In this episode of the REIMAGINE Podcast, host Gabe Schnickel, MD, MPH, speaks with Lisa Eyler, PhD, professor of psychiatry at the UC San Diego School of Medicine and director of the Center for Empathy and Compassion Training in Medical Education at the Sanford Institute for Empathy and Compassion. Eyler shares how her early research in aging, resilience, optimism, schizophrenia, bipolar disorder and brain health eventually led her toward the science of empathy and compassion. She describes empathy as the capacity to feel with and understand another person’s experience, while compassion goes one step further: it is the wish or action to relieve suffering. As Eyler puts it, compassion is empathy in action. The conversation explores how empathy and compassion show up differently in the brain. Empathy for another person’s pain can activate some of the same neural systems involved in experiencing pain oneself, which helps explain why unregulated empathy can lead to empathic distress. Compassion, by contrast, engages brain systems associated with reward, motivation, and care. For clinicians and caregivers, this distinction matters deeply: compassion may not be the cause of burnout, but one of its antidotes. Eyler and Schnickel also discuss the idea of “exquisite empathy,” the ability to walk the fine line between being open enough to recognize suffering and grounded enough to move toward compassionate action rather than becoming overwhelmed. A major focus of the episode is medical education. Eyler describes the work her center is doing to help medical students build durable skills in empathy, compassion, self-compassion, and compassionate communication. This includes Compassionatomy, an innovative program integrated into the anatomy course at the UC San Diego School of Medicine. Students engage in reflection, gratitude practices, contemplative exercises, and ceremonies that help them relate to body donors as their first patients. Eyler shares how students have responded powerfully to this work, asking for compassion practices to be included before every anatomy session. The episode also highlights CARE (Compassionate Action and Real Engagement in the Community), a core course for first- and second-year medical students. Through classroom sessions, community-based service learning, clinical observerships, arts and humanities exercises, role play, narrative medicine and contemplative practice, students learn that compassion is not simply a personal virtue — it is a clinical skill. Eyler also looks ahead to the future of compassion science, including better measurement tools, longitudinal studies of empathy and burnout in medical students, AI-enabled feedback on clinical encounters, neurobiological approaches to training, and the possibility of using neuroscience to improve how compassion is taught. At its heart, this conversation is about reimagining medical education so that knowledge and technical skill are paired with presence, humility, self-care and compassionate action.
