“We are instructed about the importance of this first word, voiced. It’s not enough for someone to have a sympathetic manner or use a caring tone. The students have to say the right words to get credit for compassion.”

Jamison outlines the requirements of the empathy exam and establishes the criteria used to assess the correct display of empathy. Jamison is later seen using these criteria in her own life, blending the fact of her life experiences with the fiction of the exam. In this way, she also asks the reader to reflect upon their own criteria for empathy and what is required to achieve it.

“Empathy isn’t just remembering to say that must really be hard—it’s figuring out how to bring the 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.”

Here, Jamison establishes the working definition of empathy that she will refer to throughout her essay collection to explore connectivity through pain. She highlights some of the more difficult aspects of building empathy, noting that the observer’s concerted humility and engagement are required to build that bond.

“You want humility and presumption and whatever lies between, you want that too. You’re tired of begging for it. You’re tired of grading him on how well he gives it. You want to learn how to stop feeling sorry for yourself. You want to write an essay about the lesson. You throw away the checklist and let him climb into your hospital bed. You let him part the heart wires. You sleep. He sleeps. You wake, pulse feeling for another pulse, and there he is again.”

Jamison’s use of the second person point of view invites the reader to explore her emotions with her in this moment of vulnerability. She and the reader attempt to navigate the complexities of letting go of expectations and feeling emotions as they exist and not as they are anticipated to be. When the “checklist” is discarded, there is renewed closeness and healing, making an argument that pre-defined expectations were a barrier all along.