There’s an aspect of being a doctor that never gets easy and that is delivering bad news.
In medical school we take a course called “Breaking Bad News“, but nothing prepares you for actually having to do it.
I’ve had my family practice for 7 years and have been practicing medicine for almost 10. I can still remember every single time I’ve had to give bad news.
- While working at a walk-in clinic, over the Christmas holidays, I had to tell a woman she had pancreatic cancer.
- In my first year of family practice, I told a woman she had cervical cancer.
- In my second year of family practice, I felt a pancreatic mass in a 55-year-old woman; she lived for 4 years after that. I attended her funeral.
- Three years ago, I felt a very abnormal prostate gland and new instantly the patient had prostate cancer.
- A young woman, believed to be about 3 months pregnant came in for an unrelated matter and asked if we could listen to the heartbeat. She’d seen her midwife the previous week and they couldn’t find it. Neither could I. An ultrasound a few hours later confirmed what I already knew. She’d suffered a miscarriage but didn’t know it.
- There was an older woman who came to see me for chest pain. She had been coughing from a cold and had a lot of chest wall pain. An x-ray showed multiple rib fractures. Spontaneous rib fractures. A week later, after sending her for a series of blood tests, I diagnosed Mulitple Myeloma.
- Sometimes a diagnosis of chlamydia can be devastating. It certainly was in the 31-year-old married woman who came in for a routine Pap. Sadly, my bad news was instrumental in her later ending her marriage.
- My first week back to work, I told a man he most likely had kidney cancer. Welcome back!
Every time I have to deliver bad news I am reminded how fortunate I am and how fortunate my patients are for living in a country where, when its required, they have access to timely health care. None of the above patients waited for more than a week or two to see a specialist. Sadly, not everyone survives after being given bad news. I haven’t had to do it very often, but when I do, it affects me personally. Often I can’t sleep for a few days. Sometimes I worry (often unnecessarily) that I missed the boat and should have caught the illness at an earlier stage. Anything else going on in my life suddenly seems not to matter for a while.
Bad news bear.
Sometimes that’s me.