The past Wednesday I had a chance to be posted on the SOPD (Surgical Outpatient Department). I was placed under a supervision of a medical officer. Though he does not show much passions in teaching medical student, still I had to find a way to learn something from there as it was part of my principles- not to walk out from a place in hospital without any learning.
This time I learnt about breaching the bad news to the patients. Almost the cases I saw in the consultation rooms were consisted of malignancy. Despite the fact that I does not feel much admiration towards the attitude of the medical officer, I had to admit that he is quite experienced in his fields because he breach the bad news in such a quick and easy way. Its like pulling off the bandage/plaster in one quick motion.
Case 1: There is this one 60-something-uncle whom I recognised from the operation room where he had TURP and rigid CU done on him. During the procedure, there were some abnormal masses in his urinary bladder. Now he came back for the histopathology report. As I mentioned earlier in one of my post, this uncle always look emotionless. His daughter was told by the medical officer that he had a bladder carcinoma and it’s already metastasize to his liver.
Case 2: A chinese lady with previous history of breast carcinoma in one of her breast. She came for the mammogram and FNAC result. “It was not good” as told by the medical officer after a brief of silence. The first response she gave was I don’t want to hear. However, the medical officer continued by telling her its resectable and she should consider that option.
Case 3: A Malay lady with a lump in her breast, nipple retracted came for a detailed examination. The medical officer explained the possibility of breast carcinoma and ordered a biopsy to be done on her.
For all cases above, I realised that the medical officer did it in a simple yet comprehensible way. It’s true that it may be very hard for the patient to accept the bad news, but somehow the bad news must be told. For every cases of suspected malignancy, he never hesitate on pointing out. There was once I read from an article that doctors are hope-givers. I won’t deny that statement but to some extent, I still believe we are there to tell the truths. I’m not sure it’s because years of experience that the medical officer could now breach the bad news in such effective way.
There is time when I placed myself in the patients’ shoes. Get a call from hospital regarding the result ->waiting anxiously outside the consultation rooms even though thousands of repetition on comforting oneself that everything is going to be alright and if it turn out to be bad, I can face it -> saw the expression of the doctor and heard the first sentence coming out from his mouth stating that “It’s not good” . Yes, we can psycho ourself numerous time that we can accept it, but most of us will never escape the 5 stages of grief- Denial, Anger, Bargaining, Depression, Acceptance. It’s exactly how I observe in the consultation room. Some people might stay in one of the stages and never get pass it. This is why I really salute the fighters of terminal illnesses. You ALL are very BRAVE.
In my journey of achieving my dream to become a medical practitioner, I learn from books, lecturers but at the same time I also learn a lot from the patients. THANK YOU FOR THE INSPIRATION AND VALUABLE LESSONS FROM YOU ALL.