If you asked medical students about issues of the human heart, you might be bombarded with facts about arteries, valves, auricles and ventricles. But the human heart also has another definition - the seat of the soul - where love, friendship and spirituality reside. This definition of the heart is the subject of a unique course at SIU School of Medicine.

What's the difference between suffering and pain? Between disease and illness? Between healing and curing? Empathy 101, an elective course, explores questions like these and shows medical students how to care for the human spirit as they care for the human body. Along the way, students learn about themselves, too.

The class is the brainchild of Kevin Dorsey, M.D., Ph.D., clinical professor in the Department of Internal Medicine at SIU-Carbondale and Lisabeth DiLalla, Ph.D., associate professor in the Department of Psychiatry, also in Carbondale. These two founded the course in 1994.

Dr. Dorsey and Dr. DiLalla feared that after enduring 10 years of rigorous scientific training, medical students might turn into emotionally distant clinicians, forgetting their warm, caring natures. Hard-working students, says Dr. Dorsey, intent on memorizing anatomy and symptoms, may forget that real people with real emotions are involved in doctoring. "But if we get the students to talk about empathy, caring and healing on an ongoing basis, maybe they won't forget these things," he says.

In a format radically different from traditional lectures, Empathy 101 uses books, short stories and poetry to inspire intimate discussions about the emotional, cultural and spiritual issues involved with being a doctor.

Roughly every three weeks, first-year medical students meet during lunch and discuss the readings assigned for that session. Readings range from short stories by authors like William Carlos Williams to collections of literature including On Doctoring, edited by Richard Reynolds, M.D. and John Stone, M.D.

Though literature may not have been a medical student's favorite class, Empathy 101 allows poetry and prose to serve as a springboard for addressing the personal issues involved in doctoring. "Literature brings an emotional and personal depth to subjects," says Dr. DiLalla. "That type of feeling can't be found in textbooks." Sophomore Laura Winkleman agrees. "Textbooks teach us the medicine side of being a physician. Empathy 101 helps us remember the human side."

The discussions often focus not on the writing itself, but on the message behind the writing. "The literature triggers talk about other things in our lives," says Dr. Dorsey. "It can become an intense emotional experience when students relate their personal experiences."

Aging. Dying. Love. Friendship. Money. Family. These personal issues are tough to discuss in a classroom, but suit the intimate nature of Empathy 101. "We encounter these issues every day but don't necessarily take the time to dwell on them," Winkleman says. "This class provides that time."

Students can attend as many empathy sessions as they wish, though each group is limited to only a dozen students. "It gives students a chance to get to know each other in a small, comfortable group," Dr. Dorsey says.

Dr. Dorsey and Dr. DiLalla are careful that the elective course doesn't interfere with the schedule of regular curriculum. The only requirement to attend Empathy 101 is to have read the assigned readings. There are no tests, no grades and no wrong answers. In fact, Dr. Dorsey emphasizes that students don't have to talk at all if they prefer to simply listen. "That's one of the things we are trying to do," he says, "enhance the listening skills of doctors. There's a difference between hearing and listening, between looking and seeing."

The interactive discussions help students understand that being a doctor means more than just prescribing a treatment. "Curing and healing are different," observes Dr. Dorsey. "You can cure a biological disease but the person may not be healed." Similarly, Dr. Dorsey distinguishes between pain and suffering. "Pain is a biological phenomenon. But suffering is a personal, behavioral, emotional and spiritual phenomenon," he says.

Discussing these issues gives students insight into their future work as physicians. "A student may think he wants to be a pediatric oncologist," says Dr. Dorsey. "But after dealing with the emotional issues involved in such a specialty, he may change his mind."

The course not only delves into issues of empathy, but issues of culture, diversity, religion and spirituality as well. "In some cases, an illness of the spirit or an illness of the mind is as big a problem as one of the body," Dr. Dorsey says. "The more I know about the person you are, the more likely I am to affect healing. There's more to the person than just his or her biology - there's the psyche and the soul."

The readings embrace the idea of diversity, with works from authors such as Anton Chekhov, Emily Dickinson, and Eudora Welty. "The readings open your eyes and your mind to a lot of different issues," says sophomore Angela Grosboll. Addressing diversity also helps physicians understand that "each patient has a different story to tell," says Dr. DiLalla. "The diverse literature stresses the need for personal growth in physicians."

Empathy 101 has become very popular with students. The sessions are nearly always full, says Dr. Dorsey, who estimates that two-thirds of each freshman class participate. Many students attend multiple sessions throughout the year. "It's a great session to attend to just relax and learn about ethical issues as well as get to know your classmates," says Grosboll.

Empathy 101 has made a real impact on helping students become better doctors. "The sessions try to get us to think like a patient - how would we feel if we had a doctor treating us like this?" says Grosboll. Lessons in empathy will help students in the years ahead. "Addressing these issues now will help me deal with them when I'm working with patients," says Winkleman.

The sessions have been so popular that medical students urged the School to continue Empathy 101 after the freshman year. The School obliged. For the past two years, empathy sessions have been offered to sophomores who read works such as Tuesdays With Morrie, a poignant and inspiring chronicle of a journalist's reconnection with his dying college professor. "We let students take the lead in the discussions," says Linda Distlehorst, Ph.D., associate dean for education and curriculum, who has helped organize sessions for the students in Springfield. "We want to make it practical so that their clinical encounters will reflect the meaning they've gotten from the readings."

Junior and senior medical students haven't been forgotten, either. A private, on-line listserve has been established this year, since students' erratic schedules make it difficult for a group to meet at a specific time. Instead of commenting on readings, this open format encourages students to post messages "about events that move them, problems they have, their own experiences or things that make them wonder," Dr. Dorsey says. Students may post messages on their own or anonymously through the Office of Education and Curriculum.

While still in the planning stages, more than two dozen students signed up for the listserve within the first two weeks of its inception last November. Additional students who register will receive transcripts of the past discussions to help them participate.

It is reassuring to see that, even with their busy schedules, so many medical students are committed to their patients, body and soul. "Attending these sessions will help me be a more intuitive and compassionate physician," says Grosboll, who finds the sessions "a rewarding experience."

Not only is Empathy 101 rewarding for the students, but the students' future patients will also be rewarded with perceptive, caring physicans. Dr. Dorsey says remembering the empathetic side of the human heart gets to the core of what being a physician is all about. "Doctoring is about people," he says. "To be more scientific does not mean doctorshave to be less humanistic."