The Empathy Exams

by Leslie Jamison

From personal loss to phantom diseases, The Empathy Exams is a bold and brilliant collection; winner of the Graywolf Press Nonfiction Prize.

Beginning with her experience as a medical actor who was paid to act out symptoms for medical students to diagnose, Leslie Jamison’s visceral and revealing essays ask essential questions about our basic understanding of others: How should we care about each other? How can we feel another’s pain, especially when pain can be assumed, distorted, or performed? Is empathy a tool by which to test or even grade each other? By confronting pain—real and imagined, her own and others’—Jamison uncovers a personal and cultural urgency to feel. She draws from her own experiences of illness and bodily injury to engage in an exploration that extends far beyond her life, spanning wide-ranging territory—from poverty tourism to phantom diseases, street violence to reality television, illness to incarceration—in its search for a kind of sight shaped by humility and grace.

Genres: Nonfiction, Essays, Memoir, Psychology, Short Stories, Book Club, Medicine

230 pages, Paperback

First published April 1, 2014

Reviews

[Roxane · Rating 5 out of 5]

This is a really thought provoking essay collection. I particularly appreciated how each of the essays took up empathy in different ways and articulated the challenges of being human while recognizing the humanity in those around us. The last essay, about women and expressions of pain, is a stunner--uncomfortable in its truths, comforting in its empathy. Whether you agree or not with the ideas expressed across these essays, their intelligence and grace are indisputable.

[Bruce · Rating 2 out of 5]

I cannot recover the time I wasted on this book, but I can make sure I never read another book by this author.

The book starts out great, and the first 20% or so of it is has me seeing myself writing a review that says "This book nourished me and made me feel more human." But, before even another 20% had gone by I was ready to throw the book against the wall. Instead of helping me to better understand empathy, it is the most self-serving piece of shit I've read in a long time. The author loves to talk about all she has been through, and that would be fine if it were done in a way that helped us (or even her) learn something from it. Instead, it's just a chance for her to use her past to show off an impressive writing style (being somewhat similar to Marilynne Robinson and Joan Didion). She must have just finished her MFA when she wrote it because it just drips with MFA-ishness: for example, say that "It was like something is XYZ, until it absolutely isn't" and then say that about something else a little later, and then say it again, except reverse the location of the is and isn't, and of course, don't forget to use the f-word, even where it is glaringly out-of-place, because every fucking writer should use the f-word, and be sure to describe the Mountain Dew soft drink as pee-colored. Lots of clever language and prose. Way too heavy on the metaphors, though, to the point of turning them into metafives. Apparently MFAs no longer teach anything about actually engaging the reader and ensuring the reader actually gets something out of the book.

As far as the the writing goes, her style is impressive and enviable, but cold. She accused herself of being a writer of cold fiction. I have not read her fiction, but I can see what she means, if her fiction is anything like her nonfiction.

[Kara · Rating 2 out of 5]

Am I the only person who didn't like this? The more concrete essays (like the one about Morgellons disease or the one about the Barkley Marathons) are quite good. The rest of them are well-written, but I couldn't get past the author's tone. And I can't even quite put my finger on it, but let me try.

Jamison says, "Part of me has always craved a pain so visible--so irrefutable and physically inescapable--that everyone would have to notice."

Pain is a very personal thing, and these are a bunch of essays about different kinds of pain. And no matter whose pain it ultimately is, Jamison finds a way to turn it around and bring it back to her. Even in the Morgellons disease essay, she ends basically wondering if she herself has Morgellons. I didn't care for this. It feels like appropriation.

Sure, Jamison addresses this almost directly in her last essay, and sure, maybe I'm one of those people who don't feel comfortable with the expression of pain, but all that means is that I didn't find the book as enjoyable as I wanted to.

[Rowena · Rating 5 out of 5]

“Empathy isn’t just listening, it’s asking the questions whose answers need to be listened to. Empathy requires inquiry as much as imagination. Empathy requires knowing you know nothing. Empathy means acknowledging a horizon of context that extends perpetually beyond what you can see.” - Leslie Jamison, The Empathy Exams

A few months ago I wrote something in my journal about the lack of empathy I was witnessing in society. It’s something that has been on my mind for a long time, as I observe how people are treated, and how they treat others that are different. I live in a very diverse city with a large multicultural population, as well as a large homeless population. In a city like mine, I believe it’s even more critical we show each other empathy. How can we live otherwise?

The essays in this book in general start from an autobiographical angle but then they delve into something more. Though the diverse situations illustrated in these essays were different from what I would have expected, it was still a very refreshing read for me. Every single one of these essays provided a lot of food for thought, so much so that I’m still thinking about them days after having finished reading them.

In these essays, empathy involves finding oneself in a novel situation, a situation where you might very well be a voyeur, a situation that you might find uncomfortable or difficult to comprehend. But instead of taking away little or nothing, you take away a lot, a deeper understanding of the situation; an understanding of what it might be like to be a prisoner, a prison guard, a doctor, a young adult accused of murder, an artificial sweetener addict, or a self-harmer.

One of the most poignant essays for me was the depiction of the American inner city. I didn’t even know they had “hood tours” and to be honest I found that fact too voyeuristic for my liking, but at the same time I realized I enjoy television shows like “The Wire”, so in a way wasn’t I benefiting from the “allure” of the inner city, albeit from my safe vantage point?

“Scholar Graham Huggan defines “exoticism” as an experience that “posits the lure of difference while protecting its practitioners from close involvement.” You’re in the hood but you aren’t- it rolls by your windows, a perfect panorama of itself. We don’t do drive-bys. You just drive by.”

“You feel uncomfortable. Your discomfort is the point. Friction rises from an asymmetry this tour makes plain: the material of your diverting morning is the material of other people’s lives, and their deaths.”

These essays changed my way of thinking; in fact they changed my image of what a literary essay is as well. I found Jamison to be very insightful, very well-informed, and with a unique voice. Her essays were filled with interesting facts and musings. For example, cutting, or self-harming, was something I wasn’t even aware of until a few years ago. It’s obviously something I don’t understand myself but Jamison calls the whole phenomena of hurting oneself “substituting body for speech.” I found that to be a revolutionary way of looking at it. She went on to say:

“I wish we lived in a world where no one wanted to cut. But I also wish that instead of disdaining cutting or the people who do it—or else shrugging it off, just youthful angst —we might direct our attention to the unmet needs beneath its appeal. Cutting is an attempt to speak and an attempt to learn.”

