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Doctors Divulge How They Really Tell A Patient They Are Dying

Doctors Divulge How They Really Tell A Patient They Are Dying
Photo by National Cancer Institute on Unsplash

Working in the medical profession simply builds a whole lot of heartache. Doctors watch, day after day, as some of their patients fall ill, only to never recover.

It's a part of the job to break gentle news both to the patients and to their families that their loved one is most likely not going to make it. Having to tell someone they're dying, and force them to deal with their own mortality, brings up a special kind of hell.

Some people have had to develop coping mechanisms to get through it.


Redditor roblixepic asked:

"Doctors of Reddit, how do you tell a patient that they're dying?"

Here were some of those answers.


Compassion Goes The Distance

"My dad’s surgeon discovered what he called 'cement' in his abdomen from cancer that had spread so aggressively that it damaged his colon and required emergency surgery. I asked the doctor while waiting for my dad to wake up if it was terminal."

"The incredible man told me he was not God and could not declare certainties. He said other patients with similar onset had anywhere from a few months to five years. He told me could not tell the future but suggested we discuss care options with my dad."

"I asked his opinion if we should tell my dad right away or give him time to recover from surgery. I’ll never forget his response: 'In my experience, patients know when their bodies are giving up. He will know before you or I do.'”

"My dad had almost 3 years after that conversation. When his body was finally giving out, he asked my mom to take him to the hospital, and for the only time ever in his adult life, he left the house without shoes. My mom said he must have realized he wouldn’t be walking back into the house."

"That was almost 9 years ago. Cancer sucks. But some of my dad’s doctors were incredible and compassionate, and the ICU nurses were amazing."-OlderAndTired

Simple And Direct

"If you’re an amazing doctor like my dads doctor was, you say, 'I gave it my last shot, buddy. I gotta turn you over to hospice now but know I don’t want to.'”

"And he had a tear in his eye. He’d been my dads doctor for a long time (and a few other relatives, actually. This guy had been our end of life a few times-no fault of his own though!). I’ll always remember his compassion in that moment. It was simple, direct and caring."-MonsoonMermaid

Clarity

"ER Doctor: Sit down with the patient and family. Introduce myself. Explain clearly in layman's terms what has been found on the scan/lab/test etc. and the accompanying poor prognosis."

"I then pause because reactions vary considerably here. Some people cry, some people are frozen with shock, many in between."

"After patient/family has had their reaction I ask what (if any) questions they have for me and reassure them I will be in the ER until whatever hour (end of my shift) to help them or provide clarity."-Fancyphones123

Eloquently Frank

"I heard a neurologist tell a brain cancer patient once: 'Some illness have cures, and others treatment. We have reached the end of all possible treatments with respect to your wishes. What life you have left depends on will and time.'”-CriticalCareTaker

Here's The Plan

"In the US, we have an agreed upon guide at my institutions surrounding end of life care. Here's what we do, if the patient is lucid:"

  1. Initiating the conversation.
  2. Clarifying prognosis
  3. Identifying end of life goals
  4. Developing a treatment plan

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495357/

"Actual conversations and details are tailored to the situation, patient, and culture."–thewaybaseballgo

These unimaginable situations are a daily occurrence for some people.

It's Important To Find The Pain Source

"I'd had scans and tests done for unknown stomach pain. The doctor came in and told me the results were back and the news was not good. Explained that I had a cancerous tumor on my bowel that had ruptured and spread to other organs."

"That it had spread too much and couldn't be cut out and chemo wouldn't make it fully go away. He told me unfortunately it was terminal and he reassured me that they would do all they could to give me more time and make me comfortable. At this point I began bawling my eyes out and crying 'my children, my poor children.'"

"He was compassionate towards me and gave me time to process it. Then came back later to explain things in greater detail once the shock had worn down a bit. There's no easy way to hear your dying in your 30s but he did an ok job."-SquelchingNoises

Undivided Attention

"There are actually pretty structured and formulaic ways to do it, but each person ultimately has their own style. Step one: hand your pager and cell phone off to someone else or silence it."

