shows doctors how to use actors' techniques to heighten their awareness of emotions such as anger, fear and sadness and respond to them without losing professional objectivity.

Barbara Coombs Lee, president of the federation, says many doctors lack rapport with their patients. “We speak with dying patients and their families all of the time and we have observed a pattern in many of the complaints. Patients have a sense that their doctors are not really hearing them.”

Coombs Lee says the heavy science requirements of medicine leave many physicians without an education in humanities, which is the basis for empathy. In addition, physicians who are naturally inclined to be empathetic “have it trained out of them.”

Cole, who has appeared on Seinfeld and ER, is now a regular visiting faculty member at the University of Texas Medical Center in Houston and part of what she calls a tiny movement honouring the human aspect of medicine.

Among the 40 or so people behind this so-called communications movement is Dr. Robert Buckman, an oncologist at the Princess Margaret Hospital. He says contrary to stereotypes about doctors being anti-soft skills, these efforts have been well received. “Many doctors express relief that others feel this way too.” Buckman says that physicians have not been taught how to express themselves and so they often appear heartless. “The emotions are there, they just don't come across, and actors are in a perfect position to help physicians develop these skills.” – Allison Gandey, CMAJ