I also liked her willingness to be open and transparent, even about personal and often tragic things that she herself had experienced.

I can’t even do this book justice. I look forward to reading more of Jamison’s work. Highly recommended.

I’ve added a link to her essay The Grand Unified Theory of Female Pain here: http://www.vqronline.org/essays-artic.... Very timely read considering some of the misogyny that is going on.

[JennyB · Rating 1 out of 5]

Readers seem wild about Jamison’s collection of essays, heaping all sorts of extravagant praise upon this collection. I do not count myself among that number of fans. In fact, after reading something more than half of the book, I feel something curiously close to rage, and definitely identifiable as disgust. Here is a woman who has led a life of incredible privilege – growing up in a glass house in Santa Monica, attending Harvard as an undergraduate, spending a couple of years at the Iowa Writers Workshop, and topping things off with a graduate degree from Yale. And yet, here we read again and again about the deep psychic pain and misfortune she suffers...

Really, Jamison? Really? With your considerable education and intelligence, you can’t think of anything more novel than the Tortured Artist trope? You should be ashamed of yourself.

There is not, of course, any shame in having enjoyed such advantages in life. What is shameful, however, is failing to acknowledge such incredible privilege, and instead focusing on the small measures of pain or disadvantage which one has encountered. It is solipsistic. It is childish. And it is, ultimately, repellent. You got mugged once, a broken nose and a stolen wallet? Really. How unspeakably awful. Good thing there was no weapon, no life-threatening gun shots, no sexual assault. Good thing you were a tourist in the place this awful thing happened, and it wasn’t, like, where you have to actually live your life every day, amidst poverty, danger and others’ unrelenting misfortune.

And that sort of event – where in the grand scheme of a charmed life, even minor mishaps become sources of exaggerated psychic anguish – happens again and again. Witness:

Oh my god, this one time, I was running around in Bolivia, and when I came back, I had this parasite! I mean, I had to go to a DOCTOR, even, to have it removed!!! SO. GROSS.

And then this other time? I went to this gathering of people who suffer from a disease that may or may not be imaginary. I looked in at how this affliction – real or imagined -- has genuinely fucking ruined these people’s lives, but like, after a day, I found their psychological pain and tragedy so, like, exhausting, I had to go sit by the hotel pool. Oh my god, and after? I even imagined I HAD this disease!! Crazy, right?

Then there was this other time I had to have an abortion, and I was like so sad and upset, I totally drank away the pain. For real, I did!

You get the idea. Jamison is supposedly, loosely, writing about empathy, which should be about our own understanding of the pain OF OTHERS. What she’s really doing, though, about 80 percent of the time, is thinking about herself. The subject of herself is so fascinating, she can hardly turn her gaze away. It’s as if she’s turning her own responses to others’ pain over in her hands, like a shiny gem, and marveling at the depth, fineness and endless faceting of her own feelings. And truthfully, that kind of makes me want to punch her, and tell her to pull her head out of her ass.

To inspire a little more aggravation, the book has honest-to-god sentences just like these: “How do we earn? By parsing figurative opacity, close-reading metaphor, tracking nuances of character, historicizing in terms of print history and social history and institutional history...”

Wait, what? Did no one edit this? No note in the margin suggesting this might be a bit thick for a non-academic essay? What IS this woman talking about? But there’s more, of course. A few pages later:

“This is truly the obsequious fruit of child-sized pastorals – an image offering itself too effusively, charming us into submission by coaxing out the vision of ourselves we’d most like to see.”

Speaking of which, here is a vision I would like to see: one of an incredibly intelligent woman and talented writer not being such an immature, self-absorbed narcissist. Readers be warned: that vision is not at all what “The Empathy Exams” offers.

[Julie Ehlers · Rating 2 out of 5]

"I have often found myself in the role that Didion casts aside—the aisle-wandering, detail-pillaging self, who comes for water-purifying tablets and leaves with the price-tagged Cliffs Notes of a country's suffering."

Yeah, no kidding.

There are so many things wrong with The Empathy Exams that it's hard to know where to begin. No matter what topic she chooses, Jamison reveals herself to be either out of touch or out of her depth. "In Defense of Saccharin(e)" and "Grand Unified Theory of Female Pain" both read like college essays; I'm sure she got an "A" on both of them but neither has much to do with how human beings live their lives out here in the actual world. A nearly pointless essay on the Barkley Marathons expects us to be equally as interested in the runners as in whether Jamison's laptop battery will last long enough for her to watch an episode of The Real World: Las Vegas. These are the annoying but essentially harmless essays. (They would have been helped by lovely prose, I suppose, but this book doesn't have that either.)

In another category are the many essays where Jamison dabbles in other people's pain: In Mexico, where she writes about dangerous areas she's never been to and behaves as if rumors are facts. On a "gang tour" in Los Angeles, where she observes herself observing parts of the city deemed violent. At a conference for sufferers of Morgellons, where Jamison fails to navigate the rocky territory of sympathizing with and respecting someone even as you disbelieve what they're telling you. I guess I have to give Jamison credit for constantly giving herself such fine lines to walk, but it's difficult to do that when she fails to keep her balance every time.

Two essays in particular really bothered me. In "Fog Count" she visits a man she knows slightly, who's in prison in West Virginia for some kind of financial fraud. What Jamison hoped to get from this visit is unclear, but she spends a disproportionate amount of the essay talking about the vending machines in the visitors' area and what she and the man she's visiting buy from them. There's the search for quarters for the vending machine, the list of perfectly standard vending-machine snacks that are eventually purchased, the fact that a machine accidentally dispenses two soft drinks instead of one. Those of us who live in the real world where vending machines exist would find all of this unremarkable. Jamison clearly finds it significant, but who knows why. On this same West Virginia trip, Jamison alludes to the ravaged countryside, where the coal industry once dominated but where coal miners are now increasingly irrelevant, but she doesn't examine this countryside, and she doesn't talk to any miners. Instead she repeats a few rumors she's heard (a "Cliffs Notes" version, if you will), talks about vending machines and the Chex Mix and Cheez-Its they dispense, and then leaves with the deluded sense that she's really given us something to think about. All I could think about was the missed opportunity to say something actually meaningful.

