Comments on: Brave Faces

By: Josa Young

Josa Young — Thu, 24 Mar 2011 19:43:40 +0000

This was nothing like so serious, but when the consultant told me I had lost the sight of an eye (completely non disabling by the way) I asked if it would look odd. He said it might wander about a bit, in which case they would take it out and give me a glass one. I was in intensive care at the time, but I summoned up my strength and told him if he said anything similar to my mother I would come after him (I hope I mentioned a hatchet). He looked rather surprised.

By: NickBoot

NickBoot — Sat, 12 Mar 2011 11:28:43 +0000

Excellent; really good writing. Thanks for sharing it.

By: Lisa

Lisa — Sun, 30 Jan 2011 11:49:18 +0000

When I was a nurse I worked in A&E and breaking bad news was unfortunately par for the course for the young SHO’s. However, it was more often than not to tell the relatives that a family member had died. There were no leaflets or pamphlets guiding them and it was often left to the experienced nurses to tell them what to say and how to say it. There is no right way to break bad news, but bad news often needed to be given and the relatives always needed to be told. In my experiences, information was of comfort to the relatives, it was the beginning of the grieving process and often helped them to come to terms with the unexpected. When it came down to it, the doctor who had cared for the patient (albeit briefly) gave the bad news. They were always accompanied by a nurse, who had to witness the uncomfortable attempts by the doctor who would fumble through, trying to explain what sudden and often unexpected event had taken place, which had cut short the life of their loved one. It was incredibly difficult. However, the doctors often tended to hide behind medical jargon, then they would leave me to try to explain what had happened in layman’s terms and comfort them. I often spent the rest of my shift with relatives, making tea, holding their hands telephoning friends and other relatives, and I often cried with them. I didn’t mind. But I must admit I really don’t miss that part of the job. Seeing peoples lives completely shattered and beyond repair and being unable to do anything is horrible, but I sought comfort by hoping that what I did helped the relatives just a little bit.

By: Luce

Luce — Fri, 17 Dec 2010 00:54:08 +0000

When I was at Medical School there was no training at all on ‘Breaking Bad News’. None. I remember when I was a medical house officer I was called to the ward by the Sister and asked to go and inform Mrs Jones’ family that their wife/mother was dead. In those days it was always the doctors job even if the doctor didn’t know Mrs Jones from Adam and had never met her family. I couldn’t believe they were expecting me to do this. I opened the door to the room where her family were waiting and was greeted by a sea of expectant, desperate faces. I blurted out ‘Mrs Jones is dead!’ and promptly burst into tears.
Since then I have learnt some techniques, and indeed have been responsible for teaching them for many years to juniors and on ALS courses. There are right and wrong ways to break bad news but ultimately, as you say, it comes down to being a compassionate human being. I still find it the single most difficult part of my job and I still cry, almost every single time.

By: deegeefee

deegeefee — Mon, 13 Dec 2010 09:40:52 +0000

I am very grateful to the lovely Simon Ricketts for recommending your blog & spent a good hour before bed last night reading through your posts. This one holds a particular resonance for me as eleven years ago we were given the news, by a dispassionate team of gynaecologists & paediatricians, that our first baby had Potter’s Syndrome and would die shortly after birth (see my last blog post). I was diagnosed at 30 weeks and brusquely informed that I would have to “be brave” and carry on with life as ‘usual’ until my baby was born; he was a full term baby. I was offered no counseling in the interim and when I went into labour, was put in an ante-natal ward with six other ‘healthy pregnancy’ women. We were actually told by one paediatrician that the hospital were “quite excited” by us as Potter’s is relatively rare and they hadn’t had a case in 15 years. When Jamie was born and it turned out that he also had sirenomelia, the hospital team were positively ecstatic. Our delivery suite was like a St. Patrick’s day parade ground with the amount of interns marching through.
At the time, my husband and I were both too raw with grief to show much anger, but my dearest friend, who is a senior nurse and who was with us for Jamie’s birth later wrote a five page, strongly worded letter to the hospital. Even she sadly acknowledged that it would probably be read by one person and put straight into the shredder.
I understand the need for a certain degree of detachment in the medical profession and have nothing but the highest respect for those who work to save lives in often under-funded, over demanding conditions, but when patients are presented with the worst possible news even the smallest gestures of compassion & empathy go far. Thank you. xx

By: Alan

Alan — Thu, 09 Dec 2010 22:19:32 +0000

Your writing really brings home what it must be like to work in the medical profession, and how the harsh realities of life and death situations affect you. I’m full of admiration for those who choose to follow this path.

I’ve often wondered how I would react to being given such news – I doubt that I would be stoic and brave either.

By: fairyhedgehog

fairyhedgehog — Thu, 09 Dec 2010 09:06:21 +0000

The medical profession really needs to hear this.

I recently had a painful procedure (a hysteroscopy). The doctor promised that after the last one I could have this one done under a GA but she went back on that, wouldn’t even let me have sedation. So I took ultra-strong painkillers.

She then said she would only take one quick biopsy and not bother with pictures as she knew I was worried about the pain. What did she do? Take a mass of pictures and several biopsies. When I queried this afterwards (I wasn’t told at the time that this was what she was doing) she said it was because I was “doing so well”. I.e. not screaming. I did scream once, “Christ, that hurt!” but they chose to ignore that. It wasn’t in the script.

Afterwards when a nurse asked me how I felt I said “crappy” and she laughed. It had to be a joke, because being genuinely in pain or not coping isn’t in the script.

Some doctors get it. We need more that do.

By: D.J. Kirkby

D.J. Kirkby — Thu, 09 Dec 2010 07:19:43 +0000

Beautifully written and thought as usual. Each of your posts has made me teary eyed, in a good way. I want to read a book full of your stories.

By: catdownunder

catdownunder — Thu, 09 Dec 2010 04:24:55 +0000

You are going to make a damned good doctor. I know I would have been tempted to say, “I would be scared too.”
It’s okay to be scared because it is another way of being brave.

By: Clare

Clare — Wed, 08 Dec 2010 23:12:44 +0000

It is such a privilege to read your compassionate and articulate posts – I do hope there are fellow medics and medical student teachers reading them as well.

“As doctors, we are not taught how to comfort or care or cry with someone who is afraid of dying.” – I’m not sure that these things CAN be taught, they come naturally to some people, such as yourself. I agree with Mick that resources might be better spent/shared on providing patients with access to someone who cares, rather than someone who is unable to deal with their inability to cure.

Your patients are fortunate to be in your care.