How not to deliver bad news
Posted: Wed Nov 09, 2005 2:21 am
I did not witness this event firsthand but I've heard about it from several people so it is true.
So we have this one class called "The Clinical Practice of Medicine", which is our most badly run class for many many reasons which I won't go into here. But we have these seminars where we interview (and will physically examine next year) standardized patients. This week the seminars were centered around delivering bad news to patients.
The situation:
Pamela Wright's ultrasound results show an anencephalic fetus—little or no brain development. The patient will carry the baby to full term and then the baby will die sometime shortly after the birth.
The cast:
XXXX XXXX as The Medical Student
Standardized Patient as Pamela Wright
TMS: Hello Ms. Wright, I am XXXX XXXX and I am a medical student working with Dr. XX, how are you today?
PW: I'm anxious about the ultrasound results.
TMS: Right. So I have some good news and some bad news, which do you want first?
PW: Well, I guess the bad news.
TMS: Your baby is anencephalic. He has no brain.
PW: Oh my God, what does that mean?
TMS: He has no brain. No brain. Sorry.
PW: Well you said you had some good news? What could that possibly be? Is there a treatment?
TMS: No, there is no treatment. Your baby will die.
PW: Oh God! [sobbing] What's the good news then?
TMS: I just saved 10 percent by switching to Geico.
PW: ...
[Other students trying to muffle their laughter.]
Seminar leader: Um. Ok, who's next?
Someone is obviously not going to be getting Honors in CPM.
So we have this one class called "The Clinical Practice of Medicine", which is our most badly run class for many many reasons which I won't go into here. But we have these seminars where we interview (and will physically examine next year) standardized patients. This week the seminars were centered around delivering bad news to patients.
The situation:
Pamela Wright's ultrasound results show an anencephalic fetus—little or no brain development. The patient will carry the baby to full term and then the baby will die sometime shortly after the birth.
The cast:
XXXX XXXX as The Medical Student
Standardized Patient as Pamela Wright
TMS: Hello Ms. Wright, I am XXXX XXXX and I am a medical student working with Dr. XX, how are you today?
PW: I'm anxious about the ultrasound results.
TMS: Right. So I have some good news and some bad news, which do you want first?
PW: Well, I guess the bad news.
TMS: Your baby is anencephalic. He has no brain.
PW: Oh my God, what does that mean?
TMS: He has no brain. No brain. Sorry.
PW: Well you said you had some good news? What could that possibly be? Is there a treatment?
TMS: No, there is no treatment. Your baby will die.
PW: Oh God! [sobbing] What's the good news then?
TMS: I just saved 10 percent by switching to Geico.
PW: ...
[Other students trying to muffle their laughter.]
Seminar leader: Um. Ok, who's next?
Someone is obviously not going to be getting Honors in CPM.