Liam Farrell: The art of breaking bad news

Bad news isn't bad news for everyone; for some, it's been good news. A lucrative little industry has built up over the breaking of bad news. Books, international conferences, TV appearances, every cloud has a silver lining.

But, as usual, at the coalface, it’s the doc who has to do the heavy lifting.

It’s far from our most onerous duty; as La Rochefoucald said, ‘We all have strength enough to bear the troubles of others’. And there is much we can do to soften the blow, such as the gift of music: "Your Auntie Rose is dead," sung to the tune of Happy Birthday; or the gift of charades, which is tricky as medical terms don't usually lend themselves to mime - just try ‘you have a whopper of a pilonidal abscess’.

In real life, breaking bad news is hard because medicine is inexact and prognostication is notoriously difficult. Every individual reacts differently; tell granny she’s got a week left and relatives will be winging their way from all corners of the globe, and then you’ll be the target of their extreme displeasure when granny inconveniently hangs on for a couple of months.

But the paradox remains; the more medical science advances, the more we become aware of its limitations.

For a while Joe and I had fudged it, muddling along with the Irish Prognosis (‘feck it, it’ll be grand’), but things were progressing and we had to accept the inevitable.

‘Winter is not a great time to die,’ he said.

‘Yeah,’ I said. ‘Dying in summer’s much more fun, after the funeral we can have a barbecue.’

‘At least I’ll have time to say goodbye to my family and friends,’ he said.

‘Those you haven’t fallen out with anyway,’ I said.

‘They'll be sad when I’m gone, I know,’ he said.

‘Indeed,’ I said. ‘I can just picture them dancing a little jig of despair.’

‘So how long have I got, Doc?’ he asked.

‘You have two months to live,’ I said.

‘Only two months,’ he repeated, shaking his head sadly.

‘It’s worse than that,’ I said reassuringly. ‘That’s from last month.’

‘Thirty days,’ he said. ‘Only thirty days to say goodbye to this wonderful world, thirty days more to walk on God’s green earth.’

‘This is February,’ I reminded him.

  • Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell

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