I don't often have to break bad news to patients. It happens much less often than you'd think. I give people advice that I know is unwelcome, I warn them of future lifestyle-related problems. I diagnose urine infections, chest infections, depression, panic attacks, high blood pressure and myriad rashes. But when it comes to giving the really bad news, when it comes to telling people that they have an imminently life-threatening disease, I am usually not involved. The patient most often has been referred to a specialist, or has ended up having tests done in hospital. I am rarely present for the 'moment of truth'.
I have needed to deliver awful news on occasion, though. Once, a patient 'Veronica' came to me rather than returning to the hospital clinic, for her head scan results. It was too much hassle to go all that way, she told me, and besides she needed to be on time to collect the kids from school. Her husband 'Phil' sat with her as I phoned the hospital. I spoke with the hospital doctor, as Veronica and Phil sat watching me.
"There are several presumed tumours - they're large, and they're deep. Looks like *GBM (*glioblastoma multiforme - a particularly nasty brain tumour). Don't think they'll be operable", reported the hospital registrar.
I thanked the doctor on the end of the phone. I carefully replaced the receiver. I slowly explained the findings to Veronica and her husband. I'll never forget the first words out of Veronica's mouth - she was in shock - 'How funny! I've just been to a charity lunch to raise funds for cancer patients!"
That was almost ten years ago, and Veronica has long since passed away. I was reminded of her, though, when I had to give some bad news to 'Rita' last week. I was reminded that there is no good way to give bad news. I also realised that I will always sag under the burden of carrying such a dire message. I wished I would not be forever recalled as the bearer of the terrible news. I wished most of all that there was no bad news at all to deliver.
As much as I try not to 'take my work home', some thoughts just follow me on the drive anyway, trailing insidiously behind me like some noxious vapour. When I reach home, and especially when I lie in bed at night, the gases swirl and mist around me, and I can't sleep for the fog.
What will happen to Rita? I don't know. It's out of my hands now.