Polite Dissent

Sharing bad news with a patient and their family is one of the toughest jobs in medicine. Luckily Will Eisner, Steve Ditko and Stan Lee have provided the fledgling physician with several lessons on how to deliver bad news:

1. Always stand when addressing the patient.
   This lets the patient know who’s in charge.
2. It’s helpful to hold an x-ray or other prop to show how serious you are.
   This reinforces the fact that you are the expert.
3. Lay a comforting hand on the patient’s shoulder or chest.
   If you don’t want to actually touch the patient, its OK to just touch their non-contagious spouse.
4. For added attention, make sure to address the patient by name.
   This is particularly important if the patient is evil or will die before the day is out.
5. Hospital scrubs are the best choice of apparel.
   They provide a veneer of respectability. If you don’t wear scrubs, at least wear a suit and tie in a subdued color.
6. Make sure you stand between the patient and the door.
   This way they can’t run away, and you can quickly escape if they become violent.

And before anyone gets bent out of shape or offended: I’m joking. This is not how we’re taught to deliver bad news (although I suspect it’s not too different from how physicians were taught not that many years ago).