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Humanities

The other side of breaking bad news

Roxana Chis
CMAJ November 23, 2020 192 (47) E1548-E1549; DOI: https://doi.org/10.1503/cmaj.201663
Roxana Chis
Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, Ont.
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  • RE: The Art in Medicine help convey the Truth to the Patient
    Dhastagr Sheriff [PhD]
    Posted on: 07 December 2020
  • RE: The other side of breaking bad news
    Catharine L. Dewar [BSc, PhD, MD, FRCPC]
    Posted on: 23 November 2020
  • Response to breaking bad news
    Rae Dalzell
    Posted on: 23 November 2020
  • Posted on: (7 December 2020)
    RE: The Art in Medicine help convey the Truth to the Patient
    • Dhastagr Sheriff [PhD], Professor, Faculty of Medicine, Benghazi University, Benghazi, Libya

    “Go placidly amid the noise and haste, and remember what peace there may be in silence.
    As far as possible without surrender be on good terms with all persons.
    Speak your truth quietly and clearly; and listen to others”- DESIDERATA
    Many times a physician is faced with the problem of delivering the message of diagnosis of a disease like cancer or poor prognosis. During such moments they need to speak quietly and clearly to the patient, preparing them to receive the message with hope and less emotional strain. The lines illustrate that by being a listener a physician may learn many things from the patient. Their suffering, their reactions, and side effects could help the physician learn more about the disease and therapy.

    Competing Interests: None declared.

    References

    • Roxana Chis. The other side of breaking bad news. CMAJ 2020;192:E1548-E1549.
  • Posted on: (23 November 2020)
    RE: The other side of breaking bad news
    • Catharine L. Dewar [BSc, PhD, MD, FRCPC], Rheumatologist (retired), Division of Rheumatology, Lions Gate Hospital, North Vancouver B.C. (retired)

    This was heartbreaking to read, and I commend Dr. Chis for writing this article. It would have been very emotional for her to pen this; she has done an excellent job. I hope that every Physician who reads this learns to be a much better caregiver and 'bad news' messenger as a result. Amongst all the decades of changes in medical school curricula, many schools have focused more effort at teaching communication skills and empathy. Students and Residents are also being taught to climb down from a privileged pedestal, to 'team manage' their patients' efforts to regain health. Physicians-in-training are being taught to 'partner' with their patient and the patient's family, during that journey. We should not be reading articles lamenting Physicians mismanaging the care of any patient but in particular their colleagues, spouses or family members. This was very difficult for me to read as it brought back memories of my own diagnosis of a brain tumor almost 30 years ago, following my presentation to the ER with sudden alarming symptoms. The specialist who was called to see me appeared to think I was fabricating my symptoms, openly suggested STD as a possible diagnosis based on his own biased assumptions of my work, and suggested I could order my own MRI as I would very likely get the needed imaging booked faster than he could. That is exactly what I did, and this is not unlike the unreasonable requests made of Dr. Chis by some of her thoughtl...

    Show More

    This was heartbreaking to read, and I commend Dr. Chis for writing this article. It would have been very emotional for her to pen this; she has done an excellent job. I hope that every Physician who reads this learns to be a much better caregiver and 'bad news' messenger as a result. Amongst all the decades of changes in medical school curricula, many schools have focused more effort at teaching communication skills and empathy. Students and Residents are also being taught to climb down from a privileged pedestal, to 'team manage' their patients' efforts to regain health. Physicians-in-training are being taught to 'partner' with their patient and the patient's family, during that journey. We should not be reading articles lamenting Physicians mismanaging the care of any patient but in particular their colleagues, spouses or family members. This was very difficult for me to read as it brought back memories of my own diagnosis of a brain tumor almost 30 years ago, following my presentation to the ER with sudden alarming symptoms. The specialist who was called to see me appeared to think I was fabricating my symptoms, openly suggested STD as a possible diagnosis based on his own biased assumptions of my work, and suggested I could order my own MRI as I would very likely get the needed imaging booked faster than he could. That is exactly what I did, and this is not unlike the unreasonable requests made of Dr. Chis by some of her thoughtless colleagues. In my case, I had bled into a large tumor at the base of my brain and that is why my symptoms were sudden and acute. I can hardly imagine how difficult things have been for Dr. Chis and her husband, with their roller coaster of thoughtless miscommunication. I thank Dr. Chis for writing this very poignant article. It is embarrassing to think that Physicians still need to be taught empathy and communication skills their patients have every right to expect, especially from their colleagues. Bless you and your husband for sharing this timeless message with the medical profession.

    Show Less
    Competing Interests: None declared.

    References

    • Roxana Chis. The other side of breaking bad news. CMAJ 2020;192:E1548-E1549.
  • Posted on: (23 November 2020)
    Response to breaking bad news
    • Rae Dalzell, Family Physician, Langley Hospital

    Thank you for your vivid portrayal of your journey and pointing out where as physicians we can do better. I can relate to much of what you say about the struggles of trying to navigate the health care system as both a patient and physician. Thank you for sharing.

    Competing Interests: None declared.

    References

    • Roxana Chis. The other side of breaking bad news. CMAJ 2020;192:E1548-E1549.
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Canadian Medical Association Journal: 192 (47)
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Vol. 192, Issue 47
23 Nov 2020
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The other side of breaking bad news
Roxana Chis
CMAJ Nov 2020, 192 (47) E1548-E1549; DOI: 10.1503/cmaj.201663

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The other side of breaking bad news
Roxana Chis
CMAJ Nov 2020, 192 (47) E1548-E1549; DOI: 10.1503/cmaj.201663
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