Sympathy, Empathy, and American Healthcare

by Liz Backstrom

When I stand on curbs or in parks for a few hours with a protest sign, I start looking for something to do, and inevitably I end up making new friends. It’s not as hard as I thought, even for an introvert like me. We may have nothing in common but the corner we’re on, but by the time we’ve been there for an hour, we’re inevitably sharing stories and swapping slogans.

At a healthcare protest in Spokane a few weeks ago, I met a nurse. “Why are you here?”

“I’ve been a nurse for 40 years,” she said. “I’m not here for me. I have great healthcare. I’ve got mine. I have a good plan, my kids are covered – but so many of my patients aren’t. They were just starting to get on their feet, and then this.”

I thought about that. For now, I have mine too. I grew up poor, but now I have a health plan that covers my pre-existing condition. If I get a seizure at the wrong time, I might die, but at least my family can pay my bills. For probably the first time in my life, I’m middle class.

I’m not on the curb, and lots of us aren’t, because we want ours, although I’ll admit it, I’m scared for myself if I lose my job. I’m here because I’ve spent my whole life hearing stories of people who had theirs – whose lives were going along just fine – until they weren’t.

Hundreds of people end up at the food bank where I work because of high medical bills. They go from shopping with a nice car to shopping with a cardboard box and a wagon because they had the audacity to get sick. Some of them are homeless.

Usually a well-meaning person comes along halfway through this story and says something like – Why are they at the food bank if they can afford a car? Or why do they have kids at all if they can’t support them? It’s all a variation on “if only that person had made better choices, they wouldn’t be where they are, and I would do better.”

I don’t believe we say things like this out of malice, usually. We mostly believe we could do better, if we were put in that set of circumstances and had to make those choices.

In a recent essay for NonProfitPro, authors Otis Fulton and Katrina VanHuss point out how easy it is to ignore another person’s suffering if it’s not something we ourselves have experienced.

In his book “Mindwise” University of Chicago professor Nicholas Epley describes the importance of “distance” and the ability people have to imagine what others are thinking or feeling.

Epley says, “Distance is not just physical space. It is also psychological space, the degree to which you feel connected to someone else. The ability to feel empathy for another group decreases as distance increases. In some cases, distance can grow and shrink. For example, when you get in an argument with your spouse, you feel ‘distant’ from them. Then, you can feel the psychological distance diminish when you resolve the conflict.

But distance from groups that are unlike ours is more difficult to close. People who are viewed as ‘too different’ from us can completely shut down our ability to connect with them.”

Author Matthew Desmond examines the same phenomenon in a piece about housing prices and wealth inequality:

“We tend to speak about the poor as if they didn’t live in the same society, as if our gains and their losses weren’t intertwined. Conservatives explain poverty by pointing to ‘individual factors,’ like bad decisions or the rise of single-parent families; liberals refer to ‘structural causes,’ like the decline of manufacturing or the historical legacies of racial discrimination.

Usually pitted against each other, each perspective serves a similar function: letting us off the hook by asserting that there is a deep-rooted, troubling problem — more than one in six Americans does not make enough to afford basic necessities — that most of us bear no responsibility for.”

This kind of thinking lets us feel sympathy – bad for someone – but not empathy – what it could be like to be in another person’s shoes. The two are vastly different. It allows us not to feel anything for those less fortunate than ourselves, especially not the possibility of a shared experience. And then we don’t do anything, because why should we? They made mistakes, we didn’t, and we’ve each faced consequences from those choices.

Except it isn’t like that in real life, at least not for most people I know. Some folks using the food bank can’t qualify for food stamps, because they aren’t poor enough. Sometimes they drive up in a car that looks a little too nice for a food bank user. Did you know if you have a house and a car, you have to list those as assets on a food stamp application?

Some still have jobs – working full time, even, but can’t quite cover the costs of raising children, or medical bills. Some stories go like this: “I worked for 20 years, and then I got (medical condition I couldn’t pay for and/or that forced me to stop working) and I couldn’t get back on my feet.”

One thing most stories have in common is the people telling them never thought they’d be there. They thought it could never happen to them, until it did.

This isn’t a threat. It’s not an admonition to be like me or share my political views. It’s me sharing what I’ve learned over a lifetime of being poor and working with the poor.

Eventually, life happens to everyone – it is the great equalizer. Someday, you might be in the position to not contribute anything. To have done all you can, made all the right choices, and still it happens – the unexpected diagnosis, the request to take early retirement, the days and weeks and years of working two jobs, only to learn your insurance doesn’t cover a fire when you lose your house – then what? No one bears any responsibility for you, do they? Are you still worth something?

Liz Backstrom is a freelance writer for Spokane Faith & Values and works as a grant writer for Second Harvest Inland Northwest. She has a BA in journalism from Western Washington University and an MPA from Eastern Washington University.

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