What’s worse? The doctor or the cancer?

Have you ever received bad news from a doctor? Did the doctor’s way of delivering the news make you feel better or worse?

Real World Story: My sister-in-law, Holly, finds a lump in her breast. Alarmed, she schedules a mammogram.  Bad thoughts lead to bad news. After giving the “bad news,” her medical group recommends she get a second opinion.

For her second opinion, Holly drives three hours in Los Angeles traffic with her neighbor, who is having severe back pain. They miss their exit and immediately notify the doctor’s office. They arrive at 8:55am for an 8am appointment. The doctor will not see them. They need to come back tomorrow. Holly is now distraught. She has just driven three hours, is anxious about her diagnosis, and cannot possibly return the next day. She insists she see the doctor today. After much back and forth, the doctor agrees to see her.

At 9:15am, the doctor walks into the exam room looking angry. There’s no “Hello. How may I help you?” The doctor instead blurts out, “I looked at your results. I know what angry-female-doctorI saw. The cancer has probably gone into your lymph nodes and could be in your bone. You need to have a chest x-ray.” Holly is now in a panic. Lymph nodes? Bone? Am I dying? –  she thinks to herself. “The previous doctor didn’t see anything in the lymph nodes,” says Holly. This doctor then aggressively lifts up Holly’s arm and starts feeling under it, and says, “See, there’s a lymph node.” Holly then lifts up her other arm and says, “Yeah, and there’s the exact same one here. Are you saying I have cancer on both sides? Are you saying I’m dying?” The doctor replies, “I didn’t say that. We have to do a chest x-ray.”

Holly tries to ask additional questions, but the doctor puts her hands on her head, as if to say “Enough already!” By the exam’s end, Holly is terrified. “I feel like I’m dying right in front of your eyes.” The doctor replies, “I’m not sure about that.”

Thanks to this doctor, Holly leaves feeling hopeless and terminal. What a horrible way to give and receive BAD news.

Two emotionally excruciating weeks later, Holly is told by a different medical center that the cancer has not spread, is only in one spot, and can be treated. A fantastic third opinion!

Strategies that Turn it Around:

  1. Ensure you are in a positive mindset, ready to “be present” when communicating.
  2. Deliver BAD news – especially about life or death – with compassion and empathy, regardless of what else is happening in your world. Please.
  3. LISTEN to your patients’ reactions first, then respond appropriately. Remember #1 and #2.
  4. Be proactive if you begin to feel angry – take a break, drink water, pinch yourself. Remember: it’s not about you!
  5. Offer alternatives. Something can always be done.
  6. Help patients look beyond the bad and focus on a positive action plan.

Remember: People need you to care about their problems as much as they do. Once you do, they are more likely to listen to what you have to say. Will it be easy? No. Easier? Yes.

How do YOU deliver BAD news? Please share in the comments section below.

2 Responses to “What’s worse? The doctor or the cancer?”

  1. 1 pregnant January 29, 2014 at 5:41 am

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