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Dr, Brian Goldman at the Rady JCC May 13

By BERNIE BELLAN

By now, it’s become standard practice for emergency room physician and CBC radio host Dr. Brian Goldman to appear at the Asper Campus whenever he launches a new book. The first time was in 2011, when he spoke in the Berney Theatre to promote his first book, The Night Shift, which talked about what really goes in a hospital emergency room.

Then, in 2015 – on Super Bowl Sunday no less, Goldman packed ‘em in to the Berney Theatre again, this time to talk about his book, The Secret Language of Doctors, which peeled back the covers to expose some of the often funny, but occasionally highly insulting lingo used by doctors in hospitals.

So, it was no surprise that Goldman chose the Campus to launch his most recent book, The Power of Kindness – Why Empathy is Essential in Everyday Life, on Sunday, May 13. Since the Berney Theatre was booked, however, the location for the book launch shifted to the Multipurpose Room. In some ways that was a better venue, as the audience was closer to Goldman while he spoke. At one point, in fact, in order to demonstrate “empathy” – which is what the book is all about, Goldman took a seat in the audience and pretended he was someone else listening to Dr. Goldman.

When she introduced Goldman to the audience, Rady JCC Executive Director Gayle Waxman noted that “every time he comes to Winnipeg he makes a point of calling us up and asking whether he can speak here.”
Gayle also introduced  former CBC radio host Terry MacLeod, who served as interviewer for the evening. (Kudos to the CBC for giving us such talented radio hosts as MacLeod and Ismaila Alfa – who interviewed Goldman when he spoke at the Berney Theatre in 2015.) MacLeod proceeded to ask Goldman about certain chapters in his most recent book.

But, before they delved into the book, MacLeod began his interview by asking Goldman where his philosophy of medicine comes from?

Goldman said, “You want to go back to the roots of my upbringing. I’m a good listener; I always listen to what people say and what they mean…The truth sets us free…In avoiding that conversation, we create more strife…What if you could really hear what people meant?”

Goldman went on to say that he’s given Ted Talks on the subject of listening to patients several times. One of them – about doctors making mistakes, has been viewed over a million times on Youtube, he said. (You can view it at https://www.ted.com/talks/brian_goldman_doctors_make_mistakes_can_we_talk_about_that.)

MacLeod asked him, “What do you mean by ‘empathy’”?
Goldman said: “Sympathy is a gesture of concern expressed by someone who really doesn’t feel what you feel…somewhat detached.”
Empathy, on the other hand, he explained, has three components: emotional, cognitive, and emotional concern. He went on to define all three.
“Emotional empathy,” Goldman explained, is “what a mother feels when a child is getting stitches. When I see someone missing a limb, I feel pain.” (Jokingly, Goldman added that he wouldn’t want a surgeon to feel that kind of empathy while operating on someone.)
“Cognitive empathy”, he said, is “the ability to use your imagination to picture yourself in the place of someone else.”
Finally, “emotional concern” is when “you get jazzed by running into the problem, not away from the problem”.

MacLeod asked: “Why did you start the book in your own brain?”
Goldman explained that “I was accused of being unkind by a family.” He went on to talk about a situation in which he was the emergency room doctor some years ago when a patient was brought into emergency.

Goldman described that particular situation as one in which there was no “medical reason” to admit the patient, but you had to admit that patient anyway. He said that is what is referred to as a “social admission”. In this particular case, the patient was close to dying, but there was nothing that could be done for the patient medically.

As a result, the patient was being forced to sit in emergency for quite a long time – until a bed could be freed up which, under the circumstances, was not going to happen anytime soon.
The family of the patient kept asking, “When is she going to get a bed? When is she going to be seen by an intern?”
The daughter of the patient finally asked Goldman: “Have you actually made a referral?”
“I snapped at her,” Goldman admitted.

Months later, the husband of the woman – who did die soon after being admitted, wrote Goldman a letter. “He accused me of being unkind,” Goldman said.
“They had me busted,” he continued. “It was only years later when my own father passed away that I experienced something like what that family went through. I went on a personal journey – and a physical journey.”