"Two: walk in, very clear introduction of your name, role, etc. if meeting them. Sit down, and don’t let anyone between you and the door. Ask the name and relation of anyone in the room. Ask if they prefer having someone else in the room (or FaceTime now because of Covid)"

"Three: ask what they know or have heard (I had patients outright say 'I know I am dying.' Or 'Everything is fine right?'). Ask what their understanding of that diagnosis is."

"Three: Warning shot and brief pause. 'Unfortunately, I have bad news.' Or 'I know we were hoping for X, but I’m sorry to have to tell you it isn’t what we were hoping for.' Pause. Let the patient panic, then they start listening again.

"Four: Be very clear, very direct when possible, and absolutely honest. Pause. At this point, I usually want to word vomit or backtrack but you cannot do that. The pause is awkward but they are thinking a million things. They will want to cling to, 'but this is curable right?!!'”

"At this point I ask if they want me to explain, give them a moment, call someone, etc. After I’ve explained, I ask them what their understanding was of what I just told them. Go from there."

"Finish by having clear plan for what happens next (oncology appointment, chaplain, etc.) and how to contact with questions. That’s my mental checklist. It’s a process."-ConEffe10

It's Not Easier For Vets

"Different perspective here, as I treat animals vs people, and thus I'm not explaining it to the patient itself."

"I usually tell people that we've reached the limit of what is possible and fair as far as curative treatment goes, and outline what they can expect as far as progression of disease and palliative care options."

"And, as I'm treating in a realm where this is a legal option, I also discuss what euthanasia entails and discuss at what point it will be warranted."-Moctor_Drignall

The Places You Have Come To Fear The Most

"We knew my mum was dying and that she didn’t have long. It was one of her nurses on the ward, clocking off her shift just before 2 days off. She knew she wouldn’t see her again."

"She hugged me, and hugged my mum, and told her that it had been a pleasure to care for her. We stepped outside and cried together and it was in that moment I knew. She passed the next morning, about 12 hours later."-juneradar

Being Straightforward

"Hospice and Palliative care doc here Do it every day I work. I do it with straightforwardness and honestly and compassion. I tell them most of my patients say they aren't afraid to die but are afraid of suffering along the way. Most agree this is how they feel. And I get to assure them me and my teams entire career is committed to making sure that they do not suffer emotionally, spiritually or physically."-Idontsuckcompletely

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And it never gets easier, despite its frequency.

It Becomes The Process

"Not a doctor but a nurse. My last job I was the one you didn't want to come talk to you and I got oddly good at it."

"You tell them straight and make sure they understand exactly what you are saying because denial can be a hell of a thing. You don't joke. You be human and be upset too as that gives them permission to break down too."

"You listen and stay as long as they need but not so long that you annoy them. Answer any questions as best you can but don't give false hope. More than anything, be straightforward and be honest. That goes a long way."-rhett342

What An Awful Moment In Time

"They wouldn't tell my Dad. He took me and his sister in to see a CT scan and it looked like he swallowed golf balls the cancer (pancreatic) was everywhere."

"Dad asked about surgery and chemo and the Doctor just said it wasn't really an option. I spent the last two weeks watching Dad get worse and worse. He couldn't sleep, couldn't eat and couldn't get comfortable."

"We managed to get him into hospice the last few days where his girlfriend wouldn't stay in the room with him so I would only leave to grab food from the vending machine."

"I had to tell her he passed. She thought he was getting better. Wouldn't wish pancreatic cancer on anyone."-Auferstehen78

How To Take Care

"It's never easy. You have to be sincere, make sure you don't give false hope but you have the have the people skill. Trying and say something like 'we have exhausted all resources' or 'we have tried all angles,' because it should be true and coming from the heart."

"Be polite and sensitive, not all the way, but to them and the family. Say you're sorry and that you'll try the best to make their time worth. Allow visits as much as you can, send them home, if allowed."

