To Tell or Not To Tell

From Guest Blogger, Dr. Jennifer Clark!

To Tell or Not To Tell…that is the question.

As a physician, I am privileged to be able to meet people and be welcomed to bear witness to the most vulnerable aspects of their lives.  Unfortunately, as a result, I am often responsible for the delivery of bad news.  I will tell you, there is nothing more difficult than that moment when you have finally pinpointed a diagnosis and realizing that you will have to somehow break this news to the person sitting in front of you.  Knowing full well that the 3 little words, “you have cancer”, will forever alter the course of that person’s life, a physician sometimes can become paralyzed and struggle to articulate that disease laden message.  Fears of dashing hope, of being wrong, of being right….

Sadly, until the recent past, the medical education community didn’t recognize the importance of teaching prognostication, the foreseeing and foretelling of a state of disease and health.  It is the skill most at the crossroads of where the art and science of medicine intersect.  On par with the skills of diagnostics and therapeutics that comprise much of modern medical training, the skill of prognostication requires a similarly intense opportunity for instruction and practice, and, fundamentally, requires the ability to communicate with compassion.   No, it is not a virtue, as no one is born with the innate skills to effectively and empathetically look someone in the eye and speak the words that bring mortality into question, but it is a skill and a skill many of us struggle to master.  Through patients with patience, we are learning, and we are grateful.

Jennifer Clark, MD, Clarehouse Board of Directors