By: Dr. Frank MacMillan – October, 2015
One of the most difficult jobs I have has been the honor of being tasked with giving bad news.
It is both dreadful and an honor. It is dreadful because we all know that in ancient times, bad news given to the emperor was likely to result in the separation of the bearer of bad news and his head. In modern times, the same fear has resulted in the invention of the “yes men,” people who tell the boss what he wants to hear.
Since I don’t have a boss, other than the patient who hires me to advise them on and manage their health problems, I have a duty to my patients to tell them the truth about what they are facing and provide options and choices for them to act upon. I do my patient no service by being a yes man, or sugar coating bad news to protect myself from the painful experience of delivering bad news.
I bring this up because I have had the painful honor of delivering bad news to people I care about recently, more times than I care to mention. This is not a skill that someone has from an early age. It is something that is developed over time, sometimes doing it well, and sometimes not so well. I can only say that the only thing that gets me through it is to be both honest and sincere.
As I get older myself, and reflect on my own mortality, I find it hard not to connect the pain and suffering of others to my own fears and anxieties. I had a conversation with a dear friend who pointed out that once we are over 50, “we are out of our warranty, and every day of good health is a gift.” While I am not sure that any of us ever had such a warranty, the expectation that we have a limitless future hits a wall whenever I have to give bad news to a friend, a patient, a colleague.
I call it an honor because someone has to do it, and I hope that I can do it well with compassion, love, and sensitivity. I also hope that I can do it with empathy and with a sense of helping to find an imaginative way of moving forward to somewhere or someplace that may have not been seen initially. As I struggle with the dread of having to tell someone that something may not be quite right, I am heartened that I have given the power to these individuals to take control of their future by acting on the best information and an honest appraisal of what they are up against, and an optimistic creativity in presenting other possibilities they may not have yet imagined.
Dr. MacMillan specializes in Gastroenterology and Liver disease and is a member of the North Andover Board of Health. Dr. Macmillan was recently elected by his peers to be vice Speaker of the House of Delegates at the Massachusetts Medical Society and alternate Delegate from Massachusetts to the American Medical Association. Dr. MacMillan is on staff at Holy Family Hospital Haverhill and Methuen, Anna Jaques Hospital in Newburyport, Lawrence General Hospital, and Parkland Hospital in Derry, NH and is the President of the Massachusetts Gastroenterology Association. Dr. MacMillan also serves as Massachusetts Governor of the American College of Gastroenterology and is a Fellow of the College.