"Make sure you talk to their families and let them know they fought to the end, even if it's not true. Treat the family as you would like to be treated, as the family. It sucks but it's the least to do."-eat_the_canvas

No Lying

"‘I’m not going to lie to you, I don’t lie to my patients. And although this is the first time we are meeting, you are my patient today. You are dying. We will do everything we can to assist you and keep you comfortable. Do you have any questions for me?’ My friend shook his head no. ‘Ok, then, the nurse will be in shortly to….’"

"Doctor left the room and I followed him out as I had questions. My friend was in the last stages of lung cancer that had spread. He passed within three hours. I had so much respect for that doctor. He gave it to us straight, but his voice was full of compassion." – friendofjay

An Observer Weighs In

"Not a DR but saw this on 24 hours in A&E and the person seemed to take it really well…"

“I’m afraid that you are really ill, in fact you are the illest person in Wales right now. We have tried XYZ but unfortunately they haven’t worked, we are going to keep trying whatever we can but there’s a high chance that you may die, so we are going to try and help you with being as comfortable as possible. We have your family here who are going to be by your side, I think it would be a good idea to say your goodbyes. I’m really sorry there isn’t more I can do”

"It was beautiful and the DR was calm, cool but also very moved and clearly very sad."-Hour-Cow-4348

Putting It Bluntly

"i took my mom to the ER in september cause she couldn’t move the right side of her body. they immediately took her into a CT scan and a white coat doctor walked in 30 minutes later, leaned on the counter in front of my moms bed and said 'we found 3 tumors and we think you have cancer”' i don’t remember much after that cause i was in shock and crying, but he basically outlined everything that would be happening from then on and then left the room. she did have cancer and she died a month later"–straightupgong

Being in a profession dealing with people's lives is an upsetting occurrence, and you have difficult things and situations to navigate almost on the daily.

Developing a system might spare you some of the more acute pain of doing the unthinkable.

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People Share The Best Little-Known Movie Facts They Know

Reddit user Kuli24 asked: 'What's a movie fact you know that pretty much no one else knows?'

movie set
Chris Murray on Unsplash

Easter eggs, bloopers, trivia, behind the scenes anecdotes... cinephiles live collecting them and sharing their knowledge with others.

Some trivia is well known—like Eric Stoltz was replaced by Michael J. Fox in Back to the Future. Other tidbits are more obscure, like Arnold Schwarzenegger was first considered for the Michael Biehn role of Kyle Reese in The Terminator.

Some stories are conspiracy theories or urban legends—like the body in the forest on The Wizard of Oz set.

But what about just film facts? The obscure ones?

Keep reading...Show less
An illuminated mansion at night
Photo by Daniel Barnes on Unsplash

It's no secret that as a person starts to make more money, they may forget how difficult they had it when there was less money coming into their bank account.

Not only are rich people often incredibly out-of-touch with the realities of most people's lives, but what they choose to prioritize and bring into their home is often pretty bizarre, too.

Already side-eyeing, Redditor Jerswar asked:

"What's the weirdest thing you've witnessed in the home of a rich person?"

Love Can't Be Bought

"Rich grandparents had a brand new house built, had a $100,000 splash pad built for their only grandchild who has never visited them at their new house."

- wyoflyboy68

"This reminds me of when my sister built her house. She had a barrier-free ground-floor apartment built in it, so my grandmother could visit. She never did."

- P44

A Separate Hoarder's House

"I had a rich neighbor growing up who'd always invite us over for parties and always insisted on giving us gifts and leftovers. They did this with every guest."

"They were also hoarders but built a separate house to keep their crap in. It was filled with whatever they bought but never used and even never got out of the packaging it was delivered in."

"They told my mom to take a box of what she wanted, and for s**ts and giggles, she did. It was a knife collection and sharpener set."

- MUSTARDUNAVAILABLE

Unusual Art

"I was at John Waters’ house for his birthday and he has a room set up as a lifelike recreation of a meth lab (it wasn’t a real meth lab, it’s an art piece)."