The absolute worst was "Lost Boys," about the West Memphis Three—three teenage boys who were wrongly convicted of murdering some other boys, and spent nearly 20 years in prison before finally being released. Jamison makes much of the fact that West Memphis is an economically depressed town at the intersection of two interstates. Isn't it ironic, she says? There are two interstates running through this town, and yet its residents are going nowhere! As someone who grew up in a depressed former coal town where two interstates meet, I can tell you that this supposed irony might make for a fantastic theme for a paper, but it has nothing to do with real life. No one who actually lives in one of these towns considers the presence of interstates ironic. Interstates are everywhere. Further, not everyone in these towns feels trapped. Some expect to leave one day. Some actually do leave. Some are (gasp!) actually happy where they are and want to stay. Jamison would know this if she had talked to some residents of West Memphis. Which she didn't do. Because the entire essay is just a response to watching documentaries about the West Memphis Three. Which she watched as a teenager. While drunk. She seems to be drunk a lot, generally speaking. I gather that's the subject of her next book. My head hurts just thinking about it.

Jamison's problem, which she is weirdly unable to self-diagnose, is that she wrote these essays in her 20s, when she had never done anything in her adult life but go to prestigious schools for undergraduate and graduate degrees. I'm not knocking higher education at all—I'm a fan of it, in fact—and I'm not trying to say that people who've spent a lot of time in school can't have life experience as well. All I'm saying is that Leslie Jamison doesn't seem to have much life experience. That she has chosen other people's pain as her subject matter is problematic. That this essay collection has received so much praise is nothing less than bewildering.

[Lee Klein · Rating 5 out of 5]

The author is a grad school friend who a mutual friend once playfully nicknamed "Exegesis 3000," since LJ reeled off workshop critiques like a supercomputer emitting reams of intriguing data. I was about ten or 12 years older than Leslie when we were at MFA school. Her critical voice at the time maybe sometimes seemed to me like it ran too quickly down the furrows of an elite English Lit education -- you know the way young folk straight outta college sometimes unfurl thoughts in loaded academic language not yet burned off by exposure to post-school existence in a way that older folks -- even those with PhDs -- rarely do? Point is, she was real smart, real young (maybe even < 21?), and a real good writer. Her stories seemed semi-autobiographical at the time, from what I remember often involving young women in trouble -- I think there was a nose job, anorexia, definitely a story involving nonconsensual groping in an alley. I thought she put up perfectly good early drafts of stories etc, but I didn't feel like her fiction at the time fully reflected her intelligence -- it felt like she was out on the highway in second or third gear, when it was clear to anyone who talked to her for a second that she had an intellectual overdrive that once engaged would lay some serious rubber upon ye olde literary speedways. I remember I gave her The Last Samurai because I was like "Helen DeWitt is a supersmart woman who wrote a really good smart novel and might be a suitable role model for LJ" but it's since become clear to me that LJ was always on another sort of track -- one more interested in bodily pain than purely intellectual pleasure (and one that saw beyond simple binaries like body vs mind etc). A year or so after Iowa she killed it with this story in A Public Space -- she'd figured out what she was trying to do, was making great progress down her path. And now with these essays (I'd already read a few in The Believer, A Public Space, Harper's, the Black Warrior Review etc), it's clear she's full throttle. Her writing now seems inhabited by totally individuated intelligence, but also there's a balance of ironic and poetic sensibilities, and a balance of book learning and life lessons. Yeah, there's thematic coherence around empathy, but other than the first essay I didn't feel hit over the head with it -- more so, for me, it was about accompanying LJ, often in journalistic mode, as she wielded considerable powers of perception to bat around varied elements of existence that interested her (her health issues, a syndrome whose primary symptom is formication, an ultramarathoner, Mexican NarcoFlarf poetry, a Bolivian town so high up some people's hearts collapse upon arrival, teaching Spanish to native speaker schoolchildren in Nicaragua, an awesome discussion at one point in the final essay about post-woundedness in "Girls," among a thousand other worthwhile perceptions, including descriptions of food trucks in Austin, Texas). Honestly, I didn't pre-order these essays as soon as I heard about them to learn something about the perma-popular literary buzzword "empathy" (in lit, I find contempt more compelling than compassion). I expected these essays to be pretty great because I'd read a few when they came out and I knew that LJ would be someone whose thoughts -- more so, thought processes -- would be worth following -- her furrows branch all over the place yet things seem irrigated, fruitful, organic -- that's a good word for this, too. Things are carefully crafted yet the sentences and paragraphs develop naturally -- that is, the structures don't seem artificially/forcefully imposed. She's willing to get out of the way and let the language go where it needs to go. Something I also really liked: she's willing to focus on her awareness of what she's doing without falling into annoying meta loop-de-loop vortices. Ultimately, it's more about valences than vortices for LJ. She's bonding disparate bits, proposing a grand unified theory of female pain as perception-enhancing textual experience, a shattered window looking out on the world as a whole.

[Tara · Rating 2 out of 5]

Something that's been weighing on my mind for the past few years is the severe lack of empathy I see in the world - just observing how people treat and think about others. This book seemed great.

I'm not sure this collection of essays was about empathy, though. Every one of these essays is about pain. But no matter whose pain it is, the author turns it around and makes it all about her. To Jamison, empathy is about interpreting someone else's story by inserting one's own pathetic life experiences and injecting it with narcissism. The narcissism I can deal with, but claiming that to be empathy really grated on me. Maybe it's just because I tend to be empathetic to the extreme, but I did not see anything that constituted empathy in the author's writing - just claims of it.

Jamison is a very talented writer, no doubt, and the book started off okay. Then she butts in with her first instance of "You know, I suffered too." In the third chapter, she dragged me through thesaurus hell, using every trick in her book to assure the reader she's been to Harvard, Yale, and the Iowa Writer's workshop. The rest of the book is littered with more stories of the author's hardships. Did you know that the author is skinny? Because she is, and she totally suffered for it. She was also promiscuous, and life was so hard. Et cetera.

There were so many missed opportunities within each essay's subject to have meaningful conversations about empathy, and it was irritating to recognize those missed opportunities and instead read as the author made everything about herself.

[Thomas · Rating 5 out of 5]

"Sure, some news is bigger news than other news. War is bigger news than a girl having mixed feelings about the way some guy fucked her and didn't call. But I don't believe in a finite economy of empathy; I happen to think that paying attention yields as much as it taxes. You learn to start seeing."

I did not love every essay in this collection, but the ones I did love, I would give six, seven, or ten stars. I came in as a skeptic: how could this one person, Leslie Jamison, capture the essence of empathy? How could she manage to write about such a mysterious, powerful, and often misconstrued emotion, even with her Harvard degree and her MFA from Iowa? As an aspiring psychologist who values empathy more than anything else, I wanted so much from The Empathy Exams, so much that I curbed my expectations even before starting the book. But I ended the book with only good news: that Jamison delivers, and she does it well.

