Breaking Bad News

....is part of our clinical skill modules since we were in first yr MBBS...
no matter how many times they teach us and how many tips they gave us...I wonder if it ever gonna be any easier with practice...
I sat with Dr Manolitsas in the consulting room at the Gynaecological Oncology Clinic last wednesday...
Most of the things he did was attending to patients' follow up appointments....there were patients treated for cervical cancer, endometrial cancer, vulval intraepithelial neoplasia as well as ovarian cancer...it was good day that all of the examination findings was found to be normal (apart from tests that had to be sent for pathology)...
until there was a patient who was referred from Ballarat (Ballarat is 2 hours away from where we are)...she came with her husband and daughter...after examining her, Dr Manolitsas also explained to her about the results of her repeat tumour marker test...which in combination tells that her cancer has returned...Dr Manolitsas said that he could organize her to undergo PET scan which would give more information about the spread of her cancer and guide further management(whether she could benefit from surgery)...he also told her that chances are, she might have to resort to chemotherapy anyway which she could otherwise start ASAP even without the PET scan...whichever she chose to do, it's not an emergency...if the cancer has spread, it has already did...waiting for the PET scan in another 10 days would not make any difference compared to starting on chemotherapy now...
she looked composed at first, but I noticed her daughter's eyes are filled with tears...
as she was about to leave the room, I could see that her face was really red and she was on the verge of tears as well...
Dr Manolitsas waited till the door was shut behind them before he turned to me and said, "there will never gonna be a right way to do this..."
I wonder how many times a gynaecological oncologist like Dr Manolitsas had done this and even he, thinks that it wasn't easy...Will I ever be good at this??



ps: I like Dr Manolitsas, he's good looking, tall, fit...he let me did a pap smear!he also quote from my favourite bridgestone ad, "Sure I'm sure" when a patient asked him if he was sure that everything looks normal...


pss: Maybe I should consider pursuing my career in nuclear medicine...apparently there are only three centres that have PET scan in Victoria...I might be able to set up the first PET scan centre in Terengganu...or in the East Coast of Malaysia...(if there hasn't been any yet by the time I became a specialist)