Summary of “How Do You Talk to Your Patients About Death?”

Instead of admitting patients from the emergency room and addressing all of their medical problems throughout their hospital stay, I saw patients only when another doctor requested a consultation for a patient, usually to treat certain symptoms and to talk with patients and families about their treatment goals-what patients considered most important and dear to them when living with a serious illness.
I’d gone from assuming that many of my patients would live for years after their hospital stays to knowing that some of my patients would die within the coming weeks or months after returning home.
“No, it’s your first day! So on our team we have two nurses and an attending physician and me. Everyone usually shows up for rounds at 9:30 or so, and we will talk about each of the patients on our list. The attending this month is Dr. Harris, and she’ll assign you a few patients to see. Oh, and you’ll need that,” she said, motioning to a pager on the corner of my cubicle.
Businesslike and efficient as she introduced herself, Dr. Harris told me that her day was packed with meetings, but that she would assign me several patients to see and we would talk about them later in the afternoon.
Almost all of our patients required family meetings, and some also required better control of pain.
The biggest shift was my new relationship to language, my attention newly focused on the words I used with patients and colleagues, and the words I heard them use.
“Take note of how long the oncology fellow talks before allowing the family to speak.” The oncologist, a brown-haired man with a kind face, spoke for twenty-five minutes about the gravity of the patient’s diagnosis, the chemotherapies that theoretically could be used, and all the reasons why the patient was too sick to qualify for them.
A patient with a failing liver asked me how much time I thought he had to live and begged me not to mince my words.

The orginal article.