We read this piece with great interest, and want to make a point of acknowledging the emotional impact that comes with being the bearer of bad news as a medical professional. But we think there is a lot of incredibly useful insight contained within this article – insight that can help us all prepare for difficult conversations, whatever the nature.

“It’s not uncommon for Andrew Epstein to spend sleepless nights replaying scenes from his day and wondering what more he could have done for his patients. Often, the answer is nothing—but that still doesn’t help his insomnia.

Epstein is an oncologist at the Sloan Kettering Memorial Cancer Center in New York. His job requires conversations with patients who are extremely sick. Sometimes, he’s breaking the news of the severity of their illness to them; other times, he’s telling them the treatment they thought may work has failed, and it’s time to begin preparing for end-of-life care.

Each encounter is so emotionally draining, he can only do it for about half of the week; he spends the rest of his time preparing for future conversations with new patients, or recovering.

Telling patients and their families that they must face their own mortality is one of the most difficult things that has to get done in the medical profession. Most patients want to have conversations about care at the end of their lives, but often don’t end up having them—probably because many doctors are not prepared to do so, despite training as part of medical school.

Not all of us will have to have these kinds of grim conversations, but we will all have to disappoint people at some point. Maybe you won’t ever have to tell someone they are going to die, but you might have to deliver a bad performance review, let someone go, or break up with a partner.  It will never be seamless, but there are ways to be a better bearer of bad news, and lessen the emotional pain for others…”

You can read the full article by Katherine Ellen Foley, science and health reporter, on Quartz where it first appeared: https://qz.com/823918/how-doctors-give-patients-bad-news/ 


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