How to Give Bad News

Turn off your cell phone (#1). We all do, ostentatiously hitting power buttons before striding into the conference room, med students playing doctor. We enter, pseudo-sad faces plastered over sheepish grins, learning how to deliver the news that our classmate's imaginary husband or wife had died from an imaginary coronary. Our partners sit at the table, five med students playing actor, knowing full well the "news" that is coming.

I sit down (#2), match eyes and keep an open posture (#3), and ask Frank if there is anyone he would like to join him to hear this (#4). I fire a warning shot (#5), informing him that I have some bad news. I tell Frank his wife has died (#6) We aren't supposed to use the words "passed away," apparently they sound too soft. Frank hams it up, histrionically shouting at me, before breaking apart into snickering. I struggle to keep a straight face. I explain what happened, and Frank regains composure, and starts playing along. An apt expression, "playing along," because we are playing, miming through one of the worst parts of life, and the discomfort of the moment expresses itself most handily as hilarious. Through that I try to remain empathetic (#7) to Frank's false misery, and answer any questions (#8) that Frank doesn't really have. I avoid medical jargon (#9), ask if he would like to see a chaplain (#10), and make arrangements for a follow up meeting that in real life (and our imaginary one) would never happen (#11). Finally I offer to take him to see the body (#12).

I've been on the other side of that table. I have heard doctors run through their checklist, the procedure of "giving bad news." In retrospect, I wonder if it has an ICD-9 code, so as to get reimbursed. But even with my perspective it was awkwardly funny, five fake tragic discourses at the same table. Awkwardly funny, until the moment walking out, when you realize that taking part in the worst moments of people's lives is now part of your job description.