Learning Good Lessons from the Bad News

It's the 3rd week of being a 4th Year medical student. And I am currently at the mid point of my Respiratory Medicine block before moving on to the next block.

One of the activities that I did in this block was to attend my consultant's clinic sessions. I had attended two of those sessions so far. These sessions were however different from the other clinic sessions which I had gone for over the past 3 years. They were unique as i have never seen so many patients crying after attending the clinic. They cried as they had got bad news from my consultant who runs the Lung Cancer Clinic on Mondays. They were, unfortunately, diagnosed as suffering from lung cancer. Most of them were at the end-stage of their cancer as lung cancer tends to be detected clinically only at the late stage. In other words, most of those patients suffered from a disease which could not be cured.

I had participated in several seminars on breaking bad news to the patients in Year 3 but I have not encountered any real cases in the clinical setting. This placement gave me the opportunities to observe how the doctor informed the patients about the diagnosis of their cancers which could be a very challenging task even to an experienced doctor. Normally, my consultant would get a nurse to come in while he told the patient about the bad news. Most of the patients, and even their partner, would cry immediately after knowing the result. Some of them would be calm after a while but some of them would be in denial state and even refused to receive any treatments. I would not be surprised as it's normal for anyone to break down when they know they have got an end-stage cancer.

There were some instance which I really had some tears in my eyes. It is such a difficult task to tell your patients that they only have months to live while remain calm. However, i think this is an essential skill to learn as a medical student so I can handle such situation after I am qualified.

Hopefully I will not have to break too many bad news to my patients next time but when I really need to do so, I hope I can manage it well.