Bad News...

It’s so hard to give, but who knew, it’s way harder to receive.

I have been practicing emergency medicine for almost 9 years and giving bad news is part of the job. I have had to tell family members that their loved ones didn’t make it out of a car accident alive. I have had to tell someone’s daughter that their mother who collapsed in front of her eyes while enjoying a meal together has an irreparable brain bleed and will never regain consciousness again. I have had to tell patients that the CT scan I did because they were having abdominal pain for weeks showed metastatic cancer. Each time, it is hard. Sometimes, I cry a little after. But within 10 minutes I compose myself and act as if nothing sad happened. Not because I am jaded but because I have to. I have to for the other patients I am taking care of that shift. As doctors, we are very good at compartmentalizing. It’s a coping skill so that we can function and do our job to help others. It’s not because we don’t care. It's not because it doesn’t affect us. It does. 

But how do you compartmentalize when bad news is so bad that it fills all your compartments?

I remember the day and time almost exactly. It was January 10th around 2pm. I got a call from the radiologist who did my biopsy the day before. She said my biopsy results came back already. I was surprised because she said it would take a few days. Already there was a red flag. Early news seemed like bad news. She said, “your biopsy results came back. Unfortunately, it’s showing cancerous cells.” She was silent for a moment. Doctors do this often to give a moment to make sure the news was heard and is sinking in. I do it all the time after giving bad news. I said, “oh my gosh...” to confirm that I heard every word, but mostly because I didn't know what else to say. She said, “I know, I was surprised too.” After I hung up I cried. I had no words. I was overcome with anger, fear, sadness, disbelief, all the “why?’s and what next's.” I cannot explain what happened but I realized there was no compartmentalizing this. It was all consuming…

I was scheduled to be at work in less than 2 hours. My shift started at 4pm. After I found out I told Dan and only Dan. We hugged and cried a bit more. I changed into my scrubs, hugged Landon, and drove to work. I cried all the way to work. Miraculously, one of my best friends from residency called on my drive to work so I told her and cried some more. I arrived in the hospital parking lot where I wiped my tears and took a deep breath. By the time I entered the ER no one could tell I had been crying. I said hi to my coworkers and the nurses like nothing had happened. When I was asked how I was, I said “I’m good, how are you?” like every other shift. I acted like I had not just heard the most devastating news of my lift. I started to see patients and just like that, for 8 hours, I forgot I had cancer. I took care of patients who were sicker than me. Somehow I was able to compartmentalize. Apparently the skills I gained while training to be a physician helped me be a patient too. Thank goodness.