When It Hurts

how giving bad news affects a physician

The phone weighed heavy in my hand as I punched the numbers in one by one. Two rings, then three — I started planning the discreet voicemail asking you to call me back so I could say words we’d both wish unspoken.

But then you answered, “Hello?”

“Hello, Mrs. Jones?”

“This is she.”

“I’m glad I reached you. This is Dr. Smith, calling about your biopsy results.”

We both paused for a few precious seconds before your life changed irrevocably.

“Mrs. Jones, the biopsy showed cancer. Specifically, lymphoma, which is a cancer of the lymph or immune system. It isn’t treated with surgery, but with chemotherapy instead. I spoke with the oncologist already and they want to see you soon to get things started.”

You asked me a few questions. I knew your mind was reeling.

“Sometimes it’s hard to remember details when you get bad news. Is there anyone else you would like me to talk to today?”

You asked me to call your brother. He knew you’d had a biopsy and were waiting for results. He wept on the phone, telling me his wife had also had lymphoma. He didn’t say directly, and I didn’t probe, but it seemed as though she had died of it.

I thought about you all day, about what this diagnosis meant for you and your family. Of the emotional, physical, financial burdens that would ensue. The poor prognostic indicators on your pathology made me heartsick.

Bad news is the worst part of this job. Being the first to confirm a new mass, recurrence, metastasis; having the anecdotal and science-based knowledge of what will likely happen to a given patient — it hurts me too.

I’ve cried over my patients; sometimes while we’re talking, and sometimes later, when the sadness catches up with me. I don’t dare grow numb, although it would hurt less. Empathy both enables me to do my job and makes it incredibly painful.

I still wouldn’t choose any other profession.

Please note that names and details are changed and multiple stories may be conflated to honor patient confidentiality.

About the Author

Single With Scalpel is a Pediatric Otolaryngology fellow who tweets about life, humor, and medical education. She blogs here when 140 characters simply aren't enough.

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