Improving medical students

Delivering Bad News & Crying

Posted by medliorator on April 29, 2008

Delivering bad news is painful. Before each session I prepare myself using a self visualization technique. I have learned over the years the art of these conversations. Each one drains me both because I empathize and I care. However, crying would detract from my ability to do the complete job of helping the patient.

I believe that my patients’ deserve my empathy, and also careful explanation. When I tell someone they have cancer, I then spend a significant amount of time explaining what it means. I then explain it again the next day, because patients often do not grasp all of my words after I say the C word.

My students and residents have told me that I do a good job of this necessary and painful task. I take the time to sit down and explore the patient’s understanding and help the patient develop a “game plan.” If I let me emotions take over, then I believe my effectiveness will diminish.

Even with the worst news I try to provide hope and support. We can always do something to help the patient. Our toolbox includes palliation and emotional support.

I once had a colleague who stressed the importance of maintaining composure when everything seems to be failing. Patients deserve composure, empathy and a well developed plan. Maybe they also deserve my crying with them, but I really do not think so.

Appropriate bedside manner [DB’s Medical Rants]

Correlate: Should Doctors Hug Patients?

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