The bad news: you are more than one tumor

Gepubliceerd op 5 november 2016 om 11:37

Who hears that it is completely wrong, needs more than a diagnosis and a treatment plan. All too often, the physician sees a disease for itself, instead of a human.


The world of John Drongelen (69) from Valkenburg collapsed when he was told in 2014 that his cough had an aggressive form of lung cancer. And it was not just the diagnosis. The doctor looked at his computer at the pictures and shook his head. ,, He said if we fight it out quickly, gives you the Christmas not even '' Minutes later, Van Drongelen and his wife were excited at the desk for a new appointment.. ,, Me see you no more, I fell only briefly in '' the doctor had given casually.

Drongelen of hits full again as he tells how this came to be bad news. And that was not all. The next doctor he met had two physician assistants him loose and hid behind the computer. ,, As if the doctor not interested. "" Again, had to do the Limburger with an interim basis. There were terms like 'major surgery', 'ribs breaking "and" long piece cut.

Off track
Whether and what treatment options were there? ,,No idea. I was at a loss. '' A third doctor offered solace.Early 30s, but very valuable, Van Drongelen says Lizza Hendriks, longoncoloog at Maastricht UMC +. ,, She sees that there is a person behind the patient. '' To that get her students between the ears, Hendriks Van Drongelen late to tell his story. ,, It's good for junior doctors to hear bad news does to someone. Treat a man as you would want to be treated, do not look at the clock, you can not hide behind a computer screen, but see the man for you, what news do with him, naming emotions. Often patients instance afraid to choke. ''

Hendriks got it, but so many colleagues no regrets Sandra van Dulmen, professor of communication in the care Nivel (Dutch Institute for Health Services Research) and the Radboud University Nijmegen Medical Centre in Nijmegen. Frequent research shows that physicians often lack the time and empathy. ,, Often presenting physicians diagnose and rattle them then with medical information and details of a treatment plan 'aimed at deaf ears. ,, A patient who has received bad news, belongs equally nothing. It is best then to leave room for emotions, dropping a silence, indicating that you understand the message carved into it. ''

Doctors are above all to solve medical problems, emotional dilemmas are of a different order, says the professor. ,, Doctors find it difficult to deal with feelings. They have not learned to do so. But to continue giving them the patient to stand there just feel for the road, which does anything but reassuring. '' Especially when they say "unfortunately, we can not do anything more for you." ,, If the patient is not cured, you can guide him still to the end as possible. So a phrase like "we will not leave you alone" is a lot more beneficial. ''

Empathy, according to research ensures that patients remember more are less fearful and experienced less pain. But more is needed for a good bad news. The physician must empathize with the patient. What type of person is there for him? Does the person himself with questions? He wants to take the helm in their own hands, whether he rather leave it up to the doctor? How someone's home situation?

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By Editors AD: Photo: Mark Reijntjens



Five bad news tips to the doctor

1. Take time for the call.
2. Enter the conversation always in person.
3. Show empathy. Use phrases like "I understand that you are frightened of this."
4. Pour any information about anyone, and certainly not information that does not matter, like "you could have a different type of tumor.
5. Look at the patient as a human being. Ask yourself: what will and will suit that person and come together to make an informed decision. Possibly you enter two or three calls.


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