Goldman proceeded to describe time he spent visiting other countries to see what he could learn about attitudes toward empathy in other cultures. His most interesting experiences, he said, were in Japan. That country has a rapidly aging population but, unlike other countries which are also experiencing similar problems, refuses to allow caregivers from other countries to stay in the country for more than three years. As a result, there is a tremendous shortage of caregivers in Japan.

But, rather than dealing with the situation by allowing more caregivers into the country, Japan has attempted to develop a technological fix, tasking scientists there with  attempting to develop caregiver robots. (To see a video of what’s happening in Japan, go to doctorbriangoldman.com.)

Of course, the challenges in building an empathetic robot are huge, Goldman explained. “Human beings are hard wired to bond to everything.” For instance, he referred to people’s attachment to pets. Replicating that in a robot isn’t easy.

Another story Goldman told was about meeting a well-know residential school survivor by the name of Ted Fontaine. Fontaine has been involved in a project “embodying empathy”, Goldman explained. Computer programmers have “attempted to create the first virtual reality interaction with a residential school”. (Interestingly, Goldman noted that the inspiration for the project came from a similar idea that was developed by the Holocaust Foundation, for which Steven Spielberg has been so deeply committed. One of the foundation’s projects has been to create a hologram of a Holocaust survivor. We wrote about that project in our story about Holocaust survivor Pinchas Gutter.)

As Goldman described it, he was able to put on a set of virtual reality goggles that are known as “Oculus Rift’ and actually experience residential school life. At one point Fontaine began describing the leather straps that the priests in the school would carry with them for quick administration to misbehaving students.

The experience of hearing that, Goldman said, jolted him into having “a flashback to when I got the strap” in school (for something that was no fault of his, he told the audience: One day in gym class his shorts ripped in the crotch area and he was too embarrassed to participate in class. As a result he was sent to the principal’s office. Rather than tell the principal why he wouldn’t participate in gym class, Goldman said he did the first thing that came instinctively to him – and stuck out his tongue at the principal.)

Fontaine, Goldman said, has participated in educational programs where he tells the story of his own residential school experience alongside a Holocaust survivor by the name of Max Aikin. Together, the two “share the pain”, Goldman explained.

Later, Goldman described the work of someone named Mary Gordon who, in 1996 developed a plan in the United States that attempts to instill empathy in students who come from troubled backgrounds through a 27-session program spread out through the school year.

That program has been successful in reducing violence, Goldman said.

But, can you teach kids to be empathetic? he wondered. The answer, he said, is “no, but you can ignite what’s already there – because we’re hard wired to be empathetic.”

He went on to note how individuals who themselves have a “limitation” of one sort or another can empathize with individuals who may have a completely different “limitation”. He told the story of a Tim Hortons owner who had been born deaf, and who later hired a young special needs student by the name of Clint – despite being told that Clint could never handle working at a Tim Hortons. Clint went on to become the “best employee” at that Tim Hortons, Goldman said, but only because his employer could relate to him from the start.

Terry MacLeod asked Goldman to describe what he meant by the term “validation”, to which he refers in his book.

Goldman cited the work of someone named Naomi Feil, who spent years working with residents suffering from dementia in a Pennsylvania seniors’ home. Feil developed the theory that behaviours often seen in dementia patients, such as repetitive banging or speaking in languages that can’t be understood, were manifestations of those individuals “retreating into their own reality”.

“They revisit major traumas of their lives,” Goldman said. “Many retreat to a time when they had agency. The rantings and bangings are symbolic. If you validate it they calm down.”

He cited, as an example, the oft-heard cry of a dementia patient who wants to see his or her mother - or grandmother, as the case may be.
In those cases, Goldman said, it is often useful to employ what he described as a “therapeutic lie”. Ask the patient, “What would you say to your mother if she were here?”

He also added these words of advice: “If you’re with someone who’s agitated, centre yourself. If you’re agitated, you can’t empathize with someone who’s agitated.”

As a result of his own “voyage of discovery”, Goldman said, “I rediscovered my own kindness…A lot of us go into fields like medicine or social work to do good.”

He is now able to relate to patients in a way that he didn’t before, he said. He can say to them: “I’ve sat where you’re sitting. If I were you, I’d be furious, too.”

“We are living in an unkind world,” Goldman said. “Kindness costs nothing. They know when you’re not kind. If you want to invest in yourself, be kind.”