The Empathy Exams: Summary & Key Insights

When illness moved from metaphor to intimacy—when I became the one in pain—I began to see the strange choreography of empathy more clearly. My own medical experiences exposed not only physical vulnerability but the moral economy surrounding it: which kinds of pain are believed, which dismissed, who gets to claim the stage of suffering. There were moments when my pain felt like a performance I couldn’t control, one I doubted anyone would find convincing.

Writing about my illness meant confessing not only the pain itself, but my ambivalence about it—how I wanted to be believed, yet feared needing to be. Our culture tends to reward stoicism, even as it sentimentalizes vulnerability. Within that contradiction, patients can feel invisible unless they narrate their pain in the right language. I felt that pressure too. The more I tried to sound authentic, the more artificial I became.

In exploring this dynamic, I started to understand empathy as a kind of mirroring: when someone else acknowledges our pain, they reflect it back to us in a form that validates its existence. Without that reflection, pain can become disorienting, its boundaries dissolving into self-doubt. To truly meet someone else’s suffering requires both imagination and surrender—to enter their story without rewriting it, to resist the urge to tidy what remains chaotic. My own body taught me that empathy can’t be tested or graded like a medical skill; it must be lived in the mess and uncertainty of feeling.

In “Devil’s Bait,” I traveled to Austin to attend a conference for people who believe they have Morgellons disease—a controversial condition marked by crawling sensations under the skin and fibers emerging from wounds. For most doctors, Morgellons is a delusion. For those suffering, it’s a desperate reality. Standing among them, notebook in hand, I faced an uncomfortable question: was I there to witness or to judge?

The essay asks how we extend empathy to others whose pain we can’t verify. Belief itself becomes an ethical act. If empathy requires recognition, what happens when that recognition must bridge the gap between fact and faith? In those hotel conference rooms, I realized that empathy is not agreement—it’s an effort to stay present in uncertainty. To say, I may not understand your world, but I will stand in it with you for a while.

Bearing witness to pain means accepting moral risk. We might be wrong. We might misunderstand. We might project our own desires for meaning onto someone else’s suffering. Yet refusing to witness—turning away because their pain seems inconvenient, unprovable, or grotesque—reveals a deeper failure. Listening, even when skeptical, is an act of respect. It reminds us that empathy begins not with knowledge, but with attention.