Dig this: Brain scans appear to show that doctors can shut down the parts of their brains that lets them empathize with pain in other people.

It makes sense, of course. Because doctors are often required to cause pain in patients — as part of treating them — doctors probably need to develop the ability to at least partly ignore the pain they’re causing, or they’d never be able to deal with the stress. The neuroscientists decided to see if there was anything in doctors’ brain activity that actually reflected this ability. So they put a bunch of doctors and a non-doctors into an fMRI machine, and had them look at randomly interspersed pictures of people being pricked with acupuncture needles and touched with Q-tips. The results? According to this write-up:

Among the control group, the scan showed that the pain circuit, which comprises somatosensory cortex, anterior insula, periaqueducal gray and anterior cigulate cortex, was activated when members of that group saw someone touch with a needle but not activated when the person was touched with a Q-tip.

Physicians registered no increase in activity in the portion of the brain related to pain, whether they saw an image of someone stuck with a needle or touched with a Q-tip. However, the physicians, unlike the control group, did register an increase in activity in the frontal areas of the brain—the medial and superior prefrontal cortices and the right tempororparietal junction. That is the neural circuit that is related to emotion regulation and cognitive control.

They also asked the two groups to rate the level of pain they felt people were experiencing while being pricked with needles. The control group rated the pain at about 7 points on a 10-point scale, while the physicians said the pain was probably at 3 points on that scale.

Now that latter paragraph is super interesting. It would appear that some of the doctors’ ability to ignore pain isn’t wilful — it’s also involuntary. It’s not just that they can turn off their empathy; they can’t turn it on again when specifically asked to do so. Thus, they’re more likely than you or I to underestimate the amount of pain someone is experiencing.

Psychologists and patients-rights advocates have long argued that doctors don’t take pain-alleviation seriously enough; Jerome Groopman wrote an article for the New Yorker on this subject a while back. These findings might help illuminate some of the reasons why pain-management goes on the backburner in medical backburner: Perhaps the doctors simply aren’t perceiving it.