ChrisMcCracken Posted February 16, 2009 Share Posted February 16, 2009 I had to tell a patient that they have cancer. I'm normally out of reach from a lot of things in my work, but this gets to me. I could have asked the attending to do it, saying that I'm not comfortable doing it; I'm a 1st year resident. He was my patient though, and I was the first one to stumble on the CT results. It only seemed right that they know rather than walking away for someone else to do it. That doesn't make it suck any less, though. -Chris Link to comment Share on other sites More sharing options...
atbarr Posted February 16, 2009 Share Posted February 16, 2009 I had to tell a patient that they have cancer. That has to be rough. A.T. Link to comment Share on other sites More sharing options...
Nik Habicht Posted February 16, 2009 Share Posted February 16, 2009 Having been in the room a couple of times when that diagnosis was delivered, I'm pretty confident it sucks for everyone involved...... Kudos for not passing the buck! Link to comment Share on other sites More sharing options...
SiG Lady Posted February 16, 2009 Share Posted February 16, 2009 That's a tremendous and important responsibility. Not unlike a police officer's announcement to next of kin of a death. You showed courage in this matter. Link to comment Share on other sites More sharing options...
John Dunn Posted February 16, 2009 Share Posted February 16, 2009 No fun for sure, especially with kids. Link to comment Share on other sites More sharing options...
XD Niner Posted February 16, 2009 Share Posted February 16, 2009 You will undoubtedly become better at delivering bad news with practice but it will never get any easier from an emotional standpoint. Link to comment Share on other sites More sharing options...
ChrisMcCracken Posted February 16, 2009 Author Share Posted February 16, 2009 I have to say that the positive side of this is that I've made a connection with this family that I probably wouldn't have, had they just had a routine problem and gone home. I don't expect it ever gets easier for each new patient, but helping each one understand, accept, and move on to whatever is next can be very rewarding. To answer specifically John's sentiment, kids eat me up every time, especially their family's reactions. Family reactions to death and such are always emotional, but pertaining to kids it's almost too much to bear. Luckily our minds/psyches give us the gift of distance and blurring of details with time, forgetting unpleasant memories unless consiously brought to the forefront. Link to comment Share on other sites More sharing options...
Tzygä Posted February 16, 2009 Share Posted February 16, 2009 That is never easy to tell. Link to comment Share on other sites More sharing options...
FranDoc Posted February 16, 2009 Share Posted February 16, 2009 ... I don't expect it ever gets easier for each new patient, but helping each one understand, accept, and move on to whatever is next can be very rewarding. Welcome to the profession. No, that discussion never gets easier. Sixteen years in ER and THE worst part was the 'family discussion' when a code ... went the way codes usually go. The hardest part of the practice of medicine is not memorizing endless information, it's not staying up at o'dark-thirty when you just desperately want to collapse, it's dealing with they psyche-wrenching human aspects. I admire that you 'stepped up to the plate' and took on this task yourself, rather than turfing it. You've built some strength there that you don't even fully realize yet. Learn what you can and can't do in these situations. Learn how to protect and nurture your own soul (something that is absolutely NOT taught in medical education). Do something good for yourself once all the emotions equilibrate. Good luck with the last 5 months of internship. Link to comment Share on other sites More sharing options...
Holshot Posted February 16, 2009 Share Posted February 16, 2009 Welcome You'll get better at it but hopefully you'll never get to the point when it doesn't bother you. I've been delivering bad news for quite a while and it still stings. If I could offer you 2 pieces of unsolicited advice. First, tell the truth to patients in as straightforward a manner as you tactfully can. I've never been thanked by a patient for beating arouond the bush. Second, as mentioned earlier, protect yourself. It's OK to feel bad, to grieve, to hug the patient and family, and even to cry with them. However you need to fall back pretty quickly to your world, your family, and your life and the comfort that comes from knowing you did the best you could. It's a skill that you will get better at with age. Good luck! Link to comment Share on other sites More sharing options...
kevin c Posted February 17, 2009 Share Posted February 17, 2009 No, it doesn't get easier. Or, more to the point, for your humanity's sake, hope that it doesn't. The profession can grind you down in so many ways. Try to find some satisfaction in what you did for this patient, doing what had to be done, and what you have done for others as well. The advice offered above is very important - finding satisfaction, joy and accomplishment in your life, both within and outside of work. Another doc. Link to comment Share on other sites More sharing options...
