Significant content of this website ‘published’ to date, has focused around those typical and well-documented early reactions and responses to “bad news”. Moreover, we know – sometimes from first hand experience – how even the most ordered and controlled of lives can, in an instance, become stricken with heart-rending pain and paralyzing grief. Also, we are already becoming familiar with an important truth; namely that loss on such a scale can and almost invariably does exert an impact not unlike a kind of naturally induced anesthesia, which we commonly refer to as shock. Its purpose, as also we have already seen, is temporarily to numb the mind in preparation for each devastating wave, which thereafter can for a while, be expected to regularly impact on individual awareness and perception. At such times and in an ideal world, a great deal by way of genuine support and kindly understanding (what we sometimes refer to as TLC,•) will certainly sustain and help to see us through. On the other hand and in the real world, such assistance is available and forthcoming to varying degrees of availability and effectiveness, ranging from very adequate and consistently present, to patchy or virtually non-existent.
Some time ago, the husband of a patient who had been referred to me told me, “When my wife and her sister came home from having been told that she had cancer, I let her ‘bubble’•• for a time over tea, whilst the rest of us got on with the meal. At the end of it I said to her; “Look Rita, life has to go on for me and the kids, as well as for you. So after tonight, I don’t want to hear any more crying; just that you are taking the treatment they give you and getting on with things””. Now whilst I fervently hope and believe that the above is wholly unrepresentative of the common response to someone in such dire and obvious need of kindly support and understanding, I am not devoid of a hint of suspicion that it’s very evident failure to even remotely recognize (much less acknowledge) the true and terrifying nature and impact of such news, is by no means unknown.
Another patient of my acquaintance, when told by her consultant that her lump was malignant, responded with the question, “How long?” According to the friend accompanying her (and the consultant to whom I spoke afterwards) he responded by saying that it was really far too early to answer such a question. He pointed out that it depended on several factors yet to be determined, such as the degree to which – given prompt and appropriate treatment – any future disease progression might be arrested and brought under control. Apparently, the patient persisted with her question, insisting that she needed “to know just what (she) was up against”. Thus, after repeating the above and other necessary caveats, her consultant reluctantly added, “It really can range from months to even years…” Thereafter, she insisted – and could not be moved from the assertion – that having first tried to avoid her question, her consultant had thereafter given her “only months to live”. Relieving the load of such exaggerated and distorted perceptions is, of course, very much the ‘name of the game’ at any and every stage of patient support and management. It is my intention therefore to ‘say’ more about that next week, which hopefully will prove to be both relevant and supportive.