"He told me that when Bill Clinton visited him the secret service agents were extremely concerned about the room."

- writeleahwrite

Weird Pet Relationships

"One client had a whole separate house on their property just for their dogs. They'd referred to it as the 'dog house,' and I was expecting like maybe a little building in the yard where they kept their toys or something, but this was a fully furnished home with king-sized beds and a huge playroom on the main floor."

"They had a full training and feeding staff to care for the dogs and everything. They lived in their own house and would come over to visit. Seemed like a weird dynamic to have with your pet..."

"One client didn't have a litterbox for the cats, their cats I guess didn't like using the boxes in the basement and they didn't want to put boxes upstairs so they put down pond liner and kitty litter across an entire room in the basement and had their housekeeper run a rake through it daily."

- daabilge

Special Needs Kitty Mystery Mansion

"As a kid back in the Mesozoic Era (I'm old), my best friend and I used to play in a converted racquetball court and lounge under the old West Coast mansion her family had lived in since its construction."

"The stairs to it were hidden behind a closet off of the abandoned servants' quarters. Halfway down the stairs was a wine cellar. A decoy as the actual wine cellar for the home was under the kitchen….. Another staircase behind a rack of dusty bottles led two stories down to our giant play area beneath this."

"At the beginning of WWII, before Pearl Harbor, my friend’s paranoid WWI vet grandfather had dug out the space over fear of Japanese (or German) invasion. Her dad made the giant room regulation designed for racquetball years later. Maybe originally squash. Not sure, but the lounge area was also glassed off above it so one could look down into the court like a gallery."

"It was really neat. Also upstairs in the living room was a wall straight out of an old mystery novel. If you pushed a spot just right, the wall opened to a hidden room. Super tiny and had a button to ring certain other rooms in the house as the home had these already to call for staff. My friend's mom said it was so if someone quickly had to hide, they could alert the household of danger."

"We used to pretend to be on Nancy Drew cases all the time... so fun."

"The family was wealthy, but despite the amazing home, they lived a completely pretentious free life. Normal cars, camping vacations, frugal living as sport."

"But they were philanthropists too, especially supporting organizations like the humane society. One thing about this family’s home was all the cats. I loved kitties but had a mother who preferred her animals well-seasoned. The family had the space so they always had, and were looking to adopt out but often didn’t, at least 20 rescue cats, many with special needs."

"I’m old, I didn’t know how to write that. Special needs kitty mystery mansion really is actually an appropriate description..."

- waltersmama

"Special needs kitty mystery mansion with hidden panic rooms and decoy wine cellars is like, the best possible fever dream."

- ConneisseurOfDanger

A Unique Viewing Experience

"In Naples, FL., I was at a house with a sensory deprivation room. Flat black walls with acoustic dampening baffles, in the middle was a coffin-like bathtub. It had speakers and a flat-screen display in the lid."

"I heard that the room cost over $100K to build."

- frank_sarno

A Christmas Village

"They had part of the house permanently decorated for Christmas and it included a fully decorated Christmas tree that was suspended upside down from the ceiling. Which was pretty awesome."

- lithecello

New Meaning to "Don't Take Your Work Home"

"My wife and I used to babysit for this wealthy couple when they went on ski trips etc."

"Except for the children's schoolbooks, there wasn't a book, magazine, or newspaper in the house."

"The man was a publisher."

- Texbadger349

The End of Laundry

"I knew someone who didn't like to do laundry so she just bought new clothes for each of her 4 kids every week. They were always high-quality or designer clothes. At the time, all her kids were 10 to 16 years old."

"What would happen if they liked an item a lot and couldn't find it again? Why not just teach the kids to do their own laundry? Why not hire a housekeeper who can do it?"

"There are so many options, other than spending thousands every month just to avoid laundry. Plus, they rarely donated it. Just bagged it up and threw it out. I never could wrap my head around it."

- coffee-jnky

Can We Be the Trivia Guy?