Tzygä Posted February 17, 2009 Share Posted February 17, 2009 WelcomeYou'll get better at it but hopefully you'll never get to the point when it doesn't bother you. I've been delivering bad news for quite a while and it still stings. If I could offer you 2 pieces of unsolicited advice. First, tell the truth to patients in as straightforward a manner as you tactfully can. I've never been thanked by a patient for beating arouond the bush. Second, as mentioned earlier, protect yourself. It's OK to feel bad, to grieve, to hug the patient and family, and even to cry with them. However you need to fall back pretty quickly to your world, your family, and your life and the comfort that comes from knowing you did the best you could. It's a skill that you will get better at with age. Good luck! Those were excelent advices very emotional but professional. I am not doctor but I can use that kind of approach when I have to tell unpleasant new to people. Thanks. Link to comment Share on other sites More sharing options...
Front Man Posted February 18, 2009 Share Posted February 18, 2009 Tough stuff. About 20 years ago I had to tell a fellow employee that her brother had committed suicide because my salaried boss was to chicken shjt. Another time I had to tell one of my sellers that their property didn't close on closing day because the buyer quit his job. The sellers had just lost an infant daughter and needed it sold BAD. I'm not a doctor or a lawyer, so I have no advice. FM Link to comment Share on other sites More sharing options...
Bwana Six-Gun Posted February 18, 2009 Share Posted February 18, 2009 Years ago in the Army, I got tagged for Next of Kin Notification a couple of times. It is the worst duty you can imagine. You just have to take it as it comes and hope for better days. Unfortunately, I found out after the first one it does not get any easier, no matter what anyone says. Link to comment Share on other sites More sharing options...
Nemo Posted February 18, 2009 Share Posted February 18, 2009 The closest I've been to this sort of situation was telling my wife that her father had passed. I wish I never have to do something like that again. In that aspect I don't envy MDs. Link to comment Share on other sites More sharing options...
snertley Posted February 19, 2009 Share Posted February 19, 2009 WelcomeYou'll get better at it but hopefully you'll never get to the point when it doesn't bother you. I've been delivering bad news for quite a while and it still stings. If I could offer you 2 pieces of unsolicited advice. First, tell the truth to patients in as straightforward a manner as you tactfully can. I've never been thanked by a patient for beating arouond the bush. Second, as mentioned earlier, protect yourself. It's OK to feel bad, to grieve, to hug the patient and family, and even to cry with them. However you need to fall back pretty quickly to your world, your family, and your life and the comfort that comes from knowing you did the best you could. It's a skill that you will get better at with age. Good luck! It does easier over time but it never gets any better. I've been doing Hem/Onc/BMT for 18yrs now, and it still stinks every time. It would be great to tell every patient that they are cured, but relapse or initial diagnosis is always very hard. Holshot has a good point which I firmly believe in and that is that I will never beat around the bush or sugar coat anything that I tell my patients and families. To do that you do nothing but a disservice to them all, and your self. On the hand I have been thanked by patients as well as family members for not sugar coating things. At times you do need to remove a bit of yourself from you job when it comes to informing patients of terrible news, but not so far that you side step there feelings and emotions that they are having to deal with. Jon Link to comment Share on other sites More sharing options...
vluc Posted February 19, 2009 Share Posted February 19, 2009 As a Practice Administrator, you've shared what I want to hear for any physician I may employ. The technical aspects are easy - the emotional areas are the ones I have seen physicians fail in - and I've been in this field since the 80's. That part doesn't change. Link to comment Share on other sites More sharing options...
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