Table 2 Different faces of empathy

Oncologists

Oncologists did not always find it easy to cite concrete examples of how they demonstrate empathy. Still, they did sometimes mention examples of empathic behavior. Firstly, they could think things through with the patient, but from a medical perspective (e.g., suggesting that a daughter get married earlier so her mother could still attend). Secondly, they could reassure the patient that they would not be abandoned (e.g., telling patients that the medical team would do their utmost). Thirdly, they could state how sorry they feel for patients

And in that way you can give some kind of positive turn to giving that really bad news—because I’d known her for some time, you see. (…) How was it [the wedding, ed.]? It was great. And now she’s going downhill, but she is very grateful to me for saying she should move the wedding forward. (4034)

It’s bad enough having to explain to someone that he is incurable ill, but if you say (…) we’re there for you to tackle problems and answer questions, in short, to support you and help you, that does help a bit. I think people do feel a lot better when they go through that door. (4012)

And certainly if there is anguish, I really feel for them, and I express in words that I empathize with them. (4039)

Patients

Patients spoke in detail about the different forms of empathy oncologists could express, based on realistic foundations. Firstly, they highly appreciated the oncologist thinking things through with them from a medical and a practical perspective: for example, enquiring about the patient’s home situation and whether they need practical help, or trying to think about the best treatments in line with the patient’s preferences

Right at the start our oncologist asked why we didn’t have home help. (…) So the fact that a doctor comes back to it like that, and says ‘think about it – you’re entitled to it’ (…) – that’s really great. But that’s what empathy is – thinking with the other person and imagining what you would feel yourself. (3018)

Secondly, they appreciated it if the doctor showed an interest in the patient and took them seriously, for example sincerely enquiring how patients and their loved ones were doing, asking about specific events such as holidays, considering patients’ thoughts, preferences, or symptoms seriously

We went to see him, and just after the diagnosis my husband got a tattoo, and he noticed. One time he was in the middle of a conversation, then he looks at my husband, and says “hey”, “you didn’t have that tattoo last time”, he says. And those are the kinds of things I think – oh, he sees. And I just like that about him – it’s genuine, and it shows you’re really interested. (3034)

And interest, and takes you seriously, and listens to what you say. Because that is, well, that’s always really important. That you have the feeling the doctor really wants to know how you are and what you think about something. (3018)

Thirdly, patients appreciated it if oncologists took enough time for conversations – especially difficult ones –, or at least gave the impression of having time and expressed a sense of calm

Even if she’s running an hour late, that she still gives you the feeling she has time for you. And that you can ask whatever you want. (…) Yes, she radiates a sense of calm, I feel (3042)

Lastly, they did not seem to expect oncologists to provide specific psychological assistance, which they sought from other sources, such as specialized nurses, psychologists, or fellow patients