As healthcare workers, one of the highest virtues we can aspire to is empathy. But what does it mean to empathize-to truly empathize? What exactly are we asking of healthcare workers? Empathy is popularly understood to be the ability to understand and feel what another person is feeling, to vicariously experience what they are experiencing within their specific frame of reference. In short, it's to put yourself in someone else's shoes and see their situation through their eyes.

Empathy, if done right, is serious business. To empathize is to truly understand, and the only way to truly understand what another person is experiencing is to share in their grief. Empathy is not just acknowledging someone's suffering; it's getting in the dirt with them; it's sitting in the ashes beside them and feeling what they feel. To empathize is to say, "I'm here. I see you where you are. I'm with you and will shoulder your burden too." So, we must ask ourselves: Is that really what we're asking of healthcare workers? Is it realistic? The answer-probably not. With so many patients and so much suffering, it is unrealistic to expect clinicians to empathize truly, fully, every time. Burnout will come swiftly and completely.

So, what's the solution? We want to empathize with our patients, but to vicariously experience their pain, their fear, their anxiety, their suffering, would simply be too much. It would overwhelm even the most resilient. Possibly the best we can do, the most we can expect, is a deep and personal understanding of what a patient or family member is feeling. Because if we understand-truly understand-it will change the way we act, the way we treat them, speak to them, the attitude we have toward them, and the care we deliver. Understanding in the head becomes understanding in the heart which births compassionate thoughts, words, and deeds.

The next question should then be: How can I understand what a patient with stage III cancer is experiencing? How can I understand what she is feeling? What emotions are tumbling through her soul? What does she fear and question and want desperately to comprehend? The answer is in the emotions. As healthcare clinicians we cannot identify with every patient on the level of his or her diagnosis. I've been through cancer, but I've never lost a baby, battled Parkinson's, or struggled to breathe because of COPD. But I have experienced loss and great sadness; I know the humiliation of being dependent on another; and I've felt real blinding fear.

Emotions are shared by all humans. Anger, fear, anxiety, humiliation, disgust, sadness, hopelessness, powerlessness . . . most of us have experienced them at some point. And that is where we can connect with our patients. Human to human, emotion to emotion. But in merely seeking to understand our patients' suffering and stopping short of vicariously experiencing it, we are not free from the hook. Understanding requires something of us. There is a price to pay to understand another human sincerely and honestly on an emotional level. There is a place we must go and a sacrifice we must make. To empathize on the level of understanding emotions may require us to relive those emotions.

Let's lay this out in realistic terms. Let's say I have a patient "Jim" who just returned home after suffering a stroke. Jim has lost use of the right side of his body. He's right-handed. He needs assistance with eating, dressing, transfers, toileting, grooming. He's wheelchair bound and now is dependent on others for just about everything. He's 58 and has worked as a mechanic since he was 18. Jim was looking forward to retiring in 7 years and enjoying the fruits of all his laboring. He's angry and depressed and disappointed. He feels powerless and hopeless. He has more questions than answers. He feels like life has sucker-punched him, and he's struggling to catch his breath.

Wow. Heavy stuff, right? I've never suffered a stroke. I don't know what it's like to lose the use of my right hand and not be able to walk. But I do know anger over feeling short-changed and sucker punched. Well into my 20s I battled a severe stutter that more than once had me shaking my fist at the heavens and asking through clenched teeth, "Why me?" I'm well acquainted with that kind of anger. And depression, yes, I've known that as well. I've experienced strings of rejections, both professionally and personally, that sent me into that downward spiral from which there seemed no return. Loathing, hopelessness, meaninglessness. I've looked them all in the eye and contemplated surrender. I've questioned life; I've screamed my share of whys; I've stared into that black empty abyss where there are no answers. Several years ago, my wife and I intended to adopt a young girl from Ukraine. We had four biological daughters and wanted in our hearts to make her our fifth. But as fate would have it, the adoption fell through and months of work and fundraising and praying and preparing were for nothing. The questions were there with no answers. The disappointment was heavy.

Most of us, over time, bury those kinds of emotions. It's just too much to have to deal with them every day. Time passes and heals wounds and lays layer after layer of scar tissue over those emotions. They're still there but now just a distant memory. From time to time, we may acknowledge their presence, but we seldom dwell on them. But if I'm going to empathize with Jim, if I'm going to truly understand what he is feeling so that my understanding will change the way I see and treat him, I must revisit those old and buried emotions. I don't have to dwell on them. I don't have to fully immerse myself in them, but I do need to dip my toe in those cold waters. I need to remember the anger I felt over my inability to put together three fluent words and feeling short-changed by life. I need to remember the sorrow and disappointment and confusion over the rather abrupt ending to our quest for another daughter. I need to think back on all those rejections and the depression that followed. I need to feel those emotions again so I can understand Jim's emotions, so I can see even a glimpse of his world through his eyes, so I can allow my understanding to change my behavior.

I think that is the best we can do as healthcare workers to empathize with our patients and meet them where they are. And if we have the courage to do that, it will not only change the way we deliver care, but it will also change the way we see and understand another human, and that's a big win for everyone.

COVID-19 vaccination and boosting during pregnancy benefits pregnant people and newborns

Receiving a COVID-19 mRNA vaccine during pregnancy can benefit pregnant people and their newborns. Researchers followed more than 500 pregnant volunteers and their newborns. Results from 240 participants, including 167 pregnant participants who received the two-dose primary series of either of the two mRNA vaccines during pregnancy, and 73 who received a booster dose. Researchers examined blood samples taken before and after participants were vaccinated or boosted, and at time of delivery and analyzed participants' cord blood at the time of birth. The antibodies effectively crossed the placenta and were also found in the cord blood of vaccinated participants. This likely conferred some protection in the newborns against these variants immediately after birth-a critical time when they are vulnerable to severe COVID-19 disease according to the researchers. Pregnant participants who received a booster dose had substantially more antibodies against SARS-CoV-2, in their own blood and in their cord blood, suggesting that boosting also increased their newborns' immune defenses against COVID-19. These findings support the use of COVID-19 vaccination, and in particular booster doses, during pregnancy for protection of mothers and newborns.