Breaking the news that no one wants to hear

By Erin Stewart

Today was the day someone’s whole life changed. Not my own, no — for me, today was a routine and pleasantly sunny day. But for Mrs B, her life would never be the same. For Mrs B, her day was well below average, and I doubt she even took notice of the weather at all.

“Oh, wait. Let’s check her pathology before we go in” said the senior doctor on ward rounds, standing outside her door, unlocking his phone. Mrs B had recently had an operation to remove a suspicious mass. The doctors suspected the mass was benign, and that thought was extended to the patient and naturally Mrs B was not concerned. Just annoyed every morning that the sun was too bright coming in through her window.

“Oh shit, that’s bad”, the only explanation given by the senior doctor. “Oh shit, that’s really bad”.

Mrs B has a high grade carcinoma, unexpected, asymptomatic, and for her, completely life-changing. We discovered it right outside her door, whispering to each other so that she couldn’t hear. It felt unprepared, but nothing could prepare her for the news. I watched the shock on her face, the tears, the attempt to place her hands somewhere but could never find the right place for them. The redness on her skin starts to extend from her chest to her cheeks. And no one was with her. Doesn’t medical school always teach us to ask if they would like someone to be with them when we break bad news?

“Bad?” she asked. How do you answer that? Yes. But you can’t just say yes. I watched the doctor find the words to say this while also trying to give hope. As a final year student, I have been at bedsides and in various family meetings where bad news is given, but today a wave of guilt suddenly hit me like never before. I was standing there, subconsciously noticing the beautiful day though the window, feeling fit and healthy and once we left the room she would be all alone with her thoughts until her husband arrived. I felt unworthy to be standing there while this news was given, as I had never felt was she was feeling. My sympathy was real but could never been complete.

I decided to peel off from the ward round and sit with her until her husband arrived, a luxury I know will not always be afforded to me as a doctor. We didn’t say much, I just held her hand and offered her water. She spoke about how she would tell her family, feeling it would all be too much for her husband.

The wards were quiet today so I was told to leave early and go home. I had lunch with my mum, which was lovely, and then went to see my husband at work. All the while I had Mrs B in the back of my mind, the first time I had truly seen someone speechless and in state of shock. I knew I had no reason to feel guilty that my day was lovely while she was struggling with some of the worst news we could ever hear. But I did feel guilty, and I still do, for being able to walk out of that room in the opposite direction to the path she is now treading.

As medical students and doctors, we spend our days with the sick. We hope that all patients leave cured, but they do not. The familiar creed “to heal sometimes, to cure often and to comfort always” has never been more poignant to myself than today. In that room, Mrs B needed someone to hold her hand and be with her. That was the best treatment I could give her today, and for that I don’t feel guilty at all.

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