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Introduction

I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.

 —MAYA ANGELOU

In 2006, Harvard Business School invited me to discuss a case study on Cleveland Clinic. The first session was positive; at the second session, a student raised her hand. "Dr. Cosgrove, my father needed mitral valve surgery. We knew about Cleveland Clinic and the excellent results you have. But we decided not to go there because we heard that you had no empathy. We went to another hospital instead, even though it wasn't as highly ranked as yours."

The student then paused and looked me right in the eyes. "Dr. Cosgrove, do you teach empathy at Cleveland Clinic?"

I was floored. No one had ever asked me that before, so I didn't have much of an answer. Cleveland Clinic had recently adopted an initiative called "Patients First" that focuses on delivering better care to patients and their families. But we didn't yet teach empathy, and we hadn't yet committed ourselves to thinking that much about the feelings of individual patients.

Ten days after visiting Harvard, I went to Saudi Arabia for the inauguration of a new hospital. King Fahd of Saudi Arabia was there. The president of the hospital said, "This hospital is dedicated to the body, spirit, and soul of the patient." I happened to look over and saw the king weeping. Many members of the audience were crying as well.

I thought, "We're really missing something. We need to treat the soul and spirit of the patient, not just the body."

A century ago, when most doctors were solo practitioners ministering to patients, they couldn't offer sick patients many treatments that actually worked. What they could offer was reassurance, comfort, communication, and empathy. By the end of the twentieth century, however, medicine had changed. Teams of highly trained specialists had emerged, delivering complex, effective, technically advanced care. Meanwhile, the human dimension of care had fallen by the wayside. Doctors devoted most, if not all, of their energy to enhancing their ability to heal patients' bodies, not their souls. Hubris and arrogance emerged among caregivers who, ironically, had chosen their careers because they cared about patients as people and wanted to help them heal.

I was as guilty of this as anybody else. When I went to medical school in the 1960s, heart surgery was in its infancy. Up to 20 percent of patients were dying on the operating table. I focused on fine-tuning what I was doing in order to bring down the mortality rate. I didn't spend much time talking to patients or thinking about their feelings. I didn't think about society, the whole patient, or how an organization works. All I did was heart surgery—all ...

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