It is "The Talk". It is the difficult act of telling someone that they or a family member is catastrophically ill or dying. It is always hard on the patient or family member. What is not so well known, however, is the fact that it is just as hard for many doctors untrained to handle the scenario or its unpredictable results.
The movies have more than a few of those heavy scenes when the doctor gives the ultimate bad news — you are dying, the loved one is dying, there is no hope. Television soap operas brought these scenes to the summit of melodrama. Very slowly the medical profession is beginning to address the training of physicians to better do the difficult job of explaining illness, pain or death.
Woody Allen made it a joke. His characters imagine the scene in their hypochondria or tell stories about "the talk" or an imagined discussion of mortality. The heavy talks are not comedy but some sense of humor or, at least, sense of the others' feelings would be helpful.
There were the scenes after my heart attack twelve years ago. The first was the day after the heart attack. I soon learned that the cardiologist (who had saved my life) was totally without a bedside manner. He visited my hospital bed where I — still in a state of disbelief and denial — was saying "You can't mean I had a heart attack!"
"Absolutely,” he said. “But don't worry. If all else fails you are a great candidate for a transplant."
"A" in cardiology, "F" in sensitivity.
Five years ago, when the bypassed arteries totally closed again and I was in great pain, sucking on an oxygen tank, my cardiologist (in Mexico) told me it was time to go back to the US. He hugged me and said that he "hoped to see me again". More sensitive; more frightening.
There were the early days after the heart attack when I would go to the doctor for regular EKGs and blood tests and ask if the EKG showed improvement. They would look uncomfortable and explain they never showed improvement. Their discomfort was discomforting.
Just recently the Philadelphia Inquirer reported in"Bad News" that medical schools are now, finally, addressing the issue of how physicians learn "how to handle the 'talk.'" Only a decade ago the schools gave no training in the kind of situation that should be discussed and taught since it is one "repeated thousands of times a day at bedsides, across desktops and over the phone, turning lives upside down.” Now a majority of the medical schools at least address the issue, says a spokeswoman from the Association of American Medical Schools.
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