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The Empathy Exams

by Leslie Jamison

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What it's about

This collection of essays explores the difficult labor of empathy, arguing that it is a conscious, intentional choice rather than an effortless instinct. The author examines her own experiences as a medical actor and a traveller to reveal how we can truly witness the pain of others without resorting to sentimentality or theft.

Key ideas

  • Empathy as labor: Caring for others is an act of work and intention, not just a spontaneous emotional reaction.
  • The limits of imagination: Assuming we know another person’s pain perfectly can be as harmful as ignoring it entirely.
  • The nature of trauma: Suffering is rarely contained or clean, as trauma spills over boundaries and defies simple narratives.
  • The ethics of inquiry: Genuine connection requires asking the right questions and accepting that we can never fully understand someone else's horizon.

You'll love this book if...

  • You enjoy essays that blend personal memoir with sharp, critical cultural analysis.
  • You're looking for a more rigorous, honest way to think about how we relate to the suffering of others.

Best for

Readers who want to examine the messy, often contradictory reality of human connection.

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  • Bluets by Maggie Nelson
  • Slouching Towards Bethlehem by Joan Didion

30 popular highlights from this book

Key Insights & Memorable Quotes

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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.
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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.
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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: What grows where you are? What are the laws? What animals graze there?
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No trauma has discrete edges. Trauma bleeds. Out of wounds and across boundaries.
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When bad things happened to other people, I imagined them happening to me. I didn’t know if this was empathy or theft.
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Empathy requires knowing that you know nothing.
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How do we represent female pain without producing a culture in which this pain has been fetishized to the point of fantasy or imperative?
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The pain is what you make of it. You have to find something in it that yields. I understood my guiding imperative as: keep bleeding, but find some love in the blood.
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Pain without cause is a pain we can't trust. We assume it's been chosen or fabricated.
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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.
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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.
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Empathy isn't just listening, it's asking the questions whose answers need to be listened to.
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Metaphors are tiny saviors leading the way out of sentimentality, small disciples of Pound, urging "Say it new! Say it new!" It's hard for emotion to feel flat if its language is suitably novel, to feel excessive if its rendering is suitably opaque. Metaphors translate emotion into surprising and sublime language, but they also help us deflect and diffuse the glare of revelation.
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Bad movies and bad writing and easy cliches still manage to make us feel things toward each other. Part of me is disgusted by this. Part of me celebrates it.
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Empathy isn’t just remembering to say that must really be 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. Empathy means acknowledging a horizon of context that extends perpetually beyond what you can see:
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This is the grand fiction of tourism, that bringing our bodies somewhere draws that place closer to us, or we to it. It's a quick fix of empathy.
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Imagining someone else's pain with too much surety can be as damaging as failing to imagine it.
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Empathy means realizing no trauma has discrete edges. Trauma bleeds.
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Girl gets; girl gets; girl gets. Not that she is granted things but that things keep happening to her, until they don’t—until she starts doing unto others as they have done, hurting everyone who ever hurt her, moving the world with her mind, conducting its objects like an orchestra.
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We like who we become in response to injustice: it makes it easy to choose a side. Our capacity to care, to get angry, is called forth like some muscle we weren't entirely aware we had.
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We want our wounds to speak for themselves, but usually we end up having to speak for them.
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Commonality doesn't inoculate against hurt.
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We care in order to be cared for. We care because we are porous. The feelings of others matter, they are like matter: they carry weight, exert gravitational pull.
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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.
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Empathy is always perched precariously between gift and invasion.
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I think dismissing female pain as overly familiar or somehow out-of-date--twice-told, thrice-told, 1,001-nights-told--masks deeper accusations: that suffering women are playing victim, going weak, or choosing self-indulgence over bravery. I think dismissing wounds offers a convenient excuse: no need to struggle with the listening or telling anymore. Plug it up. Like somehow our task is to inhabit the jaded aftermath of terminal self-awareness once the story of all pain has already been told.
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Bolivian women sewed their lips shut for days. They threaded needles through their skin to stop their speech, to show what good speaking had done them.
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This is part of what we disdain about sweeteners, the fact that we can taste without consequences. Our capitalist ethos loves a certain kind of inscription—insisting we can read tallies of sloth and discipline inscribed across the body itself—and artificial sweeteners threaten this legibility. They offer a way to cheat the arithmetic of indulgence and bodily consequence, just like sentimentality offers feeling without the price of complication.
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She is going through something large and she shouldn't be afraid to confess its size, shouldn't be afraid she's 'making too big a deal of it.' She shouldn't be afraid of not feeling enough because the feelings will keep coming--different ones--for years. I would tell her that commonality doesn't inoculate against hurt.
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Oscar Wilde summed up the indignation: “A sentimentalist is simply one who desires to have the luxury of an emotion without paying for it.
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