"Empathy isn't just something that happens to us - a meteor shower of synapses firing across the brain - it's also a choice we make: to pay attention, to extend ourselves. It's made of exertion, that dowdier cousin of impulse. Sometimes we care for another because we know we should, or because it's asked for, but this doesn't make our caring hollow. This confession of effort chafes against the notion that empathy should always rise unbidden, that genuine means the same thing as unwilled, that intentionality is the enemy of love. But I believe in intention and I believe in work. I believe in waking up in the middle of the night and packing our bags and leaving our worst selves for our better ones."

Jamison delves into empathy across several unique situations: her time as a medical actor, when she got punched in the middle of Nicaragua, a sadistic trial known as the Barkley Marathon, the pain of womanhood as a whole. She analyzes these experiences with a powerful blend of fierce insight and vulnerability. Jamison approaches tough topics - Morgellons disease, imprisonment within the justice system - in a way that shows her intellect while honoring her humanity. The theme of empathy soaks into each of these short essays, the emotion sometimes small, sometimes large, but always there.

"Empathy isn't just remembering to say that must be really hard - it's figuring out how to bring difficulty into the light so it can be seen at all. Empathy isn't just listening, it's asking the questions whose answers need to be listened to. Empathy requires inquiry as much as imagination. Empathy requires knowing you know nothing."

Even though I did not agree with all of Jamison's ideas (in particular her essay "In Defense of Saccharine"), I clung to her every word, riveted by her logic and her ruthless self-examination. Her last essay about her grand unified theory of female pain blew me away, as it integrated feminism, history, empathy, literature, and so much more into a painful and poignant message of hope. And when she quoted Caroline Knapp, whose memoir about anorexia tops my favorite list, I knew Jamison had her bases covered.

I would recommend this book to anyone who wants to be a better human, to anyone who wants to read about a woman's attempt to be a better human. I will end this review with the closing lines of the collection, just because I hope the strength of Jamison's conclusion will motivate someone to read the book in its entirety.

"The wounded woman gets called a stereotype and sometimes she is. But sometimes she's just true. I think the possibility of fetishizing pain is no reason to stop representing it. Pain that gets performed is still pain. Pain turned trite is still pain. I think the charges of cliche and performance offer our closed hearts too many alibis, and I want our hearts to be open. I just wrote that. I want our hearts to be open. I mean it."

[Nethra Ram · Rating 1 out of 5]

The first chapter of this book is sublime. The medical acting part of it, and the actual context of empathy reach out to you and make you think from different angles. Then, the author steps in and tells you 'You know, I suffered too...' and you feel something going wrong. Maybe chapter 2 will rectify that, you assume. Chapter 2 stuns you, the concept and the facts, the writing not so much, but it is atleast understandable. Again, the author butts in, telling you she's worried she might have the disease she just wrote about. You smell smoke and you are annoyed with her. What's her problem, you wonder.

Then chapter 3 happens and all goes to hell . She drags you through Dante's version of thesaurus hell, using every trick in her book to tell you she's been to Harvard, Yale, the Iowa Writer's workshop and hence the need to write in such a way that makes no sense, leaves every single sentence independent of each other and the entire content pretentious, insincere and incomplete. Does this stem from a need to be rash and abstract in order to make people go hunting after meaning and hence achieve immortality in prose? If these are non-fiction accounts, why not make them sensible? Why make them hazy and stranded somewhere between comprehension and poetry?

Add to all this the author's chronic need to insert herself into every story and tell you she suffered. Its her suffering too. Too much she has suffered and hence please excuse the rambling. Well, my bad for expecting something good. The book has absolutely no structure and the title does not map to the themes discussed. They are not clearly presented anywhere except for the 1st half of the 1st chapter. They do pop in now and then everywhere like a kaleidoscope pattern rearranging itself, but have no impact and make no sense. Put your time to better use.

[Melanie · Rating 5 out of 5]

"She wants an empathy that arises out of courage, but understands the extent to which it is, for her, always rooted in fear. Imagining the pain of others means flinching from it as though it were our own, out of a frightened sense that it could become our own. She refers to psychological studies in which fMRI scans have observed how the same kind of brain activity is provoked by the observation of other’s physical pain as by the experience of one’s own. She says that she feels heartened by this instinctive identification, but wonders what it might finally be good for. Much of the intellectual charge of Jamison’s writing comes from the sense that she is always looking for ways to examine her own reactions to things; no sooner has she come to some judgment or insight than she begins searching for a way to overturn it, or to deepen its complications. She flinches, and then she explores that flinch with a steady gaze."
Mark O'Connell for Slate

Of all the reviews I've read about this phenomenal collection of essays (part memoir, part journalism, part travelogue, part philosophical treatise), Mark O'Connell's in Slate was the only one to put its finger on one of the essential qualities that make these essays astounding and one of my favorite features of this book: Leslie Jamison's dazzling (yes, the superlatives abound here and so be it) mind constantly oscillates between fierceness and vulnerability. If the main theme is that of empathy, there is also a constant search on her part for absolute truthfulness in her accounts of encounters, emotions, events and intellectual musings.

The level of observations and reflections, of intellectual and emotional involvement in the stories of others, is on par with the few essays I've read by Joan Didion, David Foster Wallace, Mark Slouka, George Packer and Rebecca Solnit.

A book that defies characterizations. A book that is relentless in its honesty and willingness to dive in, to go deep, to dwell where it hurts, whether real or imaginary. Trust the words of Mary Karr: "This riveting book will make you a better human."

A humbling and and transformative reading experience.

Read the entirety of Mark O'Connell's review here:
http://www.slate.com/articles/arts/bo...

[Trevor · Rating 2 out of 5]

I am not sure what to say about this book. Do you know how they say that you can’t judge a book by its cover? And how that’s exactly what we do all the time… Well, I don’t think it is unreasonable to judge a book by its title. Which is much of the reason why I read this one. I thought this was going to be about a woman telling me what it’s like to be a medical actress – someone who is given a script about an illness she’s meant to have and to tell us how that plays out with the almost, very nearly doctors who are sitting an exam to test their diagnosis and empathy skills – the doctors have to verbalise their empathy, not just give you a nice nod and a reassuring look. And it sort of was about that – for the first essay, anyway – but then it wasn’t for almost all of the others. Much of the rest of the book is more ‘let me tell you about the medical procedures I’ve had’ – which is fine, but essentially the opposite of ‘empathy’, unless by empathy you mean, ‘I’m going to teach you, dear reader, to be empathetic with almost exclusive reference to my own trauma’. Empathy from others, rather than for them…

This wasn’t always true – the people with the cords growing out of their skin was closer to what I was expecting the book to be about – but I’d have put that essay closer to the end, away from the first one – to distract from how ME centred the other essays are.

