I practiced the words in my head one more time before I picked up the phone and dialed. When my patient’s son answered, I froze for a moment, imagining the roles were reversed and I was about to receive the news that I had to give him. After collecting my thoughts, I introduced myself, reminding him that we had met the previous night.
Then I said: “I’m calling with bad news. Your father’s illness worsened this morning. He is going to die. I encourage you and your family to come to the hospital as soon as possible to say goodbye.”
My patient’s son will probably remember this phone call for years. I still remember everything about it six months later. It was only the third time I’d had to tell someone that their loved one was dying. Looking back on the conversation now, I’m glad that I prepared for it. But I am also concerned to realize that the practical steps I took — get the facts, write out the objective, address my own emotions, prepare for possible reactions, practice aloud — came not from my medical training but from a business-school course on hiring and firing employees.
Like most doctors, I spent four years in medical school learning to treat hundreds of illnesses and help patients manage their health. I spent very little of this time learning how to work with patients when modern medicine runs out of miracles — and only a few hours, spread over four years, learning to lead end-of-life conversations and deliver bad news.