The Other Side of Bad News

I arrived home from work to find my husband uncharacteristically sitting at the dining room table, waiting for me to walk through the door. He said, “Sweetheart, I think there is something wrong with me.”My heart dropped as I noticed the left-sided Horner syndrome that had developed overnight and as I watched his face turn bright red when he lifted his left arm. He complained that the left side of his neck was uncomfortably tight, and I was already walking him to the front door as I felt the rock-hard mass in his supraclavicular fossa. While I drove him to the emergency roomof the university hospital where I worked, his subtle and not-so-subtle complaints of dysphagia, fatigue, and lethargy over the last few months were now prominent in my mind. I was relieved when we walked into the waiting room and found only two patients waiting. The triage nurse recognized me, and she quietly expedited our emergency department intake.Withinminutes, an attending physician with whom I had worked walked into our bay and skillfully dismissed the medical student who followed him in to obtain the history and physical examination. The events over the next few days changed our lives, and my medical practice, forever. Myhusbandwasdiagnosedwith anaggressive lymphoma during my second year of internal medicine residency. I had delivered bad news many times and was beginning to feel comfortable in that role and somewhat skilled in the process, but I was completely unprepared for being on the other side of bad news. Multiple medical providers entered our lives during the initial weeks following his diagnosis, and I was surprisedathowmyhusband interpretedand reacted to their words and actions. Several examples stand out. In each case, I fully understood the perspective of the medical professional andnowhave anewappreciationof the patient’s perspective that has changed the way I approach bad news with my patients.