"I know someone who's worked for a very rich person, probably worth billions. He had more than 100 staff on site, including chefs for the staff...all while divorced and living alone. He had a 'trivia' staff member... someone hired to tell him interesting facts and stories daily. That was his only job."

"Someone else was hired to maintain his shoes. Polish, shine, the works."

"If I didn't hear it firsthand, I wouldn't have believed it."

- mambo-nr4

A Mud Room, Indeed!

​"I used to work as an exterminator, mostly pest control. This had me walking through houses from the poor to the rich."

"One day, I pulled up to a four-story mansion with more rooms than I could count."

"I spoke with the lady at the door and got started. As I sprayed, I noticed there wasn’t much furniture in the house. As I went, I made a game of counting the furniture I could find. Over 50 rooms and the whole building had 13 pieces of furniture."

"Pretty odd, but then I went into the very last room, a mud room right by the door I came into."

"I stopped as I walked in, completely shocked. A huge, full-sized (alive) adult pig stretched from one end of the room to the other, resting on the tile floor. I’m talking five or six feet stretched out across the room. Flies buzzed around its head as it stared at me."

"Suddenly, the lady (who I hadn’t seen since she let me in) said, 'Oh, don’t go in there. She doesn’t like men,' and then she walked me out, paid me, and went back inside."

- Moist-Exchange2890

His Very Own Hot Wheels Garage

"Buddy of mine has a car elevator."

"Instead of just building a bigger garage, he stores his cars stacked onto each other, like some kind of Hot Wheels accessory. It's very surreal."

- SmackEh

Make Yourself at Home

​"My friend's dad growing up was one of the top lawyers in our state. Their house was so d**n big, I got confused (lost as h**l) on all the staircases they had everywhere. They would split in a few places and lead to banisters that had different connections to different parts of the house."

"They had a room just for dishes. Her mom had a huge room for sewing and another for different crafts. They both had an office. Many guest rooms. A small kitchen in one part with a sink, coffee pot, and fridge. Their main bathroom for guests had heated floors and rainfall showers and everything. I LOVED HER SHOWER."

"Her room had a balcony and a table outside."

"They had a pool and hot tub. Horses and a barn and lots of cute barn cats."

"I was very poor and had a messed up situation in my childhood. I stayed there a lot and they would even take me for weeks in the summer because my mother was not there. They are really great people."

" They didn't give handouts or anything, I would literally scoop up horse shit and clean stalls and help with everything for those horses when I stayed. I wanted to help."

"They had a maid, but we still cleaned up after ourselves. Their kitchen was gigantic, and I always loved the fancy pasta water arm over the stove. I had so much fun cooking with her mom and us having the big dinners (Easter, Thanksgiving, and Christmas) with them."

"They were so magnificent and beyond anything I would have ever experienced without them. I got my first pair of cowboy boots from them for Christmas. Her dad bought me a plane ticket one time out of the blue because I wanted to visit my grandmother. Never forget them."

- xNinjaNoPants

So Much Wasted Food

"A very rich person I know does not eat leftover food. They will cook a feast and after, everything goes straight in the garbage no matter how much is left over."

- duckduckroosebolton

"My husband won’t eat leftovers because he thinks it will give him diarrhea. His family is preoccupied with food poisoning but doesn’t know any of the actual food safety rules."

"Oh well, more for me."

- jendet010

"My brother-in-law’s family does this but they are middle class. It’s such a waste!"

- outlawjoseymeow

An Art Enthusiast

"Not weird but a Van Gogh, just chillin' in the hallway. I took a selfie with the flash on, whoops."

- Raccoon_Expert_69

"When I did executive level IT support years back, I found a Monet dangling haphazardly on an office chair in the CEO's extra office (which was unused for storage, and had an extra desktop computer I would sometimes use for quick tasks when on that floor)."

"Another time, I was admiring a Joan Miro coffee table book in his main office, and when his assistant noticed, he showed me into a side room I didn’t realize was there, which had a mini gallery of original Miro drawings."

