although this book is titled, “the empathy exams,” i feel like it is more about pain rather than empathy. how do people experience pain? how do narratives centered around pain unfold? how do people translate their pain into something that others can understand? although the author terms that as empathy and sentimentality, i personally felt like this was a series of essays about pain and the way it transforms people rather than about true empathy. in addition to that, i usually approach collections of short stories or essays with the understanding that i won’t love all of them equally, but this book felt especially difficult in that the good ones were outstanding and merited a full 5 stars, but the bad ones were....honestly 1 star at best. 

she always finds a way to bring the essay back to her own personal experiences, and although that can reveal new layers and meaning to a story, it doesn’t work for every story. for example, she wrote an essay about patients with morgellons disease, which is often termed as “delusional infestation” where people believe that their skin lesions are from fibers and parasites. it could have been an interesting narrative about belief, illness narratives, and patient / provider trust, but then she sorta fixates on how she might have it and about the time she got a parasite in bolivia. it detracted from the overall message. a similar thing happens when she talks about a prisoner in west virginia, and instead of centralizing on the prison narrative, she talks about how guilty she feels about being free while he's not, and it made the whole essay seem rather shallow. i also just didn't love her story about getting punched in the face in nicaragua, but i feel like she's aware of that because she self-references that in another essay about how she loves to dwell in her own pain and find meaning in it. however, her essays on things like the empathy exams, the female experience of pain, etc were powerful and moving.

i also just love her prose in general. i understand that this writing style isn't for everyone but to me, i think there is a certain gift in being able to translate a mundane experience into a beautiful narrative and finding new symbols and meaning in previously ordinary things. i read a library copy of this book but i would love to purchase my own and thoroughly annotate it. because the stand-out essays were so so good, i finally settled on a 5 star rating for this book, but if you do choose to read, just be aware of the self-centralization of the narratives and read with a grain of salt.