Transcending the Clinical: Empathic Care Work, Moral Injury, and the Community Health Worker in Rural Maine

The Maine Mobile Health Program is a federally qualified health center and community health organization that provides healthcare to migrant and seasonal farmworkers in rural Maine. The MMHP employs community health workers to act as negotiators between unjust systems, physicians, and patients. This thesis investigates the ways in which community health workers provide patients with “empathic care” and details how this happens in practice based on field observations and interviews. It also addresses how empathic care benefits patients by creating empowerment, building trust, and giving patients agency in their healthcare decision making. Furthermore, this thesis discusses the cost of providing empathic care as “moral injury” and considers how community health workers are emotionally and psychologically impacted by the work that they do. Ultimately, this thesis illuminates the transformative capacity of empathic care and the burden it imposes on community health workers operating within inequitable systems.