Why Real Empathy Has to Start with Real Listening

Visiting with patients during rounds is one of the things I love most about my work with health care providers across the country. I remember conversations with patients that cover the range of emotions – uplifting, sad, funny, disheartening, frustrating … and almost always humbling.

But it is a conversation with a paraplegic patient at a HealthSouth acute rehabilitation hospital a few years ago that I still reflect on often because of the important lesson it taught me.

The nurse manager for the unit explained that Mr. Jones (not his real name) was a frequent patient at HealthSouth and would appreciate a visit. I walked into the room and did everything by the book, just like I’ve explained hundreds of times to thousands of caregivers in my workshops. I greeted Mr. Jones by name, shook his hand, made good eye contact, explained my role and sat down across from his wheelchair at eye level. I started with my open-ended question: “So tell me about your stay. How are you doing?”

He paused and slowly looked up. “Well … not very damn good,” he said matter-of-factly.

My heart went out to him. So I crafted my best empathy statement: “I can understand how difficult this must be for you.”

He paused longer this time. “You know, I don’t think you can. I really don’t think you can.”

And he was absolutely right.

I fumbled around for a few seconds. “Oh, I’m so sorry. I didn’t mean that I could begin to ….” Then I stopped. “You’re right. I can’t understand. But I do want to hear about what you’ve been through if you want to tell me.”

Then I listened. I mean, I really listened. I learned that he loved racing motorcycles, and that he had lost his legs in a tragic accident. His dream was to ride again. And he felt so fortunate to be in the care of the team at HealthSouth who understood that dream.



The very definition of empathy – the ability to identify with the feelings, thoughts and attitudes of another – demands that focused, non-judgmental, active listening must come first. Otherwise, how can we possibly begin to understand what another person is feeling or thinking about his or her situation. Without that understanding, we’re simply expressing sympathy that may be un-welcomed.

The very definition of empathy – the ability to identify with the feelings, thoughts and attitudes of another – demands that focused, non-judgmental, active listening must come first.

Another unforgettable conversation with a different HealthSouth patient brings this point home. John (also not his real name) was an energetic, athletic, young man who was admitted to HealthSouth after a heartbreaking accident that the nurse manager explained to me. Because he was so fit, it was easy for him to climb a tree to try to retrieve a small child’s kite that had gotten tangled in the upper branches. Sadly, a branch broke under him, and he fell nearly 50 feet to the ground causing a spine injury that left him paralyzed from the waist down.

When I knocked on John’s room door, I heard from behind the pulled curtain, “Yeah, give me just a minute. I’m changing my clothes.”

A minute later, the curtain flew open to reveal a smiling young man with the physique of an “American Ninja Warrior” contestant. “Hi, I’m John. It’s good to meet you.” And for the next 15 minutes, I heard only about how determined he was to walk again, about how fortunate he was to be alive, and how he appreciated being in a place where people were so caring and could help him with his rehabilitation. It was one of the most uplifting conversations I’ve ever had.

Given the circumstances, one would have anticipated that a well-intentioned empathy statement would have expressed how emotionally and physically difficult his situation must be. But for John, that would have only sounded like pity, not genuine empathy.

So what does it take to truly listen to another human being in a way that makes real empathy possible? We all have tips and techniques around eye contact, repeating back what the other person has told us and asking questions. But in reality, those techniques only scratch the surface. Perhaps we could learn more by reflecting on the people we’ve known and worked with during our lives whom we recognize as especially gifted listeners.

So what does it take to truly listen to another human being in a way that makes real empathy possible?

As I was thinking about this article and asked myself that question, I came up with a surprisingly short list. In my next post, I’ll share with you that list and what I learned from those special people who showed me what sincere listening really looks and feels like.

Stamp & Chase offers unexpected solutions to universal challenges facing leading healthcare organizations. To learn more about our robust tools and approaches that help healthcare leaders transform patient and staff engagement, visit Stamp & Chase.

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