So, now I wonder if I found this book less than I was hoping because I’d been primed to anticipate a book I actually wanted to read while being tricked into reading a book I simply wouldn’t have. You know, like buying a book called ‘Photographs of Human Emotions’ and finding every photo is of the author, ‘this is me smiling, this is me frowning, this is me…’ I became cynical towards the end, wondering if the last essay was written in anticipation of my response – ‘how come this is another essay about YOU?’ With the author saying, ‘look, other boys have read my stuff and have learnt to be more empathetic as a consequence – what’s the matter with you, McCandless?’

Don’t get me wrong, bad shit has happened to this writer, there is no doubt about it. And I felt sorry for her repeatedly throughout. But…

Recently, an Australian politician was forced by his political party to undergo empathy training. He had been accused of up-skirting a young woman and of harassing two other women on social media. He said, after the training, that it had been a real eye opener for him. He said his problem had proved to be that he was cursed with an excess of empathy, and it was this super-over-abundance of empathy that had gotten him into so much trouble, something, he now realises, has been a tragically misunderstood theme throughout his life. I couldn’t help thinking about him while reading this book. ‘Are you seriously telling me about your broken nose again?’

I put my response to this book down to unmatched expectations – I was told I would be drinking tea while being given coffee.

[Debbie "DJ" · Rating 2 out of 5]

Yup, I'm going to do it. Two stars. I just cannot wrap my brain around many of these essays. It started out really good, but fell off the edge for me around 20%. I struggled through the other essays, and liked the last, but the rest hurt my head.

Here's an example from an essay on sentimentality...
"In another 'In Defense of Sentimentality' philosopher Robert Soloman responds to thinkers like Jefferson and Tanner, testing out the differences between distinct critiques of sentimentality that often get lumped into a single campaign. Is the problem of sentimentality primarily ethical or aesthetic? Solomon paraphrases Tanners argument that 'sentimental people indulge their feelings instead of doing what should be done' and cites the example of Nazi commander Rudolf Hoess, who wept at an opera staged by concentration camp prisoners. Perhaps this wasn't simply ironic but casual:"

I see a lot of good reviews for this one, so maybe it's just me. While I do find the topics interesting, I have no desire to dig so deeply into them.

[Oriana · Rating 5 out of 5]

This book was kind of a big deal last year, receiving glowing accolades from everyone from NPR to Flavorpill to Slate to the New York Times, so I was well primed to love it. And while that often ends very badly for me (looking at you, Swamplandia and Woke Up Lonely and The Particular Sadness of Lemon Cake ), for once thank god it did not.

This is a wildly varied exploration of really diverse topics by an incredibly smart writer and thinker. I was nearly as awed by her choices of subject matter—bizarre ultramarathons, the time she was mugged in Nicaragua, a defense of saccharinity, diseases that may or may not exist, and medical acting, to name only a few—as by the connections she draws and the thoughtlines she pursues. These essays are both meanderingly philosophical and deeply personal, and the majority revolve around themes of pain (physical, emotional, mental, whatever), the desperate need for connection and the despair of being misunderstood, the abilities of the body to withstand awful things (both self-inflicted and not), and the impossibility of / desperate need for empathy.

Leslie is incredibly well read, quoting everyone from Carson to Tolstoy to Didion to Vollmann. She brings in so many disparate sources, finding material to riff off of from obscure neuroscience journals and Ani DiFranco albums and a documentary about murdered children in Arkansas. She connects a part-time gig pretending to have various ailments to test doctoral students with a time she got an abortion, draws parallels between Frida Kahlo and James Agee, has a long relationship with a West Virginia white-collar convict and visits a silver mine in Potosí, Bolivia.

She says things like: "Sentimentality is an accusation leveled at unearned empathy" and "I wish I could invent a verb tense full of open spaces—a tense that didn't pretend to understand the precise mechanisms of which it spoke" and "The grand fiction of tourism is that bringing our bodies somewhere draws that place closer to us, or we to it."

I took a long time with this book, and have referenced it often in conversation, during and since. I loved it so, so much.

[Cheryl · Rating 4 out of 5]

When we hear saccharine, we think of language that has shamed us, netted our hearts in trite articulations: words repeated too many times for cheap effect, recycled ad nauseam. Ad nauseam: we are glutted with sweet to the point of sickness.

There are writers who have the gift of the essay gab, words strewn together into the kind of texture that produces hard-hitting language. Such writers have the talent to continue this personal-philosophical literary tradition started by the likes of Fitzgerald, Turgenev, Montaigne, Orwell, Borges, Hazlitt,Didion, Baldwin, and Ginzburg. Leslie Jamison is that writer. I daresay that one of these essays will be published in the next highly acclaimed personal essay anthology (hopefully one akin to The Art of The Personal Essay??).

If sentimentality is the word people use to insult emotion--in its simplified, degraded, and indulgent forms--then "saccharine" is the word they use to insult sentimentality.

If she isn't defending saccharine, she is taking pain tours or examining empathy in this book. Empathy: that thing that society seems to have trampled upon and called weak. Must we only empathize when others endorse it? Shall we choose to like or understand someone simply because the crowd has deemed it appropriate to do so? Can we try to understand the pain of others?

Empathy comes from the Greek empatheia--em(into) and pathos (feeling)--a penetration, a kind of travel. It suggests you enter another person's pain as you'd enter another country, through immigration and customs, border crossing by way of query.

I love reading personal essays because it is an art form that is memoir, yet distinct in its tone and structure. The essayist is a philosopher, a whiner, a searcher, an educator, and a person trying to make meaning of this thing we call life. What's intriguing is that all of this meaning sought is mirrored in the form of this literary art: it starts strong, wavers a bit as the essayist searches for truth, and it doesn't seek to give you any answers. Emboldened. Unmoved. Transparent. Calls to mind Mark Haliday's "The Arrogance of Poetry".

The anti-sentimental stance is still a mode of identity ratification…it's self-righteousness by way of dismissal: a kind of masturbatory double negative.

