Delivering Bad News As a Physician
During my hospice rotation in residency, Dr. B, the hospice director, asked me questions that really caught me off guard. The rhetorical questions went like this: “Are you uncomfortable delivering bad news to patients because you are projecting your feelings? Are you uncomfortable with death, and therefore, you have a hard time talking about it?”
During this time, my mom was still battling breast cancer. When Dr. B posed these questions to me, I was taken aback. I looked him straight in the eyes, and as I repeated his questions in my head, I began to feel a sense of confusion. Am I uncomfortable talking about death because I am uncomfortable with the idea of death? Am I afraid of my mom dying because I don’t want to feel the pain of her loss? Am I afraid of dying? Am I projecting my fear onto my mom?
When caring for someone kind and loving, you want to ensure they feel your love and joy in return. You want them to have everything they could ever want. How do you give them everything when you don’t have the most important thing to offer, time? When I posed this question to Dr. B, he reminded me that projecting my own emotions onto my mom was not helpful. Those are your emotions; you may be projecting pain onto her when she just needs your presence of joy and love. Your mother likely has her own fears and anxieties, and projecting your own onto her would only make things worse.
As physicians, we have many responsibilities, including delivering bad news. Instead of learning how to deliver news, we should learn how to manage our own emotions to deliver news more effectively.
Death is a complex topic that affects everyone. It is an inevitable part of life that we all have to face. From the moment we are born, we carry a proverbial ticking bomb inside us that will eventually go off, whether it is in two years or over a hundred. It doesn’t matter what our personal preferences are; death comes for us all and maybe there is beauty in that.
