by Laura Yeater, MD
I have been a part of giving bad news several times in my career. I have had to tell families after or during an unexpected code that their loved one had died. I have been involved in giving cancer diagnosis during medical school. I have had to share with a woman that her pregnancy was lost after an unexpected ultrasound. I have shared chronic illness diagnosis and shared that babies would be born with unexpected birth defects, but I have never had to share largely life altering news with a patient I knew quite well. I have shared many different types of news both good and bad and I have had many different reactions to the news personally. Most of the previous experiences of sharing difficult news the patients have not been mine personally or I have only known them for hours to days in the hospital. Those cases stick with me but overall, I have been able to process and recover from these relatively quickly. I try to learn what I can from the patient, learn more tools on how to share difficult news and continue going with my career and training.
Recently I had to share life changing news with a patient that I know quite well. A patient that I have cared for in multiple capacities over the past 2 year and also care for their family members. It was the type of news that you wouldn’t want to share with a stranger let alone someone that you know quite well and like. I am able to recognize that as a primary care provider it is a privilege to get to walk through life’s difficult journeys with patients. I understand that getting terrible news is better from someone you know and who will continue to follow you throughout the illness journey, but it has been harder than I anticipated as a provider. I have found it challenging to manage my own emotions in regard to how terrible the diagnosis is. I also am wondering how the unexpected disease will affect my clinical decision-making choices going forward. It is hard to separate medical guidelines and appropriate testing from a recent terrible patient case. This is something that I am sure we all struggle with as clinicians but is definitely something worth considering.
Ultimately, the privilege of getting to know a patient well and care for them can also be really painful when you have to share bad news. It is such an honor to be the point contact for a patient who trusts you and wants your support during an illness, but it is also hard to be the person that they trust most. I find myself spending a lot of time digesting and trying to figure out how to help patients digest information. Difficult news is not just difficult for the patient, and we deserve to acknowledge and recognize that. Being a primary care doctor is a hard job and we should give ourselves credit for the challenging and important work that we do. I know that our patients are better served because we exist and because we care.
Dr. Laura Yeater is from Ashland, Ohio. She received her undergraduate degree in biology from Youngstown State University. She then went on to Northeast Ohio Medical University, in Rootstown, Ohio, as a part of their 6 year combined BS/MD program. Her medical interests include rural medicine, palliative care and hospice, full spectrum family medicine with obstetrics, and community impact and outreach. Outside of medicine Laura loves to travel, try new foods and restaurants, spend time with her husband and family, and play board games. She chose the University of Utah because of an instant connection she felt during her interview day. Additionally, she loved the “Intern Fridays” and the opportunity to learn from excellent faculty, residents, and staff about full spectrum family medicine. Lastly, the natural beauty and opportunities in Salt Lake City were just icing on the cake.