Bad news from doctor

By BBC Doctor Colin Thomas

I don't like telling people they've got things wrong with them.

I know that's supposed to be the job, but somehow it never seems to get any easier.

I'm not talking just about death or fatal diseases here either, there are still plenty of other conditions that you wouldn't wish on your worst enemy.

As we deal with illness all the time you might think it strange that doctors might not like seeing people ill.

I'm sure I'm not alone, but I could never understand the enthusiastic interest that at least some of my colleagues used to show in the illnesses people were suffering.

I suppose this is one of the mechanisms that doctors use to distance themselves from the pain of reality.

But from my viewpoint when seeing the interesting case of "Bloggs" disease all I could see was the rather uninteresting suffering, and at worst fatal consequences for the patient.

I know that you shouldn't shoot the messenger, but somehow I can't help feeling responsible in some way for the conveyance of bad news.

I know it's silly, but just as a weatherman has no control over the weather, he or she may nevertheless find the need to be apologetic when the weather is bad.

Emotional medicine

"Don't get emotionally involved with your patients" we are told at medical school.

I'm not really sure how you can ever totally achieve that gold standard.

Medicine is about emotions, and I believe it is a case of trying to balance the emotional with the factual rather than stone-walling any emotional feelings.

Of course it would make it better if doctors could cure everything, but as we all know although medicine has made huge leaps in many fields, there are still areas where modern medicine has about the same curing power as a 15th century monk.

I don't think being a sensitive doctor makes you any better or worse at medicine, but I must admit to being slightly envious of what seem on the surface to be totally detached medical practitioners with stiff upper lips who can come in, assess the situation, and get out again rather like a precise well organised guerrilla attacks.

Sensitive moments still happen. Even recently I was faced with a similar situation. Both me and my patient were very disappointed at the progress she was making and I had to tell her that I was considering other diagnoses for her symptoms.

"Not arthritis" she said, and certainly that was one thing that was on my list.

"I'm very upset", she said. So was I, but I tried not to show it.