On Monday morning, my classmates and I lined the perimeter of a large conference room, whose center had been cleared of all folding chairs and replaced with props and lighting suggestive of a makeshift theater set. I knew that the morning’s activities were to be centered on the theme of “breaking bad news” to future patients and families, but when a local troupe of actors entered the room, I was confused and (admittedly) a little skeptical. My overly left-brain way of thinking failed to see the connection between that which typically surrounds us in medical school (information, diagnoses, physicians, patients) and…theater? Over the next hour, however, I watched a skit in which seven actors portrayed the demise of Joanne, the main character who learns increasingly devastating news about a polyp found on a routine colonoscopy that develops into terminal cancer.
I watched small interactions that, when compounded on one another, were in some aspects worse than the diagnosis itself: a physician towering above—rather than sitting near—the patient as he informed her she had cancer; an oncology fellow whose nervousness about the situation caused him to use medical jargon incomprehensible to a patient desperate to understand; an impatient receptionist who would make no scheduling concessions for a young woman terrified of dying. Even with my lack of experience in the clinical world, watching this skit entitled simply, “Breaking Bad News,” I knew that it was not fabricated or even exaggerated; I felt confident that these small flaws in the process of sharing unfavorable diagnoses occur countless times every day in top hospitals around the country. Although she was clearly fictional, my heart went out to Joanne—to the many Joannes out there that very moment—whose already heavy burdens were made just a little heavier as the result of insensitively or inadequately broken bad news.
To demonstrate that this process is certainly easier said than done, following the play, we were broken into small groups where medical students were asked to practice sharing a piece of adverse news with one of the actors. Although I was not one of the students in my group to do this, I still squirmed in my seat as one of my classmates had to tell the actor that he should consider seeking hospice care as a result of a failing heart that had exhausted all treatment options. His disappointment and despair seemed so real that it was almost unbearable to watch. While I’m sure no medical student was perfect at this delivery—if one could even be perfect at such a task—the honesty, compassion, and emotion I saw displayed toward our group’s actor differed drastically from what I had just seen in the skit. Although this was merely an exercise and not a real life situation, I believe it provided us with a foundation on which we can build further skills in this incredibly difficult task required of physicians. I felt compelled to write about this activity because it was one of those learning experiences—so understatedly woven into our curriculum—which I feel will ultimately prove invaluable to our medical education, perhaps most tangibly the first time we must deliver bad news to a real patient.
Finally, in case the picture I’ve attached to this blog post seems completely unrelated to this subject, it really is. I just couldn’t resist posting this picture of a few of my classmates and me after we finished the Detroit half marathon on Sunday (naturally, my medal is the only one on backwards). After weeks of training, it was great to have the race day finally arrive and to get to share in the post-race celebration with fellow M2s. Even four days after the race, my body is still feeling the 13.1 miles, but the experience was definitely worth it!