I was listening to Mrs. P explain, through tears, how unfair it felt for her cancer to have returned. I said, “You're right, and you are being very polite. This sucks.” The oncology Fellow next to me looked a little surprised, but Mrs. P laughed. Later, when we were out in the hallway, the Fellow said, “I've never seen a conversation like that before. She really calmed down.” What the Fellow had seen up to this point left her with some common but misguided assumptions – that she should stick to the medical facts, minimize the patient's emotions, maintain an objective distance, and hope the patient has good coping skills. I hadn't done any of those things. “What you said really worked,” the Fellow said, “how did you do that?” This book is our explanation.

Who is this book for?

This book is for physicians who want to communicate better with seriously ill patients and their family members. It isn't surprising that many of us struggle as we seek to combine explaining biomedical science, dispensing clinical judgment, and counseling about how to cope with a life-threatening illness. This book seeks to respond to that struggle. Consider this book as an advanced course for those who have some experience and want to use their time with patients wisely, find deeper meaning in their work, and protect themselves against burnout.