Wednesday, 20 January 2010

Breaking Bad News

2010 has not exactly had the best start. Our landlords have just given us notice on our flat as they wish to return and I've been in a car crash which was the fault of some idiot who didn't even bother to stop to check I hadn't died. As they say, things come in threes and it was only a matter of time until something else happened...

Breaking bad news is never easy and is best done under controlled conditions by either a GP or a senior consultant ideally with the support of a specialist nurse. Sometimes it doesn't happen like this and it can be junior doctors who are put in a very awkward position but we're trained for that right? At medical school, a great deal of emphasis was put on communication skills, with particular emphasis on breaking bad news so it should be easy? I've had my own experience of breaking bad news to patients and relatives. Imagine breaking bad news to someone who is a doctor, would that be easier, harder, or perhaps just different?

Yesterday morning I had an ultrasound scan.

I can pinpoint the exact second I knew for sure I had it. It was 11:21 am and I was laid on the ultrasound couch chatting to the radiologist about my career aspirations as he probed my groin. The second he moved the probe up to look at my liver I knew, there could be no other explanation, he was looking to see if it had spread. He didn't say anything and nor did I, but he didn't have to. Although I remained calm, everything after that became a bit of a blur. When he'd finished I'm sure the radiologist already knew that I knew but he nevertheless confirmed my fear, I can't even remember how he broke the bad news but he almost didn't even need to. Before I knew it I'd had a chest x-ray too and was back to work on my ward. I sat there trying to to the simplest of jobs but 10 minutes later realised I hadn't actually done anything. At that point I knew I needed to go home, my consultant was great and I was soon back at home in desperate need of a cuddle or two.

So yeah, I've got testicular cancer, watch this space.

30 comments:

madsadgirl said...

That is bad news indeed and it really isn't fair. I hope that it has been caught early and that treatment is not only possible but successful. 2010 has certainly not got off to a good start for you both so I hope that things get better.

insideiamdancing said...

I'm really sorry. My thoughts are with you... I hope things work out. That sounds really trite- I don't have words of wisdom. I'm no doctor, but I hope, like madsadgirl said, that treatment is successful and 2010 turns out to be an incredible year for you.

Grumpy Biomed said...

That's awful. My thoughts are with you, I wish you all the best.

JordanWilliams said...

do sorry to hear about the news... I will be praying for you.
-J.M.Williams
www.nowhereinparticular.co.cc

GrumpyRN said...

Sorry to hear about this, I had a mixed teratoma/seminoma 20 years ago which had metastasised to my lung so understand what you are going through.

Not sure what modern treatment is but back then it was Cisplatin, Bleomycin, Etoposide and Vincristine. Interesting experience watching your renal function decrease, your Hgb drop to 8 and getting breathless just turning over in bed, not to mention the peripheral neuropathy in my fingers and toes, oh and your emotions will be all over the place.

Good news - all these side effects were expected and cared for, I only have a little neuropathy now which I am only aware of intermittently.

You will come to hate the oncology department while loving the people who work there, your taste buds will change and you will lose a bit of weight.
As you are well aware it is emminently treatable although it does not seem like that at the present. Do NOT watch the film Champion starring John Hurt unless you want to see how bad it can get - I watched it after my treatment was finished and remember saying I am glad I did not see it during treatment.

Family and friends are essential at this time. Find things to take into hospital to do - very boring places hospitals, I did painting by numbers and jig-saws, no portable DVD's then.

Sorry, I have gone on a bit but I wanted you to realise that there is hope, that life will be back to normal although you will look at cancer in a totally different manner from now on.
Oh, one last thing, forget you are a doctor while you are in hospital. The staff are much more experienced at it than you are so dont get bogged down about the detail of treatment - relax.

Merys said...

thinking of you both

alhi said...

I am so sorry. I hope you are and Miss Bliss are doing OK. Will be thinking about you.

medstudentitis said...

Holy shit. I have been rotation through palliative care for the past month and I'm pretty used to giving bad news but this actually has really shaken me. I think a lot of us young docs take our health for granted. As everyone else has said - I hope you kick it with minimal crap happening.

Mayhem said...

I literally said "what the f**k" out loud. I don't even know what to say except I hope it hasn't spread. I'll be praying for you.

XE said...

Oh my gosh TLM, I'm so so sorry. Wishing you and MissBliss all the best.

Anonymous said...

I'm so sorry. My thoughts are with you, and hopefully this has been caught early.

Trinity (of haiku tofu) said...

you're in my thoughts, stranger.

Ms-Ellisa said...

I'm really sorry to hear that. My thoughts too will be with you, and I hope you'll get through this very quickly. All the best.

Sam said...

Have faith in yourself, remain positive and hope ..

I too hope you will come out of this trimphant.

Best regards,

Sam

Polly said...

That sucks. Seriously.

Here is to a quick and uneventful treatment and recovery phase!

xx

Jo said...

Oh, I am so sorry to hear your bad news :-(

Thinking of you both, and I hope that the treatment is effective without too many unpleasant side effects.

{hugs}

Score One Art Gallery said...

I am so sorry. But you know, you can beat it. You kick it's behind and go on with your life. Fight like hell, and don't give up.

Dragonfly said...

So sorry to hear that. Hope it goes as well as possible. Thinking of you guys.

Liana said...

Delurking to say I am so sorry. I have no words.

Dr. K said...

I am so sorry to hear this. Fight, little medic, fight. My thoughts are with you.

Milk and Two Sugars said...

TLM, like all I'm so sorry to hear your news. By now you are post-surgery and I wish you a good recovery and the best possible news in follow-up. Take good care.

The Girl said...

I'm so sorry. Best of luck for your treatment and recovery.

BenefitScroungingScum said...

I'm so sorry to hear this. Thinking of you
BG

fallenkshatriya said...

I've lurked on your blog for ages, mate, and have never written a comment, despite your fine writing...I am trully sorry this has to be the first time.

I'm sorry for to hear of this and wish you the best of luck in the coming months...i only wish i could do more...

niceladydoctor said...

I'm so sorry to hear this.
NLD

Chris said...

Hey

I'm sorry to hear about your diagnosis but as I'm sure you're aware Testicular Cancer is the one to get (if you're going to get a cancer at all). I am currently a 4th year medical student at the and when I started reading your post this morning I felt I knew what was coming as soon as you said US scan. The reason is I had almost identically the same thing happen to me this same January. As soon as the US scan was done I was certain of what it was, before the radiologist even said a word. I had a pure seminoma which hadn't metastasized and had the operation to remove the testicle 2 days later. I completed the course of chemotherapy last week (and so now have 3 weeks off to play FIFA!)
As hard as it is, try to stay positive, it's a shock but its quite possible that by summer you can be 98% confident that you're cancer free :)

studentnurse said...

Hiya

I'm new to your blog, just want to say even though it might sound coney I'm gone pray for ya, you got a nice blog by the way.

Anonymous said...

2010 will be a good year for you then...

the year you kicked cancer's ass!

P said...

Wow. I just want to say - I love reading your blog, I've read it for years, and (silly or not), it reinforced my want to be a doctor.

Best of Luck to you, and to echo some of the posts above, keep it positive - you have quite a few well-wishers floating about.. :)

Vagus Nerve said...

Hey,I've been following your blog for a while.
Wanted to say get well soon mate,my thoughts are with you.