Jamison goes to the core of empathy in this book, delving into the good and bad kinds of empathy. It is contemporary philosophical meandering. "The Empathy Exams" was by far my favorite essay in this collection, followed by "In Defense of Saccharine" and "Devil's Bait." I read and re-read those essays, wading in their nuance and clarity and just plain and simple forthrightness. It was the power of those beautiful words that made the other essays pale in comparison.

I needed people to deliver my feelings back to me in a form that was legible. Which is a superlative kind of empathy to seek, or to supply: an empathy that rearticulates more clearly what it's shown.

Classic in its delivery, modern in its form, quirky in its appearance. I had the chance to hear Jamison read from this work and as I stood in line to talk with her and get my copy signed, I remember thinking to myself, she is about as quirky (this is a good thing), kind, inquisitive, approachable, and unapologetic as her collection.

I want us to feel swollen by sentimentality and then hurt by it, betrayed by its flatness, wounded by the hard glass surface of its sky.

[Rebecca · Rating 3 out of 5]

I didn’t enjoy this essay collection nearly as much as I expected to. I liked the medical-related pieces – attending a Morgellons disease conference, working as a medical actor – but not the Latin American travel essays or the character studies. The overarching theme of empathy was not as strong as I thought it would be; really, the book is more about how experiences mark the body. In Jamison’s case, these include an abortion, heart surgery, and a broken nose from a mugger’s attack in Nicaragua. I find it hard to pinpoint why I never warmed to Jamison’s writing, but many of these essays struck me as digressive, too cleverly structured, and too obvious in their literary debts (e.g. to Susan Sontag or Lucy Grealy). Two similar books I would recommend over this one are The World Is on Fire by Joni Tevis and On Immunity by Eula Biss.

[Shawn Mooney (Shawn Breathes Books) · Rating 2 out of 5]

First, the good news: Leslie Jamison is an amazing writer. There are literally hundreds of breathtaking sentences, passages, and insights here. She's also a talented essayist: her essays about being a pretend-patient-actor for med student training, about attending a conference of Morgellons sufferers, and the one about the bizarre Barkley Marathon, were as polished, memorable, and brilliant as any I've read in years and years and years.

The bad news is, I join the sizable minority of readers who deem this essay collection to be a complete and utter failure. Perhaps her topic - empathy - simply cannot be successfully explored by any writer in the form of the personal essay, which is by its very nature self-focused? I don't think so. She herself does an amazing job in two of the three essays mentioned above. (There's almost no relationship between her overall topic, empathy, and the marathon essay.)

No, the problem here as I see it is that this particular writer cannot stop gazing at her own navel when she's purportedly practicing or reporting on her empathy towards others. She has had some difficult experiences in her life, and when those experiences fit in with - rather than overwhelm - the essay topic at hand, such as the one about the med school training, it's magical. But her self-preoccupations infect almost every other piece in the collection; she can't seem to stop herself from inserting the most unbelievably jarring me-me-me digressions into the midst of essays about the deeply traumatic experiences of others, experiences with which she is supposedly trying to empathize!?!?

This tendency started rubbing me the wrong way fairly early, but I was carried along by the few narcissism-free essays and by the delightful prose; it was her essay about some wrongfully convicted boys made famous by a multipart documentary that finally made me blow my top. There were way, way too many I's, myself's, and me's for her to feign anything remotely approaching empathy for them. The narcissistic gall, to keep turning away from these boys's ordeal to exclaim in paragraph-length digressions, Here I am, empathizing, which reminds me of this bad thing that happened in my past, oh, and I remember empathizing with them 10 years ago, too, which reminds me of another bad thing that happened to me: look, look at me!

I was so turned off from then on that I wasn't able to judge the lengthy, final essay: I suspect it might have been one of the great pieces, though. But I was basically hate-reading by that point. I will wait a year and then go back and reread that last one.

Reader friends who I greatly respect adore this book. That's so great! Despite Jamison's abundant writing talents and the couple of wonderful essays, though, this was a bitterly disappointing and infuriating reading experience for me. Different strokes for different folks, right?

Were I the one grading these so-called empathy exams, it'd be an F.

[Rachel Aloise · Rating 3 out of 5]

Disappointed to be more annoyed than anything else by Jamison’s explorations into empathy. Her understanding of pain seems to concentrate largely on her own physical injuries and on each and every slight she has suffered in her personal life. The sense that empathy requires a minimum of humility appears to be entirely absent from these essays.

During the final piece, the ‘Grand Unified Theory of Female Pain’, I found myself repeatedly leafing through the pages to see how many numbered #wounds were left to go… I got tired of the extreme positions, between ironic detachment and avid entitlement. Her argument leaves no room for a more nuanced view on gendered constructions of pain, in itself a fascinating topic.

Leslie Jamison is undoubtedly a very talented writer. But despite the elegant prose, I didn’t care for the sensational subject matter in many of these essays. (‘morgellons’ disease, poverty tourism, crime in ‘Lost Boys’, an essay that I couldn’t finish, too lurid for my taste) Perhaps this is a current trend in creative nonfiction that I am too old (or too squeamish) to appreciate.

[Suzanne]

I gave this every opportunity to win me over, but at 120 pages out of 218, 6-1/2 essays out of 11, I’m throwing in the towel. I was slogging through, hoping at least one of these essays would click with me, and might have finished the collection if I’d had any encouragement at all, but this completely failed to impress, entertain, enlighten or stimulate me. I have to say I'm puzzled by the accolades and acclaim. Her prose isn’t bad, she can turn a phrase, but too often those phrases didn’t seem to clarify her points as much as exist for their own sake. And thematically, the point, in main, is plainly about the pain. Empathy seemed to be an afterthought rather than the unifying theme, rendering the whole thing pretty depressing.

I don’t want to be too harsh and I wouldn’t discourage anyone from trying this, if they want to see, as I did, what the fuss is about. But I can’t recommend it based on my experience.

[Ellen · Rating 4 out of 5]

The Empathy Exams: EssaysReview to follow by Leslie Jamison is a collection of essays examining empathy-what it is, what its risks may be (for example: is it empathy or is it stealing someone else's feeling?), what prevents it ("They don't have much energy left over for compassion). Jamison freely draws on her own life experiences.

My overall sense of the essays is that they are astounding-enlightening and exciting. There were some I liked better than others but all of them had striking moments. In the title essay, Jamison analyzes her experiences as a medical actor in which she plays patients with various illnesses and evaluate the treating physicians for the level of empathy shown. I found this essay both hilarious and fascinating. I was intrigued by the fact that the medical students are judged not so much for tone of voice but by the actual words they use. There is a kind of formula for professional empathy and avoiding the traps of "comments that feel aggressive in their formulaic insistence." What seems to lead most directly to an empathy that feels comfortable for the person it is directed towards (or felt for) is a kind of humility and an act of imagination.

