Dr. Austin Sloper appears sympathetic in some ways but incredibly arrogant in others. For example, though he is a bright and honest physician, he enjoys making a point of his intelligence and skill with his patients. As James writes, "He sometimes explained matters rather more minutely than might seem of use to the patient" (1). In other words, Dr. Sloper is clever, but he also enjoys appearing clever in front of his patients. In his relationships with his patients, he values appearing intelligent over communicating with them in a way they can understand. This behavior implies that while Dr. Sloper is not dishonest or malevolent, he values his own position and reputation over the comfort of others.

In addition, while Dr. Sloper merits sympathy for the loss of his wife and first-born child, a son, he is not very sympathetic towards his daughter. James writes that his daughter's sex "rendered the poor child, to the doctor's sense, an inadequate substitute for his lamented first-born" (3). The doctor is sexist and disappointed in having a girl, and, as his daughter grows up, he senses that she is not totally up to his standards. He exercises a great deal of authority over his daughter, Catherine, and is not entirely loving towards her. His relationship with her seems to be mainly about himself and his desires for her. In this sense, he is not an entirely sympathetic character but one who is arrogant and self-centered. 

In Chapter 1, we find out that Austin Sloper is a very bright, prominent doctor in New York. He is honest, often to a faulty, and incredibly intelligent. We also find out that he has had one true love in his life. Catherine Harrington is gentle, clever, and kind. Unfortunately, the doctor is unable to save his three year old son. Two years later, he is unable to save his wife when she gives birth to their daughter. Tragedy seems to follow poor Doctor Sloper.

As an audience, we are inclined to feel sympathetic towards Austin Sloper. He seems tragic, destined to save others at the cost of his own family. However, the author leads us to a few reservations about Dr. Sloper that keeps us from being fully sympathetic. The description of his daughter as an "inadequate substitution" for the young deceased son, for instance, removes some of our sympathy, as does the statement that he tried to make the best of it, and that he did not fear losing her "such as she was." These statement diffuse our sympathy and make us guarded against the good doctor, seeing the potential for coming conflict.