Leslie Jamison’s The Empathy Exams is an extraordinary essay collection driven by a fierce, piercing intelligence laced with endless amounts of curiosity about the world and the thoughts, feelings, and ability that make us humans who can, to quote E.M. Forster, “only connect.” By looking at subjects like ultrarunning, poverty tourism, phantom diseases (in the skin-crawling “Devil’s Bait”), and working as a medical actor, Jamison invites the reader to make brand-new connections and insights over ideas like saccharine, empathy, and female pain. It’s a startling work of nonfiction that deserves every accolade it’s going to receive, and it announces a voice that you’ll want to follow anywhere. I spoke with the current Ph.D. student at Yale, New York Times Book Review “Bookends” columnist, Iowa grad, and author of the fiction debut The Gin Closet over coffee at Soho’s HousingWorks Cafe.

Flavorwire: “The Empathy Exams,” the title essay about working as a medical actor, was in the January issue of the The Believer. I was wondering if you’ve heard back from doctors and medical students about this piece?

Leslie Jamison: I’ve gotten a lot of responses to fiction, but I feel like nonfiction, I feel like it gets under people’s skin in a different way. When the opening essay came out in The Believer, I heard from a ton of doctors and a ton of medical actors and that’s partially something to do with the essay, but tends to do with people are also interested in what they do and what their world is. And so hearing from doctors who think differently about what it feels like to a patient when I am [as a medical actor] running a script through my head, I’ve gone back and forth for years on whether questions of empathy are worth it or whether they do more harm than they do good. One of the ways that I come at questions is that it “doesn’t it lend itself to prescription,” being like, “this is what I think you should do?” That’s what’s legible as valuable information, but I’ve been really gratified by how many doctors feel like it made them question certain functions they had and offers of their sympathy as they go about their daily work.

Part of the experience of reading The Empathy Exams is going on this journey with you as you’re working through an idea and examining it from all sides. It’s very different from today’s mostly opinion-driven, pundit-flavored essay writing. How do you come to writing that has many ideas within the text?

I’m interested in destabilizing the totality of opinion in general. There’s a quote [at the end of The Empathy Exams] about this idea of thinking against oneself, and I adopted it as a mental footnote, because I really do feel like that’s the key to my process. I beat up on myself for years about not having strong enough opinions, and people would be like, “Did you think that book was good or not,” and I’ll feel paralyzed, because I’m like, “Well, there’s this, and there’s also this, and this…”

I think that having thoughts that are like crossing vectors is valid, and I think it can be forceful, and I think it goes a lot deeper often than just having an opinion. That’s the same impulse behind the choice to honor side productions of thought like journalistic process, alongside journalistic account. I’m just interested at looking at some things from a bunch of different angles, and I feel like the essay offers the chance to give your readers, like, “OK, you’re looking at the front side of a thing, now come along to the back, and look at it from the other side,” and I think you can do that in terms of concepts, you can do that in terms of recounting what was said in an interview, where that interview happened, what fears propelled it, all that stuff …

There are a couple of essays where you use the editorial “we,” and it’s an interesting rhetorical device. I’m curious about your thoughts on choosing to use the “we” before the “I.”

One of the moments that’s coming to mind is the end of “Lost Boys,” when I say that we can think about what these guys are going to do now that they’re out or we can think about all of the prisoners left behind. A part of what I want the “we” to do is to say: whatever particular story I told you, whether there’s a story about my own life, or there’s a story about these guys’ lives, it matters for all of us. But there’s some sort of ethical obligation that’s suggested here, or some sort of ethical opportunity. The “we”… it’s like a hug, but it’s also like a…

A nudge.

It’s a hug-nudge.

A hug and a poke.

A hug and a poke. And it’s interesting because another thing that a couple of the essays do, some of the “Pain Tours” [a series of essays] use a “you” instead of an I or a we. The “you” was something I followed, and that retrospectively was “what’s the conceptual implication for that,” or I guess more of a retrospective question, asking what was I after, why I was compelled to do that.

For some pieces that are about pain tourism, sometimes I’m writing about experiences that felt sort of uncomfortable, like being on a bus in gang territory or walking through silver mines. It’s almost like I wanted to get outside of my own body because I was so uncomfortable in my body in that experience, so I was like, “Okay, I’m just going to hover over my shoulder and write about what’s happening,” but also try to give myself instructions about “this is how you navigate this tremendously, epically complicated territory of gazing at other people’s pain.” I wanted to be in there to help as a guide, Virgil style.

Can you use the Internet for empathy?

Yeah. Last year I was teaching a playwriting course at Yale, and I feel like Twitter was on my kids’ minds, but they wanted to write a lot about Twitter, and I had just gotten on Twitter, so it was on my mind. And what was interesting was around the time that they were writing — they were supposed to be writing cultural critiques — was when that Boston Marathon bombing happened.

A couple of their essays ended up focusing on what is the role of social media in response to a tragedy, and a lot of interesting issues came up. There was clearly something that rubbed them the wrong way about the sort of outpouring of empathy that comes up on the Internet. Like, one guy had all this beef with the phrase, “Our thoughts and prayers go out,” or something that felt like it was really hollow and trite and what did it mean that it was so easy to offer and that there was no work behind it? And this other girl was taking issue with people who would do things like post photos on Instagram for email listings they’d gotten for charitable donations. Stuff like that.

I feel like when we critique hollow displays of empathy on the Internet, what we’re critiquing is usually some aspect of empathy that is much more deeply entrenched but just made visible. For example, we’re critiquing the way that whenever we feel empathy, we also feel proud of ourselves. So it starts to feel a little bit dirty or polluted. And so be it, I think there’s something valid in that, if you are thinking about how your empathy makes you look, to the exclusion of actually empathizing or acting on your impulse, that’s misguided and ultimately not that useful.

But that’s not because of the Internet; that’s always been a part of empathy. But it becomes part of our identity gratification and it doesn’t necessarily mean that something like that going on, some kind of pride that can be validated there can also be something beautiful or useful in these exercises. I think in this way, the Internet can shine a little spotlight on things we have been uncomfortable about or should have been uncomfortable about for a while. It means that a lot of things that wouldn’t otherwise get said get said. I like to think there’s something about the mass support that could be comforting, but again the danger is if a tweet becomes a substitute if you live in Boston and instead of donating blood you’re just tweeting about your feelings.

How long did you work on the book?

The first essay I wrote in 2006, but I hadn’t been working on it constantly since then. The bulk of the essays were written between 2009 and 2012, I would say. So three years. There were a lot of other things going on in my life, work-wise, I was working on my first novel, and then I was working on another novel, and a lot of the essays started when I was really frustrated by the experience of that novel, so I gave myself permission to follow these [essays].

The one that I always think about is the Barkley Marathons one [“The Immortal Horizon”]. Because I was living in Iowa, working on this novel, frustrated by this novel, and I decided I was going to go to this race and write about it, and it was just such a pure, fun experience writing. Part of it was that I wasn’t trained as a journalist so it felt like an experiment, it felt new, I felt kind of liberated. For a while I think they gained a lot of energy because they were side projects.