Unprofessional behaviour

Like every other job I've had, I have good and bad days at work. Most days are good. I can help my patients and coworkers have a better day and, cheesy as it may seem, that makes me happy.

Bad days can include patients having bad days, me screwing up, the usual type stuff.

Really bad days often occur because other physicians have neglected to complete what I consider their duties.

My worst day to date ended in me crying for over an hour and hiding in the dictation room until my face was no longer red and streaky. There is nothing sadder than hearing a stoic man with a paralyzed larynx cry because he had no idea that his illness is terminal. This despite seeing a specialist for the illness for the past two years. He had been told the diagnosis but did not understand what it meant.

The medical profession has acronyms that the public doesn't always understand. It's not fair to use these acronyms to protect us from having to deal with the squishy, sad and emotional delivery of bad news.

Our whole team had been avoiding mentioning the diagnosis to the patient because no one knew if this man actually knew how sick he was. I tend to be much more straightforward.

Telling this man that he had a terminal illness in a way that he would understand made both of us break down in tears. It shouldn't have been a complete stranger telling this patient he would die within the next few years. It shouldn't have been in the hospital when he was already feeling vulnerable and unwell. It should have been the specialist who made the diagnosis who could answer his difficult questions and had been with him on the journey to make the unusual diagnosis in the first place, or the family doctor who knew him well.

We learn about transference and countertransference in medical school. Essentially, I shouldn't get so involved with a patient that I take bad news this poorly. It was unprofessional of me to cry with this man who I just met over his death sentence. To be honest, I think this is the first time I've actually cried while giving bad news and I'm sure at least part of that was because he was alone and reminded me so much of the small town men I grew up around.

I think that I was also crying from frustration. There were other doctors who, in my opinion, were also behaving unprofessionally. Not communicating a diagnosis in a language that a patient understands undermines the doctor - patient contract. Not only are these docs unprofessional, they are also cowards and I think that if I ever meet them at a party I will snub them for fear of getting into an argument that will end violently with me in jail.

Unfortunately, as a resident, I am in no position to tell docs who have been in practice for years how to behave in such a way that they might be recognized as human. Instead, I'm forced to sit on my hands, shut my mouth and take the garbage they shove out, just like their patients are doing.