Medliorate

Improving medical students

How to Give Bad News (Randy Pausch)

Posted by medliorator on July 21, 2008

The horrible exchange was surreal for me.  Yes, I felt stunned and bereft for myself and especially for Jai, who couldn’t stop crying.  But a strong part of me remained in Randy Scientist Mode, collecting facts and quizzing the doctor about options.  At the same time, there was another part of me that was utterly engaged in the theater of the moment.  I felt incredibly impressed – awed really – by the way Dr. Wolff was giving the news to Jai.  I thought to myself: “Look at how he’s doing this.  He’s obviously done this so many times before, and he’s good at it.  He’s carefully rehearsed, and yet everything is still so heartfelt and spontansous.”

I took note of how the doctor rocked back in his chair and closed his eyes before answering a question, almost as if that was helping him think harder.  I watched the doctor’s body posture, the way he sat next to Jai.  I found myself almost detached from it all, thinking: “He isn’t putting his arm around her shoulder.  I understand why.  That would be too presumptuous.  But he’s leaning in, his hand on her knee.  Boy, he’s good at this.”

I wished every medical student considering oncology could see what I was seeing.  I watched Dr. Wolff use semantics to phrase whatever he could in a positive light.  When we asked, “How long before I die?” he answered, “You probably have three to six months of good health.”  That reminded me of my time at Disney.  Ask Disney World workers: “What time does the park close?” They’re supposed to answer: “The park is open until 8 p.m.”

The Park Is Open Until 8 p.m. [The Last Lecture by Randy Pausch]

Correlate: Delivering Bad News & Crying

Correlate: How to Communicate with Cancer Patients

Correlate: Discussing End-of-Life Care

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