When receiving difficult news, words certainly matter—but so does the way they are delivered!
In serious illness conversations, the difference between feeling overwhelmed and feeling supported often comes down to something as simple as a pause after an empathetic statement.
Same Words, Different Impact
Consider this exchange between a physician and a patient who has just learned that their cancer has no cure:
Scenario 1: No Pause
Patient: So you’re telling me … there’s no cure?
Doctor (without pausing): While there isn’t a cure, there is treatment, and we are going to figure this out together, so let’s talk about next steps. We are going to need some additional bloodwork, and I’ll send you to the lab now…
The doctor’s words are meant to be reassuring, but the rapid delivery makes it hard to absorb. The patient stares blankly and disengaged, not taking in anything the doctor is saying.
Scenario 2: The Pause
Patient: So you’re telling me … there’s no cure?
Doctor: While there isn’t a cure, there is treatment, and we are going to figure this out together. [Pauses]
Patient: …Ok. Can we talk about next steps?
Doctor nods, then continues: Ok, we are going to need some additional bloodwork…
With just a few seconds of silence, the doctor gives space for the patient to process their emotions, take in the reassurance, and re-engage in the conversation.
How Patients and Caregivers Can Use the Pause
Conversations with your doctor can often feel rushed, because this is modern day medicine and doctors are under tremendous time constraints. Unfortunately, difficult conversations with your doctor suffer the same time pressures. Coupled with a lack of training in high-stake conversation skills, many healthcare professionals are compelled to move quickly into treatment plans and next steps – to both their and your detriment.
If you are a patient or caregiver, here are some ways you can use the power of a pause to take control of the conversation:
- Ask for a moment. If information is coming too fast, it’s okay to flat-out say:
- “Can we pause for a second? I just need to take that in.”
- “That’s a lot. Let me sit with it for a moment before we talk about next steps.”
- Use silence as a tool. You don’t have to fill every quiet moment with a question or a response. Pausing before speaking can help set a cadence that encourages your doctor to slow down, too.
- Repeat what you are hearing. If you need clarification, say:
- “So what I’m hearing is that while there isn’t a cure, there are treatments?”
This signals the doctor to stop giving new information while you double check you’re accurately taking in what they’ve said already.
- “So what I’m hearing is that while there isn’t a cure, there are treatments?”
Advocate for palliative care!
Palliative care teams are experts at navigating difficult conversations when emotions tend to run high. If you or your loved one has been diagnosed with a serious illness, ask for a palliative care consultation as early as possible. Palliative care specialists can help ensure your concerns are heard and that your medical treatments are centered around what matters most to you.
Final Thoughts
In medical conversations, especially those involving serious illness, information overload is real. Doctors often move quickly (with the best intentions), but you have the right to slow the conversation down when you need to. A simple pause can give you time to process and engage meaningfully in your care.
Remember: you don’t have to navigate serious illness alone. Palliative care teams are there to help, and you can ask for them by name—at any stage of illness!
Citation: October et al. “Characteristics of Physician Empathetic Statements During Pediatric Intensive Care Conferences With Family MembersA Qualitative Study” https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2687051