‘A tricky part of my job,’ the GP said, scrolling through the next patient’s notes, ‘is breaking good news.’ As a medical student on placement, I listened as he told the young woman that her ‘presenting complaint’ —blurred vision, fatigue and tingling down her arms — was not in fact multiple sclerosis. The diagnosis had been made several years earlier but her latest MRI scan suggested that MS was very unlikely. Despite the GP’s prediction that this would be a complicated consultation, he still looked frustrated when the patient didn’t respond with relief to his diagnostic revision. Instead, her weariness was edged with anger. ‘If it’s not MS,’ she said, ‘why do I feel so unwell?’
For most doctors, ‘bad news’ means metastatic cancer, a paralysing stroke, amputation. For a patient, bad news might also include things like insomnia, taking pills for life, severe migraine. ‘To the typical physician, my illness is a routine incident in his rounds,’ said the American writer Anatole Broyard, ‘while for me it’s the crisis of my life.’ This different scale of suffering helps doctors triage with a cool head, but it can also lead to dispiriting clinical encounters. One might say the profession and the public do not always see eye to eye. Danielle Ofri argues in her new book that the problem is rather one of listening.
A physician of general medicine at Bellevue Hospital in Manhattan, Ofri is known for reading poems aloud on ward rounds. Her articles in the New York Times teach readers to appreciate patient stories as the most valuable currency in the unpredictable, imperfect business of healing. She is well aware that writing about medical mistakes, as in her book What Doctors Feel: How Emotions Affect the Practice of Medicine (2013), doesn’t enthuse all of her colleagues.
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