Living and Dying with a Brain Tumor - The Question

“What’s it like to tell someone they have a brain tumor?”

Ned, my high school buddy asked me recently at our reunion luncheon, trying to get an insider’s view of a neurosurgeon’s life. It’s actually a very common question that I am asked.

My reply has always been, “It is incredibly difficult, but I wouldn’t want anyone else to do it.”

This is the absolute truth. When it comes to delivering bad news, I prefer to do it myself. Not because I have an intrigue with the macabre, but rather I believe I can deliver it better than anyone else. To me, it’s as intricate a procedure as any of the most complicated operations I perform. The script needs to be clear, just the right length, and delivered perfectly.

Such an important conversation requires more than precision of words. If medicine is a theatre and our consultations the acts, such a moment demands perfection in all aspects of the production. The stage needs to be set: a quiet space away from the hustle and bustle of the hospital or office. There must be a feeling of separation without isolation. As the main actor, this is the patient’s most important moment. She must understand every aspect of her role; completely appreciate the gravity of the scene.

In my role of doctor as director, I have to coordinate this moment on stage. What happens in the next few poignant scenes is one of the most profound moments in my patient’s life. Not only will what follows forever change my patient, but their families and loved ones will remember and relive it long after I bow out of the consultation room.

Act One- Fighting a Brain Tumor... Informing the Patient