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What to do when the patient starts to cry

This is my every day: breaking the bad news, reminding people of their mortality, and reassuring them I'd do my best to care for them. Dr. Bishal Gyawali's essay reminds us to connect with our patients' humanity. And nothing confronts a person with his humanity as when he is faced with the reality of death and dying.

Dr. Gyawali offers a peculiar insight on the beautiful intricacies of cultural differences in how patients and physicians from Canada, Nepal, and Japan approach bad news.

In my brief medical career, I have worked in quite a few different countries. I went to medical school in Nepal, where I was born and raised. I then went to Japan in 2012 to train in medical oncology. Five years later, in 2017, I returned to Nepal to work as a medical oncologist before moving to Boston, Massachusetts, for a research fellowship in cancer policy in 2018. I now live and work in Kingston, Ontario, Canada, having moved here from Boston in early 2019.

He continues:

Although training does help, the most crucial elements of delivering bad news to patients—having empathy and being sensitive—cannot be trained. Knowledge can be obtained anywhere, but listening to and genuinely caring for a patient has to be built into an individual's character with inspiration from experienced mentors. Protocols and guidelines help, but the richness and diversity of the patients we serve are reminders that we need to be flexible, listen to our patients, and respect their values and the culture that created those values.

Thanks, Alfie Chua, for the heads up on this article.

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