How patients can handle bad medical news

When bad medical news hits, the blow can be devastating.

Shock is almost always the first thing people feel, followed by anger, fear and often a profound sense of sadness.

At times like these it came be extremely difficult to collect your thoughts and decide what to do next.  Your head is likely to flood with questions that arrive at various moments – in the middle of the night, in the shower, in between sips of coffee.

An experience like this is made all the more difficult if you are someone whom others rely on, which is why I’m writing about this topic here.

Just the other day I met a woman who received a game-changing medical diagnosis.  Amongst the worries that were obviously overwhelming to her, one in particular stood out and took the form of a question: Will this illness prevent me from taking care of my aging parents as I’ve been doing for the past several years?

I encouraged her to ask it at her upcoming doctor’s appointment.  What better way to cut to the chase and get to what matters most to her and to her mental well-being?  I also offered her the advice below.

1. Write down every question you can think of starting with the ones that scare you the most

You might be surprised by how much better you feel after doing this. That’s because there’s something very powerful about putting our fears in writing – as if the thought aren’t free to swim around in our heads anymore because we’ve expelled them somehow.  This helps us to regain a much-needed sense of control.

Obviously, this exercise also helps you to focus on the questions that matter most to you which is critically important when appointments are brief (and let’s face it, they often are).

2. Try to organize your questions into things you need to know by the end of today, by the end of this week, by the end of this month

Along the same lines as #1 above, it’s very easy to get lost in conversation that is inconsequential when you’re pressed for time.  Instead, understand that every minute counts. Just like the “Sell by” date on the milk container in your fridge, put a “Need to Know By” date next to each of the questions on your list so that you can stay focused during the appointment and leave with the information that’s most important.

3. Invite someone you know and trust to go with you to the appointment – preferably someone who is a good listener and note-taker

Depending upon who’s in your social circle (and how forthcoming you’ve been with friends/family about your bad medical news), you may have more than one person offer to go with you to the next appointment. Choose wisely here.  This is not the time to feel obligated to take your sister because she was your Maid of Honor 20 years ago. It’s also not the time to be a hero and go alone – got me?

The purpose of taking someone with you is a strategic one:  You want an extra set of eyes and ears to help you recall what was said later on.  Plenty of research shows that people hear only a small fraction of what’s said in a doctor’s office. Especially when anxiety is part of the picture.

4. Regardless of time constraints, ask your questions

Remember how I said before that it’s easy to get stuck in conversation that’s inconsequential to you when you’re pressed for time? Yeah?

Well it’s even easier to lose your nerve or feel unworthy of answers when the provider seems big and distinguished and important … or when he/she seems incredibly rushed.

Whatever happens, don’t let the hustle and bustle stop you from getting the answers you absolutely need.  If you run out of time, schedule another visit as soon as possible.  You are worthy and you do deserve the answers.

5. Give yourself time to digest what you’ve heard so you can make good decisions

When you leave the doctor’s office you will likely have a mix of emotions not unlike the ones you felt going in.  But, you should have a clearer understanding of the most important things.  Inevitably there will be decisions to make and next steps to take, so do yourself a favor and take some time to digest what you’ve heard.  Whatever this “digestion” looks like for you, I would encourage you to regroup with your co-listener/note-taker to compare what you heard the doctor say.

Above all, be gentle with yourself.  A diagnosis of a serious illness is one of the most stressful life experiences a person can have.  If at all possible, try to find others who have been where you are and accept their support.

Maria Basso Lipani is a social worker who blogs at Geriatric Care Management.

 

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  • http://fertilityfile.com IVF-MD

    The skills required for a doctor to discuss bad news with his patients are learned and refined over time. Comparing how I did it 10 years ago to how I do it now, it’s clear that almost all of my learning in this particular area (and many others) came on-the-job, rather than from my time sitting in med school classrooms.

    In my field of fertility treatment, over 30% of IVF cycles and over 80% of IUI cycles end up failed and it becomes necessary to tell the patient that unfortunately, she did not get pregnant yet.

    One key tip is not to have a pre-scripted one-size-fits-all way of delivering this message. Instead, keep the conversation interactive, listen attentively to the patient’s response and adjust your words and demeanor accordingly.

    • http://twitter.com/GeriCareMgmt Maria Basso Lipani

      I couldn’t agree with you more.  Scripted responses often come off as disingenuine.  Much better is to stick with where the patient is. 

  • http://drsamgirgis.com Dr Sam Girgis

    When a patient receives very bad medical news or a bad diagnosis, they almost alway never hear or register the conversation that takes place afterwards. The best thing to do is give the bad medical news, give a few words of support, and answer any questions. Let the patient think about the news for some time. Then return to the topic at a later date, after the patient has had some time to think about what you have told them. This way, they will be much more receptive to any further discussions that are necessary. This is my personal experience.

    Dr Sam Girgis
    http://drsamgirgis.com

    • http://twitter.com/GeriCareMgmt Maria Basso Lipani

      And just knowing that your doctor is available and willing to talk at a later date goes along way in helping patients and their families to cope with the bad news.

  • https://www.dialdoctors.com/ DialDoctors

    I believe it is difficult for a doctor to give out bad medical news to patients, as well as it is extremely difficult as a patient to hear bad medical news from your doctor. As IVF-MD previously mentioned, doctors require skills to “break” the bad news to the patient, but these skills are acquired with time. As well as patients need ways to manage these atrocious news. Of course emotions will try to overcome any type of reasoning at the moment; but it is extremely important to find a sense of focus amongst this awful time. As Maria mentioned in the article the ways of collecting the thoughts, asking questions, make all information completely clear and decide what is next.

  • Jackie

    From the patients point of view, the diagnosis is not necessarily a ‘shocker’ – the patient probably has been suffering from the ailment and is eager to deal with it. The more important thing, to me, is that my doctor provides a ‘solution’.

    The neurologist who announced the discovery of my life-long brain tumor 21 years ago did the right thing: “Good news and bad news – bad news is that you have a brain tumor; good news is that it is in a location that is operable. And judging from its appearance, it’s mostly benigh. But it is in a bad location, I would not recommend anyone but Dr. so-and-so…”

  • https://www.dialdoctors.com/ DialDoctors

    I agree Jackie. Sometimes it isn’t a s shocker for patients who have been dealing or facing the symptoms for a while. This is when the doctor must be clear, concise and strategic on how to proceed with the solutions toward the diagnosis.