This essay also talks about the idea that "empathy is always perched precariously between gift and invasion." I also love this definition of empathy: "Empathy means realizing no trauma has discrete edges. Trauma bleeds. Out of wounds and across boundaries....It suggests you enter another person's pain as you'd enter another country, through immigration and customs, border crossing by way of query..."

I don't know where to stop with this book. I want to quote endlessly from every essay, whether it is the plea for empathy made by the reality television show "Intervention" in which the "warning...is also a promise" of disturbing language and subject matter. Or the one about James Agee and his Let Us Now Praise Fmous Men which has as its subject the "endlessness of labor and hunger....a story that won't end." Empathy is, Jamison says, contagious and Agee has caught it and "passes it to us," something which Jamison seems to be attempting with every essay.

My favorite essay (a strange way to identify something that I reread three times and was completely blown away by) is the final one, "Grand Unified Theory of Female Pain," in which Jamison takes on the challenge of how female pain is perceived by both women and men, the reaction against traditional fetishizations of female suffering leading to the current anger at women who seem to perform their pain and an uncomfortable, distancing irony about one's own pain.

Jamison makes a plea for the courage to empathize with pain that may be performative, that pain is real and that the story doesn't have to end there but can continue to include its healing. I was very moved by the idea that "Pain that gets performed is still pain" and deserves our compassion. That, in fact, human beings deserve and need compassion in order to live and to heal. Jamison cites works such as Lucy Grealy's Autobiography of a Face (a work I love which is apparently disparaged because Grealy doesn't seem to be brave enough not to care about being disfigured), works like Stephen King's Carrie and poet Anne Carson's Glass, Irony and God (another favorite work of mine) and musical and dramatic works by Tori Amos, Ani DiFranco, Guns N'Roses, La Boheme, and (of course) Tennessee Williams' A Streetcar Named Desire with it heroine who is the epic suffering woman.

I felt like a part of myself that I was afraid of, distanced from, cut off from was freed to come into the light and perhaps be given a space. We all suffer but I do think as a woman I am particularly determined not to be jeered at for being in pain. I can remember in my 20s being confused by hearing man ridiculing women frequently enough that I was both enraged and terrified by it. I have struggled with wanting to be seen as "tough" while also being a compassionate human being. Maybe tough is over-rated.

Every essay made me think and then think harder. Jamison is brave in sharing her own struggles and ruthless in analyzing her relationships with others.

Definitely a book to read.

[Maxwell · Rating 4 out of 5]

4.5 stars

Leslie Jamison pokes and prods at empathy from a variety of angles in this collection of essays. She examines how we ignore others' pain, how we erase others' voices, how we need to listen, how we fail at recognizing our own pain at times even when it's right in front of us.

What I find so enjoyable about these essays were their ability to completely entrance me. Jamison writes on a variety of rather obscure or oddly specific topics at time that would seem uninteresting or irrelevant if it weren't for her prose. She writes with conviction, honesty, and a voice that is fresh, snarky, and bold. Though I know nothing about her as a person or essayist, I believe what she writes. This small sampling of her writing leaves me wanting more; hers is a career that I am sure to follow.

My favorite essay was by far "Lost Boys." She retells the story of three young men convicted of the murders of three boys in their community. Rather than address it from a journalistic POV, simply relaying details of the case, Jamison follows the different people involved, the context, and the outcome with empathy. She shows you the people as they are, not how they are portrayed by the media.

I also really enjoyed her "Pain Tours" essays in which she writes briefly about different aspects of human life in which we get a sort of sick pleasure out of witnessing another person's pain.

I think these essays are important to read. They are insightful, impactful, and extremely convicting. Empathy is a topic that can easily be glossed over, but in each and every one of these essays Leslie Jamison examines just how important and central a role empathy plays in our lives, and why we must listen.

[McKenzie Richardson · Rating 5 out of 5]

I got my hands on an Advance Reader's copy of this book and words can almost not describe how thrilled I am that I did. Beautifully-written as much as it is thought-provoking.

I will confess that I hate emotion; I hate expressing it, I hate the awkwardness of not knowing how to react when others express it, and most of all, I hate reading about it. However, Leslie Jamison completely changed my response to emotion. This compilation of essays takes emotion and empathy and spins it in a new way, demonstrating a deep understanding on an unknowable topic. She shows the importance and necessity of empathy as well as emotion. I felt personally connected to Jamison as she described pains in her life and at times it was almost as if she were speaking from my own mind. Whether it was breakups, getting punched in the face, skinning her knees, eating disorders, an abortion, or cutting, I was just as connected with her during the pains that I myself had experienced as with those I have not. Jamison invites the reader into her own life so openly, that it is difficult to not be drawn in by her words.

I absolutely loved this book. Even if you don't read all of the essays, I would highly suggest reading, "The Empathy Exams", "Pain Tours (I)", and "Grand Unified Theory of Female Pain", all of which were simply amazing. This book was absolutely perfect.

[Marjorie Ingall · Rating 3 out of 5]

The first essay, about being a medical actor, is a tour de force. WOWZA. It truly is about empathy, and human interaction, and literally embodying someone else's suffering, and it's told with humor and compassion. It was a serious BOW DOWN MOTHERFUCKERS feat of writing.

But then the conceit that each section was about empathy started to feel increasingly forced to me. As the book went on it seemed like a strained framework serving only to keep the book from being straight-up memoir-meets-stunt-journalism -- and the poetic voice started to feel too performative and self-conscious. There were essays, such as the one about a possibly phantom illness called Morgellons, where Jamison almost seemed snarky -- the opposite of empathetic, and while wearing this strange, ill-fitting mask of sympathy and arty writing. I wanted to shake her into directness -- being elliptical and lyrical there just felt like inappropriate *withholding*: LOOK AT ME DO MY FANCY WRITING DANCE, at the expense of other people's pain.

But oh. That first essay.

[Ami · Rating 5 out of 5]

Empathy is something I spend a lot of time thinking about. One of my favorite quotes from Riot Grrrl extraordinare Kathleen Hanna is "be as vulnerable as you can stand to be," which is sort of the core of empathy but also speaks to how it can be a double-edged sword. By being open you can see and accept the flaws of others much more easily, but you're also making yourself more exposed and easily hurt.

