Health panel discusses how to break bad news

Samford University’s Department of Communication Studies hosted a health provider panel on April 10.

Dr. Matthew Heimann, Dr. Fran Burgan, Daniel Marvin, Alayna Wells and Paul Byrd spoke. The panel discussed how to break bad news and shared their experiences.

As an emergency room doctor, Heimann said he breaks bad news everyday.

Heimann said while exercising a woman in her 20s collapsed and her heart stopped. An ambulance rushed her to his hospital.

For an hour, Heimann said he performed CPR, but she died.

Then, he confronted the family. Despite its regularity, Heimann said he still braces for their reactions. Every family differs. He said some hug and sit silently while others throw things.

After entering, Heimann said he first asks what the family knows.

“I have to pick up the story from that point because they don’t know what’s happened. I let the family set the stage,” he said.

Before arriving, Heimann said the family only knew the woman had been exercising and had passed out. She had seemed well.  

After updating the family, Heimann said he tells them, without medical jargon, that their daughter died. He pronounces it like a fact.

“In practice, communication is more important than the physiology,” he said. “If you can’t get the information to the patient then it doesn’t matter how many life-saving drugs or pathology pathways you’ve memorized.”

As a doctor, Heimann said he prioritizes facts and chaplains serve as emotional support. Nevertheless, Heimann said a family lost a daughter and a mother. The woman left behind a newborn baby.

Heimann said he wants to linger, but a whole clinic waits outside.

Pediatric nurse Daniel Marvin said he still struggles delivering bad news, especially concerning children. Marvin watches infants die from sudden infant death syndrome or SIDS. He said at least adults had a chance to live.

“How do you go to parents when their child is only a week old and explained to them … that their child died for no reason,” he said.

As the doctors leave, chaplain Paul Byrd enters. Despite ministering for 25 years, he said nothing prepares him for a grieving family.

After the shock, Byrd said silence follows. Byrd said the room transforms into a holy space. He’s entering someone’s life.

“The news has a mass that fills the room. Nothing else can be said because there’s nothing that can fill that space,” he said. “Their lives from now on will be defined by … this news.”

He said some remain hopeful while others feel guilt.

For example, Byrd has visited a terminally ill child for the past nine months. On April 9, the mother began weeping. She struggles with psychiatric issues. Due to her illness, the mother told Byrd she had failed her child. The woman felt she couldn’t help her child even at the end.  

All this time, Byrd said he listens to patients. While listening, Byrd said the distinguishment between doctor and human disappears.

Anesthesia nurse Alayna Wells remains beside patients beyond the bad news. She comforts them when they’re most scared, such as before surgery.

Often times, Wells said patients fear the anesthesia more than the surgery.  

“Your relinquishing your body’s control and handing it over to another human being,” she said.

Wells said she comforts patients even during death.

“There are patients and families I will never forget. I will never forget the looks on their faces, the conversations we had, and the last moment they breathed as I was holding their hand,” she said.  

For instance, Wells said throat cancer patients must have their entire throats removed except for blood vessels and essential tissue. Afterward, the patients will never speak or eat again.

Before surgery, Wells said she watched 20 family members encircle one patient and pray. The patient told their family they loved them for the last time.

Despite their conditions, Burgan normalizes it so patients don’t feel scarred and marked forever. She said her patients motivate her.

“I want to continue to get better because just when we think we’ve mastered our craft then something else blows us off our feet,” she said.  

However, Wells said she eventually succumbs to the emotional toll. After arriving home, she confides in her spouse, parents and friends. Without them, Wells said she can’t continue.  

Byrd said his faith even wavers after enduring so much grief, death and unanswered questions. Three quarters of the time, Byrd said he feels agnostic.  

However, Byrd said he also sees things that restore his faith.

“The other 25 percent of time, you’ll see something else you can’t explain such as hope, strength, or grace,” he said.


William Marlow, News Editor