bearing bad tidings
March 21, 2003 10:46 AM   Subscribe

The terrible business of bearing bad tidings: “You never know how someone will react ... Some people will start screaming when they see you coming. They just know something is seriously wrong when a uniformed soldier comes to their door.” The military, law enforcement, and even MADD have written protocols for contacting the next of kin when someone dies. But doctors are pretty vague about how to handle the conversation, which is odd, considering that 70% of American deaths occur in hospitals.
posted by whatnot (5 comments total)
"Deep down, though, many physicians feel that when a patient dies, they have failed."

I'm not a doctor, but I would think that physicians reporting a death tend to lack the options that those other groups have. If soldiers were obligated to report casualties face-to-face as they came in from the battlefield or if police had to deal with family members at the crime scene (handcuffed the girl's mother?) then the situations would probably be more alike. A doctor in the middle of a shift at trauma ward lacks the time and resources of the other groups. Still, a widespread doctors' protocol probably would help.

(Nice post, by the way-- depressing as hell, but good.)
posted by tyro urge at 2:14 PM on March 21, 2003

kind of a downer, especially for friday, especially in the wake of the world affairs. sorry about that.

thanks for bringing up an angle I hadn't thought about, tyro.
posted by whatnot at 2:55 PM on March 21, 2003

I know that when my step-dad was needing to be pronounced last month the doctor had a difficult time in that little room they had us all in. (Beware of the little room - no good news happens in there).
Anyway, after he got it out, I went out to the carport outside the ER and saw the Dr. (he is a neuro-surgeon) come out to have a smoke. I had to chide him a bit about it, but he said that was one of the ways how he dealt with death - even though he knows that it isn't good for him, it is a release valve that he uses.
posted by thatothrgirl at 3:10 PM on March 21, 2003

Interesting post, thanks.

Reminds me of a show I saw on Discovery Health recently...they were following "a day in the life" of three different doctors at three different hospitals. One was an aging hippy type - long ponytail, John Lennon glasses. Anyway, at one point, he had to go in and tell a young woman the bad news: after her latest round of chemo, her cancer had spread.

He was matter-of-fact, almost friendly. He was actually smiling through part of it, but I think that was just part of his personality. He'd been working with this woman for so long, he felt close to her. Anyway, he said something like "Well, remember when we started this last round of chemo, I told you that if it didn't work, it was pretty much our last chance..." pause The woman starts crying softly. He continues, showing her her latest MRI, pointing out where the cancer has spread. He started to sound like a sports analyst - "I really thought we had it beat at this point, when we were doing the such and such and your CA reading was so and so...." Were I the patient at this point, I probably would've been patting his hand and telling him "there, there....". Then he got to the part that, for me, sent the icy fingers of fear up and down my spine: "now what we want to concentrate on is managing your pain, while you get things settled..." So final. Suddenly you realize it's not really "we" but just you. After comforting the patient a bit more, the doctor left. Out in the hallway he lost his composure for about two seconds. Then he visibly shook it off and said aloud, "Next" as he continued on his rounds.

Well, this was a "telling someone they're dying" post rather than a "telling someone their loved one is dead" post; sorry about that. Although I do have an anecdote for the other, as if I haven't been depressing enough...
posted by Oriole Adams at 5:29 PM on March 21, 2003

Good post, whatnot. Once when a friend suffered a sudden loss of someone close, she asked me to help notify friends and family because she couldn't. Wow, that was hard! Here are some great resources I've found on the topic:

Messengers of Death - a helpful how-to for those who have to break the news.

A Child's Grief - an excellent article talking about how different kid's experience and process death ar different ages, and suggestions for adults in how to help a child grieve.
posted by madamjujujive at 11:09 AM on March 22, 2003

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