5 Good Ways To Get Bad News About Your Health
Last week, I wrote 5 Ways Your Healer Can Harm You, about how the way your doctor delivers bad news can affect your health outcome. This week, I want to focus on what you can do to protect yourself from this unhealthy dynamic.
Giving and receiving bad news is an unavoidable part of health care. Every time a blood test is ordered, a radiology study is done, or something is biopsied, there’s the chance that we’ll get bad news. But few people realize that there is a good and bad way to deliver and receive bad news.
Consider the case of Steve, a physician diagnosed with lung cancer (the exact same illness that was his specialty). When he learned he had malignant tumors in both lungs, he was told by his doctors that he had five years to live. Knowing what he knew about the disease, Steve believed this death sentence. Exactly five years later, to the day, Steve died.
The Healer’s Role In Delivering Bad News
If a patient’s outcome may be negatively influenced by fearful thoughts about their health, what is the healer’s role when it comes to delivering bad news?
As a physician, I always assumed it was my job to load up my patients with as much data as I could. For example, if a patient was diagnosed with cancer, and I knew from the scientific data that, statistically, the patient had a 95% chance of dying within a year, I felt compelled to share this data, even if the patient didn’t ask about her prognosis.
However, once I learned how profoundly negative prognostic data can adversely affect patient health outcomes, I began to question this.
Surely, there’s a happy medium that allows for patient autonomy, while also leaving room for the patient to stay hopeful. Even when the outcome looks bleak, there are often case reports in the medical literature of spontaneous remissions from the very same illnesses our patients are suffering from. Might we not direct the patient’s attention to these reassuring case studies?
It strikes me that health care providers are so afraid of giving false hope that we’re wary of offering any hope at all. How did we get so pessimistic as a profession? Since when is hope something we feel the need to withhold?
How do we know whether or not the patient will be the miracle? We are not God. We hold no crystal balls that predict the future. Why do we feel so inclined to offer bad news with little hope to mitigate it?
Take Charge Of What Thoughts Enter Your Mind
In the training program I created for health care providers, I invite them to be mindful of how they deliver bad news. Based on what he wrote in The Biology Of Belief, Bruce Lipton teaches these health care providers how our beliefs affect our bodies on the physiologic level, even on the level of the genes. (Learn more about this program and register to participate here.)
Bruce and I advise health care providers not to automatically share negative prognostic data without asking patients how much they want to know. We recommend that health care providers warn patients that negative prognostic data can adversely affect health outcomes.
Scary statistics can trigger stress responses in the body, filling the body with harmful stress hormones, deactivating the body’s self-repair mechanisms, and making the body even more susceptible to disease. Such stress responses can even affect how your genes express themselves.
In other words, you’re not a victim of your genes. But you may be a victim of bad news!
Hope, on the other hand, can be potent medicine, relaxing the nervous system and helping the body’s self-healing mechanisms get to work. We invite the health care providers to communicate with their patients and let them know they have a choice about how much they want to know about risks, statistics, and prognosis. The minute we start putting negative thoughts into the patient’s mind, we potentially alter the patient’s outcome.
Informed Consent Vs. Hope
As health care providers, how can we balance our desire to fully inform our patients with our obligation to protect their health? And as patients, how can we protect ourselves from outcomes like Steve experienced?
I recommend that health care providers explain to patients that statistics about health outcomes can be a blessing or a curse.
Sometimes statistics can be very reassuring. The imagination can create worst case scenarios far worse than reality, and sometimes the actual numbers are far more comforting than what the imagination conjures up. Other times, statistics can poison our minds with doomsday thoughts the imagination might never have created.
The problem with statistics is that, even if they're very grim, we can’t ever know which patient will be the miracle and which will succumb to prolonged suffering, disability, or death. Even if there’s only a 1% chance for cure, if you’re the 1%, YOU’RE CURED!
How To Use Statistics
I believe health care providers should be available to educate patients, while also letting patients participate in deciding how much information to hear. If a patient is getting genetic counseling for BRCA testing, for example, those kinds of statistics might be helpful in decision-making. If the patient is considering undergoing an elective surgery that comes with risks, percentages might help inform the decision.
If a patient is diagnosed with cancer, knowing the statistics might relax, rather than stress, the nervous system, depending on the patient’s personality. But the patient might prefer to keep the mind free of these kinds of frightening numbers, preferring to follow their intuition instead of making fear-based decisions based on statistics.
It’s also our responsibility as health care providers to explain that such data is based on groups of patients, not individuals, and that if the individual cancer patient, for example, is still alive 30 years later, it really doesn’t matter that he only had a 5% chance of surviving five years.
Using the language of statistics, every patient is an “n of 1.” You never know how the individual patient will respond in the face of a disease, so it may not be in their best interest to fill the mind with negative statistics. Every patient is different. It’s important to honor these differences.
It’s YOUR Decision. Be Proactive.
If your doctor is about to give you news about a test, mindfully consider how much you want to know. Here are 5 tips for how to get bad news in a healthy way.
1. Ask for facts if you want them.
If it comforts you to have all the facts, just ask. It’s your health care provider’s responsibility to share all the available data. Some people feel the most calm when they can anticipate the worst case scenario and prepare for the worst.
2. Temper negative statistics.
If you’re one of those information seekers who wants all the statistics, keep in mind that if even one person has been cured from your disease, you might be that person. Don’t let your mind go down the pessimistic rabbit hole. Don’t let yourself fall into a victim role. You are not a victim of these statistics.
You may be able to change the outcome of your health because of your attitude. If you don’t believe me, learn the 9 key factors patients with Stage 4 cancer employed to enable cure or read Dr. Kelly Turner’s book Radical Remission: Surviving Cancer Against All Odds.
3. If you’d rather not hear statistics, say so.
Don’t just sit and listen to your doctor rattle off hopeless numbers. Speak up.
4. Seek out hope.
Ask whether your doctor is aware of any patients who have ever had surprisingly positive outcomes. Have there been any reports of spontaneous remissions from the illness you’re facing? (Keep in mind that your doctor may not know and you may have to do this research yourself…)
5. Don’t be afraid to initiate this conversation with your health care provider.
It’s your right to protect what your mind believes, and it’s your responsibility to be proactive about making your sure your beliefs support your health, not from a place of ignorance or wishful thinking, but from a genuine commitment to HOPE.
What Do You Think? Share your thoughts in the comments.
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