Delivering bad news.

15 Jul

Saturday workout:  Fun run through the city with Dean

I really just love exploring random streets and neighborhoods in Chicago by running.  Yesterday, Dean and I headed Southwest on our run.  We ran through the UIC campus and then through Little Italy.  Cool new sights…

Near the UIC campus.  We both loved studying the homes in these random neighborhoods.  That’s Dean, btw, in the middle of the street.

A church nearish to Taylor street.

Same church from another angle and different filters.

A random park along the west side of the city. It started to downpour after this…

Just a little wet…Dean just loves running in the rain ; )

Running in the rain actually felt really good.  I actually really enjoy running in the rain (in the summer).  Kinda makes me feel like a little kid playing outside.

~

On a more serious note, last night I got a call from the ED asking me to (ultrasound) scan a patient’s palpable lump.

Ultrasounds can sometimes take awhile to complete…you’re standing there in a room with a patient for 20 or so minutes concentrating on the screen in front of you that is displaying what you’re scanning.  Meanwhile, the patient is listening and watching your every move…closely studying your facial expression for any hint about what’s going on.

When the young guy was wheeled into the room, I could tell he was really nervous, and I knew the scan would take awhile, so I told him not to worry if I didn’t speak for awhile….that I had to complete the scan first and then I would go over what I saw.

Usually when I say this, there ends up being nothing serious going on.  Usually I complete the scan with a quiet, focused attention on what I’m doing and then when I’m finished, I gladly ease the patient’s fears by telling them everything was alright.

As soon as I put the probe on the patient, I realized that would not be the case this time.  My heart sank.  What he had felt was a tumor.

As I continued on and completed the scan, I attempted to keep a straight, emotionless, down-to-business look on my face.  When the scan was over, he immediately asked me

“What did you see???”  “Can you please tell me if you saw anything??”

Uggh.  I thought.  Normally if I see something potentially concerning while imaging a patient, I’ll tell them I need to review the images first on our larger, higher resolution monitors and that they should follow up shortly with their doctor for the report.  I usually do this, because I feel it should be their primary doctor who knows them well and ordered the scan be the one to sit down with them and give the results, not some random radiologist stranger.

In this man’s case, however, it would be either me or the ER resident to break the news to the patient, both of us who had just met the patient.

I told him I would go over the results with him when I was done, and so that’s what I did.  I think waiting in fearful anticipation would have been worse, and I already knew what his diagnosis was, so why delay?  He had to find out eventually.

As a physician, you want to help people…you want to make them better, to deliver good news, to be optimistic…but you can’t sugar coat things.  You should be compassionate, but you have to be realistic and straightforward.   You can’t beat around the bush when dealing with someone about their health.

After I told him that he most likely had a tumor and would need a biopsy for confirmation he had a mixed look of shock, panic, and fear on his face.  Then there was silence …. a silence filled with a heaviness that I wanted to break through by making small, light hearted talk.  I was uneasy seeing him uneasy, but I realized that sometimes respecting the silence is the best thing to do, so I kept quiet.  The only thing I really felt I could do to help him and the situation was to bring him back to his hospital bed myself rather than waiting for hospital tranpsort so that he could more quickly return to his family/friend…

Ughhh.  Not fun : (  My heart goes out to all those who are or have dealt with a scary diagnosis, and my full respect to those of you healthcare professionals who deal with these hard situations on a regular basis.

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6 Responses to “Delivering bad news.”

  1. Losing Lindy July 15, 2012 at 3:31 pm #

    :(

  2. Danielle A. July 16, 2012 at 8:22 am #

    I am a nurse and I have to tell you how much I appreciated reading this. Your bedside manner is amazing. I know that young man will never forget you. Not because you delivered the scary news but because you were kind, honest, compassionate, and treated him with the great respect. Keep up the great work you do.

    • Julia July 18, 2012 at 7:08 am #

      Thank you so much Danielle. Your words mean a lot to me.

  3. justgngr July 16, 2012 at 12:18 pm #

    tough situation that you handled expertly with grace. As Danielle said, your bedside manner is great. I dont think most patients would expect that from a radiologist – especially in the ED

  4. Mom Mom's Apron July 16, 2012 at 7:41 pm #

    You did a really good job of handling a tough situation with compassion.

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