Other Features: Teaching and Learning Moments
Many physicians will agree that one of the most daunting tasks in the practice of medicine is delivering bad news to patients and their loved ones, a skill that is not formally taught in medical school. During my second year of medical school, I worked as a clinical research student volunteer in the ER at my university's medical center. I know that the experience I gained that year will have a lasting impact on my future in medicine.
Early one evening, a 26-year-old Hispanic male was brought into the ER with a gunshot wound to the stomach. In the operating room not long after, he went into cardiac arrest and was pronounced dead. The police officer who drove his parents to the hospital only gave them a brief and inaccurate explanation of their son's injuries. Armed with great hope, then, they were not prepared to hear of their son's death.
To make the situation more complicated, the family had recently emigrated from Cuba and spoke no English. Instinctively, I spoke up when no one else on the team knew enough Spanish to convey the news to the young man's parents. As a second-year medical student, I understood the science that led to this man's death, but my experience delivering bad news was limited to lectures and standardized patients. Still, I wanted the chance to help my team and the family. I took a seat next to his mother and father and began to speak, “Es muy difícil para mi hablar con ustedes, Luis* tuvo una herida muy seria y los médicos intentaron todo lo posible sin éxito y Luis se murió.” My words had an immediate impact. I spent the next three hours with the family, trying to communicate my compassion as best I could with the Spanish I knew. I held their hands and listened to their words of grief and the stories about their son.
Months have passed since that night in the ER, yet it is still crystal clear in my mind. I often find myself wondering how Luis's parents are coping with their loss. That night I learned that my ability to speak Spanish was helpful but not enough to deliver such news. I learned that the words were necessary but not nearly as powerful as the unspoken impact of my embrace or the touch of my hand. When I left them that night, they told me that they loved me and would never forget what I had done for them in their time of need. What they didn't realize, though, was that they had done something for me as well. They had taught me that delivering bad news is about so much more than the words. It is about connecting with people, like Luis's parents, who may need your compassion more than your explanation.
Ryan David Whitney
*To protect the identity of the patient and his family, the names have been changed in this essay.