Unit 7 Section 1 Breaking bad news
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At the hospital, the doctors rolled an ultrasound machine into the room. I lay on a bed, pale as Snow White on my sheet, while they huddled around the screen, pointing and whispering. This was a teaching institution, after all, Moffitt Hospital in San Francisco, where years later I would interview for medical school. Did anyone teach the doctors what to say to a young mother when her baby is dead? Suddenly the white-coated flock all flapped from the room like startled birds. The youngest, an intern, was sent back after a moment or two to tell me the news.
The senior doctors often send the trainees. This I learned years later, when I myself, a resident rotating in the emergency room of our community hospital, was instructed to tell a woman her husband had just died. I stood awkwardly delivering my sentence, the one that would stick with her the rest of her life, without preparation, without any sense of what to do next. The seniors send the medical student, the new trainee on the block, because ‘you’ve got to start somewhere learning this stuff,’ they say. In reality, it’s unpleasant to tell a patient he’s dying, or some such bad news. It’s not a job for volunteers. So the assignment gets bounced down the ladder. Understandable. We’re all only human.
That being said, the intern didn’t fall on her face, nor did she provide memorable comfort. It’s hard for any doctor in a crisis to find the right formulation. Afterwards, the patient goes over and over the words she has heard, as though in the awkward, bungling, uncomfortable moment of truth, the messenger bears part of the blame. So I can’t fault the intern who came to my side if I remember her precise words after twenty-two years.
“What does it mean?” I asked.
It took her some seconds to gather her answer. “It means,” she finally said, looking hard at her shoes, “that your baby has been dead for three days.” She had the grace to speak frankly, for it seemed that was all there was to be said.
The purpose of this section is to understand the challenges of breaking bad news and to demonstrate techniques for breaking bad news effectively. |
