November 2008 Author: Nathan Goldstein http://www.getpalliativecare.org/quick-facts/ No one likes to receive bad news, especially when it is about your health. Being diagnosed with a serious illness is one of the scariest and most upsetting things that can happen to you or a loved one. It is not uncommon to have a mixture of many emotions – fear, anger, sadness, anxiety, guilt. Also, if a person has had symptoms for a long period of time or has undergone many tests, finally “knowing the answer” to what is wrong may in some ways even be a relief.
Studies show that when given bad news about an illness, it is rare for patients and families to be able to remember everything they are told during the appointment. You may have to be told the information several times, and in different ways, before you are able to absorb or understand it. In addition, it can be very hard to think clearly in such a situation, so try not to be preoccupied with asking all of the “right” questions immediately. Below are some questions you should ask your physician when you or a loved one is diagnosed with a serious illness.
1. Can you tell me that again?
When being told bad news, it is completely normal to not be able to take in everything that you are told. Whether it is at the same appointment or at the next one, it can be helpful to ask this question to make sure you understand what your doctor is telling you. 2. Can I say that back to you so I know that I correctly understand what you are telling me?
Studies show that in many cases physicians believe they are clearly and fully explaining a diagnosis, while in reality the patient has left the discussion with only a partial or incorrect understanding of the information. Ask your physician if you can tell him/her your understanding of the conversation in your own words to make sure you fully comprehend what has been said. 3. What do we do next?
While it takes a while to adjust to bad news, knowing what comes next can often relieve anxiety and help focus your mind on positive activities. Work with your doctor to get a sense of the plan so you can better understand what comes next. When are you seeing the doctor next? Are there more tests that need to be done before the next visit? 4. How serious is this?
This is probably the scariest question of all. Many times there are very good treatments that can cure your disease, and your doctor can tell you about them. Remember that not everyone wants to know the answer to this question – so doctors may not always tell you this without your asking. Also remember that if you are a family member who hears the diagnosis with a loved one, he or she may not want to know the answer (and vice-versa). So sometimes it is important to first ask your loved one, “How much more do you want to know now?” 5. What else should I be asking at this point?
This kind of open-ended question allows your doctor to give you information that you might not think to ask. Many times the shock of hearing bad news makes it difficult to think, and so you may need help with asking the next question.
Remember this is a stressful time, and it is normal to forget things. Write down what your doctor says. Then, when you get home, write down questions you and your family have about the diagnosis. If you are the patient and you went to the appointment alone, it is a good idea to take a loved one with you next time – both for emotional support as well as to help you understand and remember what the doctor says.