Instead of identifying with my panic...he was helping me understand that evening this...would be okay. His calmness didn't make me feel abandoned, it made me feel secure. It offered assurance rather than empathy, or maybe assurance was evidence of empathy, insofar as he understood that assurance, not identification, was what I needed most. Empathy is a kind of care but it's not the only kind of care, and it's not always enough. I needed to look at him and see the opposite of my fear, not its echo.

I needed people – Dave, a doctor, anyone – 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 re-articulates more clearly what it’s shown.

Part of me has always craved a pain so visible – so irrefutable and physically inescapable – that everyone would have to notice. But my sadness about the abortion was never a convulsion. There was never a scene. No frothing at the mouth. I was almost relieved, three days after the procedure, when I started to hurt. It was worst at night, the cramping. But at least I knew what
I felt. I wouldn’t have to figure out how to explain it. Like Stephanie, who didn’t talk about her grief because her seizures were already pronouncing it – slantwise, in a private language, but still – granting it substance and choreography.

la belle indifference, a manner defined as the ‘air of unconcern displayed by some patients
toward their physical symptoms’. It is a common sign of conversion disorder, a front of indifference hiding ‘physical symptoms [that] may relieve anxiety and result in secondary gains in the form of sympathy and attention given by others.’ La belle indifference – outsourcing
emotional content to physical expression – is a way of inviting empathy without asking for it. In this way, encounters with Stephanie present a sort of empathy limit case: the clinician must excavate a sadness that Stephanie can’t fully experience herself.

We’d been in love about two months when I got pregnant. I saw the cross on the stick and called Dave and we wandered college quads in the bitter cold and talked about what we were going to do. I thought of the little fetus bundled inside my jacket with me and wondered – honestly wondered – if I felt attached to it yet. I wasn’t sure. I remember not knowing what to say. I remember wanting a drink. I remember wanting Dave to be inside the choice with me but also feeling possessive of what was happening. I needed him to understand he would never live this choice like I was going to live it. This was the double blade of how I felt about anything that hurt: I wanted someone else to feel it with me, and also I wanted it entirely for myself.

In this sense, empathy isn’t just measured by Checklist Item 31 – voiced empathy – but by every item that gauges how thoroughly my experience has been imagined. Empathy isn’t just remembering to say that must 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. It means acknowledging a horizon of context that extends beyond what you can see: an old woman’s gonorrhea is connected to her guilt is connected to her marriage is connected to her children is connected to her childhood. All this is connected to her domestically stifled mother, in turn, and to her parents’ unbroken marriage; maybe everything traces its roots to her very first period, how it shamed and thrilled her.
Empathy means realising no trauma has discrete edges. Trauma bleeds. Out of wounds and across boundaries. Sadness becomes a seizure. Empathy demands another kind of porousness in response. My Stephanie script is twelve pages long. There is so much it doesn’t say.
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?