Leslie Jamison's essays expose over and over again that core truth. She comes at it from a number of angles, discussing her work as a pretend patient teaching doctors how to diagnose, her brother's adventures in hyper-marathoning, and the ways empathy for the female body have evolved in culture. This push and pull--the desire to be open enough to truly know others, vs the desire to protect yourself--comes up in nearly all the essays. Jamison has no qualms about using herself as a subject, and I found her to be a fascinating character to spend time with.

Highly recommended.

[Audacia Ray · Rating 1 out of 5]

The capacity for empathy is a major thing in my life and work, so I was really interested in this book's premise and ideas, but HELL NO. The writer tangles with empathy in both concrete and abstract ways, but the classism and racism of her perspective and insights run deep.

There is, in fact, only one essay that explicitly includes people of color, and it is an essay about the author taking a Gang Tour of LA in an air conditioned bus - which she identifies as a thing that has an uncomfortable dynamic (!!!!) but doesn't take it farther than that.

In two other essays, she writes about men in prison and they are all white men who are in exceptional circumstances - a rich white collar criminal in prison for fraud and the West Memphis Three. Why explore empathy for uncommon incarcerated people instead of digging into what it means and looks like to have empathy for the millions of men of color who are incarcerated in the US? Another essay is about empathy for the pain that (mostly) men experience when running the Barkley Marathons, an ultramarathon in the wilds of Tennessee, a race *inspired by the prison break of Martin Luther King, Jr's assassin.* So, she writes about empathy for the pain experienced by white men running an ultramarathon in the terrain around a prison, no comment about the literary implications of running near a prison or the racist inspiration of the thing.

Oh, but the book is not all about men and feeling for them! The writer feels for herself and (her definition of) women a lot. The first essay, about medical acting and also having an abortion, is actually quite good. But the final essay in the collection is called "Grand Unified Theory of Female Pain." The examples of female pain are, unsurprisingly, white and cisgender.

So, fuck this book and fuck the New York Times Best Seller label on it. Empathy for middle class white people in extreme situations is not a thing that "will make you a better human" as Mary Karr's blurb on the cover says. It will make you a worse human.

[Lauren · Rating 4 out of 5]

I missed the buzz on this book back in 2014, and came to Jamison through her contribution to an amazing anthology I read (and adored) last fall, Love and Ruin: Tales of Obsession, Danger, and Heartbreak from The Atavist Magazine. Her essay in that book was so brilliant that I sought out more work by her.

This thread of empathy, pain, and loss is palpable in each piece. I read this one relatively slowly, contemplating the essays, and sharing the themes with some of my friends, spurring some interesting conversations and anecdotes.

Just shy of a perfect 5 stars. I hope to see much more from Leslie Jamison.

[dc · Rating 5 out of 5]

Here's the thing essayists everywhere: Jamison is either wiping the floor with your ass right now, or she's coming for you. This woman can write.

[jeremy · Rating 5 out of 5]

war is bigger news than a girl having mixed feelings about the way some guy fucked her and didn't call. but i don't believe in a finite economy of empathy; i happen to think that paying attention yields as much as it taxes. you learn to start seeing.

leslie jamison's the empathy exams is an absolutely remarkable collection of eleven essays. through subjects as varied as medical acting, morgellons disease, poverty tourism, a 100-mile marathon of sadistic proportions, the west memphis three, prison life, and female pain, jamison explores not only empathy itself but also the capacity for and necessity of identifying with and sharing in the feelings of the other.

incisive, astute, and self-reflective, these essays are not only absorbing, they are also impressively crafted - in both style and prose. jamison's writing is simply magnificent; a gift that would allow her to make even the most inane subject endlessly fascinating. while not a perfect collection, there isn't a single uninteresting piece to be found. the empathy exams's finest entries are the title essay, "devil's bait," "lost boys," and the poignant "grand unified theory of female pain." there may not be a more resplendent collection of essays published this year - and surely not one possessed of as much candor, compassion, and cultivation.

what good is this tour except that it offers an afterward? you're just a tourist inside someone else's suffering until you can't get it out of your head; until you take it home with you - across a freeway, or a country, or an ocean. no bail to post: everything lingers. puppet lingers. those clapping seventh graders linger. your own embarrassment lingers. maybe moral outrage is just the culmination of an insoluble lingering. so prepare yourself to live in it for a while. hydrate for the ride. the great shame of your privilege is a hot blush the whole time. the truth of this place is infinite and irreducible, and self-reflexive anguish might feel like the only thing you can offer in return. it might be hard to hear anything above the clattering machinery of your guilt. try to listen anyway.

[Lyd Havens · Rating 5 out of 5]

I don't know if I can say that I've read "a lot" of essay collections in my life so far, but right now I feel confident enough to say that The Empathy Exams is one of the best I've ever read. It feels bizarre to praise a nonfiction author for being honest (like... duh?), but empathy as a concept can be a slippery slope & Jamison isn't afraid of attempting to slide all the way down. Jamison is okay with letting readers know when the empathy she exhibits for people involved in these essays (such as a man whose skin condition has gone undiagnosed & almost mocked by medical professionals for years, or an acquaintance in prison) evolves into something self-serving, or even invasive. This is to say: in a book about humanity, she does not shy away from being human. Not to mention, her writing is precise & crystal clear, & I was left awestruck by the ways she could bring certain ideas/quotes back in an essay twice, three times, even four, & it never felt repetitive. Nearly two years after reading the titular essay in a creative nonfiction class, I'm so glad I finally pushed myself to read the whole collection. I'll be thinking about this for a long time.

[Connie G · Rating 4 out of 5]

The Empathy Exams: Essays is a collection of intelligent, thoughtful essays about understanding pain in ourselves and others. Leslie Jamison writes about a wide range of physical and emotional suffering with great insight. Essays include subjects such as her experiences as a medical actor training medical students, observations in impoverished communities, abortion, incarceration in the West Memphis Three case, the ultramarathoners at the Barkley Marathons in Tennessee, a Morgellon's convention, Frieda Kahlo, heartbreak, anorexics and cutters. The essays combine her own and others' experiences, and delve into social and philosophical issues. She refers to other literature such as James Agee's "Let Us Now Praise Famous Men," and works of Susan Sontag and Joan Didion. Jamison writes, "Empathy isn't just something that happens to us--a meteor shower of synapses firing across the brain--it's also a choice we make: to pay attention, to extend ourselves."