- spymusicspy

It's amazing what people will spend money on when they have the money to spare. It would be so interesting to see how much more a person would explore a hobby if they had the money to spend.

There's nothing like leaving a movie theater having just seen an excellent movie.

Particularly one that took you by surprise.

Perhaps it was deeper and more meaningful than it purported itself to be, or on the flip side, had much more warmth and humor that you would have expected.

Or, the film took an unexpected twist that you never saw coming.

Resulting in your needing to bite your tongue until the rest of your friends and family see the film, and not spoil the surprise for them.

Redditor HornyCorny was curious to hear which plot twists left viewers utterly speechless, leading them to ask:

"What’s a movie twist that caught you completely off guard?"

He Didn't See It Coming Either!

"Brad Pitt in 'Burn After Reading'."

"So surprising and downright freaking hilarious."- thefirehairman

If The Shoe Fits...

"'The Shawshank Redemption'."

"Come on."

"It's not always a man notices another man's shoes."- FUBARspecimenT-89

Lucky For Some, Not For All...

"'Lucky Number Slevin'."

"Huge twist and very satisfying."- kvlr954

angry josh hartnett GIFGiphy

Rosie O'Donnell Would Agree...

"Fight Club."- BuchseeI

"once watched it with a friend who had never even heard of it, and she called the twist like, a half hour in."

"She said it as a joke and didn't realize she was right until the actual reveal, but still I was shook."- yugosaki

I See You Keyser Söze

"The ending of 'The Usual Suspects'."- Schwarzes__Loch

Definitive Shyamalan

''The Sixth Sense'."

'I love movies with plot twists, but I never imagined this one. It caught me completely off guard."- lucasduka

Haley Joel Osment Movie GIFGiphy

The Title Is Also Misleading...

"The second half of 'Parasite'."- iwontrememberthat4

Appropriately, They Really Toyed With Your Cognition

"'The Game'."- DudeHeadAwesome

"Good one!'

"I spent the entire movie going 'is it a game? Is it real?'"- fastpixels

There Were Definitely Ghosts...

"'The Others'."

"Unsuspected end."- NeckComprehensive743

scared horror film GIF by FilmStruckGiphy

One Unforgettable Opening Scene

"'Scream'."

"The Drew Barrymore role."- LivingTheLife53

The Real Reason Everyone Is Terrified Of Bees...

"When I was a kid, I wanted to feel good and happy."

"So at the video store, I decided to rent a movie with two happy laughing kids on the DVD cover, thinking it would be a feel-good playful story."

"That movie was 'My Girl'."

"Eff that movie."

"Seriously."

'The DVD cover lies."

"IT LIES."- buckyhermit

You THOUGHT you knew who the villains were...

"'From Dusk to Dawn' — midway point."

"Didn’t know at all what I was walking into when saw it in the theatre decades ago — just, you know, Salma Hayek. Good enough."

"Quentin Tarantino slurping tequila from her foot after it ran down the entire length of her leg — that was already a 'Holy WTF' moment."

"But then, well.. . you know."

"And if you don’t know — quick, go watch it. "

"No trailer, no synopsis, no summary."

"Find it and load it 'blind' and fasten your seatbelt."

"You’re in for a wild ride."- canada11235813

George Clooney Tarantino GIF by MIRAMAXGiphy

It's Title Is More Than Accurate!

"'Crazy Stupid Love'."

"The scene when the whole movie goes apesh*t in the yard is one of my all time favorite movie scenes."- Fimbulvintern

Trifecta Of Twists

"'The Others'."

"The end of 'The Mist'."

"'The Prestige' (though, I ALMOST had it figured out, but not quite)."- Krinks1

There's nothing better than when a movie surprises you.

Even if it does make talking about said movie with people who haven't seen it a bit more challenging.

Case in point, people who saw The Sixth Sense and The Usual Suspects after their endings were spoiled for them, don't seem to like those movies as much as those who went in blind.