Post: #1

Just discovered this piece of writing after listening to it on Jocko Podcast ep. 58.

This article was written by doctor Naomi Rosenberg, an emergency room doctor at Temple University Hospital, for the NYT.

Heavy, heavy subject but there's great lessons here on keeping frame, having to be hard and concise yet remain vulnerable.

The wisdom shared here can be applied to various situations that demand that you be the bearer of bad news.

Quote:How to Tell a Mother Her Child Is Dead

By NAOMI ROSENBERG
SEPT. 3, 2016

Philadelphia — First you get your coat. I don’t care if you don’t remember where you left it, you find it. If there was a lot of blood you ask someone to go quickly to the basement to get you a new set of scrubs. You put on your coat and you go into the bathroom. You look in the mirror and you say it. You use the mother’s name and you use her child’s name. You may not adjust this part in any way.

I will show you: If it were my mother you would say, “Mrs. Rosenberg. I have terrible, terrible news. Naomi died today.” You say it out loud until you can say it clearly and loudly. How loudly? Loudly enough. If it takes you fewer than five tries you are rushing it and you will not do it right. You take your time.

After the bathroom you do nothing before you go to her. You don’t make a phone call, you do not talk to the medical student, you do not put in an order. You never make her wait. She is his mother.

When you get inside the room you will know who the mother is. Yes, I’m very sure. Shake her hand and tell her who you are. If there is time you shake everyone’s hand. Yes, you will know if there is time. You never stand. If there are no seats left, the couches have arms on them.

You will have to make a decision about whether you will ask what she already knows. If you were the one to call her and tell her that her son had been shot then you have already done part of it, but you have not done it yet. You are about to do it now. You never make her wait. She is his mother. Now you explode the world. Yes, you have to. You say something like: “Mrs. Booker. I have terrible, terrible news. Ernest died today.”

Then you wait.

You will not stand up. You may leave yourself in the heaviness of your breath or the racing of your pulse or the sight of your shoelaces on your shoe, but you will not stand up. You are here for her. She is his mother.

If the mother has another son with her and he has punched the wall or broken the chair, do not be worried. The one that punched the wall or broke the chair will be better than the one who looks down and refuses to cry. The one who punched the wall or broke the chair will be much easier than the sister who looks up and closes her eyes as they fill.

Security is already outside the room and when they hear the first loud noise they will know to come in. No, you will not have to tell them. They know about the family room in the emergency department in summer in North Philadelphia. It is all right. They will be kind. If the chair cannot be sat in again that is all right. We have money for new chairs every summer. If he does not break your chair you stay in your chair. If he does you find a new place to sit. You are here for the mother and you have more to do.

If she asks you, you will tell her what you know. You do not lie. But do not say he was murdered or he was killed. Yes, I know that he was, but that is not what you say. You say that he died; that is the part that you saw and that you know. When she asks if he felt any pain, you must be very careful. If he did not, you assure her quickly. If he did, you do not lie. But his pain is over now. Do not ever say he was lucky that he did not feel pain. He was not lucky. She is not lucky. Don’t make that face. The depth of the stupidity of the things you will say sometimes is unimaginable.

Before you leave you break her heart one more time. “No, I’m so sorry, but you cannot see him. There are strict rules when a person dies this way and the police have to take him first. We cannot let you in. I’m so sorry.” You do not ever say “the body.” It is not a body. It is her son. You want to tell her that you know that he was hers. But she knows that and she does not need for you to tell her. Instead you tell her you will give her time and come back in case she has questions. More questions, or questions for the first time. If she has no questions you do not give her the answers to the questions she has not asked.

When you leave the room, do not yell at the medical student who has a question. When you get home, do not yell at your husband. If he left his socks on the floor again today, it is all right.

https://www.nytimes.com/2016/09/04/opini....html?_r=0

Post: #2

It should be specified that this is soley for people who have been murdered, not children dying of any reason.

Post: #3

(02-10-2017 02:49 PM)Mercenary Wrote:  It should be specified that this is soley for people who have been murdered, not children dying of any reason.

You completely missed the point.

There would have been minimal change if the diseased had died during an accident, surgery, or what have you.

The most superficial layer of the anecdote is that Dr. Rosenberg has to tell a mother that her kid died after likely being shot in a gang or crime related incident.

The second and third are about doctors or military personnel or whomever who have to tell families that their loved ones died.

The deepest layer, the one that offers most of us the biggest takeaways, is how to deliver hard news:
- Rehearse saying it out loud
- Be polite upon meeting, shake people's hands
- Precede your announcement with "I have bad news"
(- If related to people, rather than terminating someone from a job for example, use their name. Don't say "the patient", "he/she", etc. Call them by their name)
- Deliver the news in the clearest way possible, but withholding any excessive information
- Don't GTFO, stick around briefly for support
- Answer questions without lying but without giving away senstive details

Reading it all again, I feel like listening to the podcast is very worth it's time - Willink's read is powerful.

From 01:45:

Post: #4

No, it makes a huge difference.

If it's a not a murder or horrible violent accident every person should have the right to see their dead child immediately.

Post: #5

I've had to deal with death notifications before. It is extremely important to use the word "died." Certain cultures and the human mind in general will hold out hope, or not understand, if you use indirect terms such as " he didn't make it" or "she passed on."

Post: #6

(02-11-2017 10:58 AM)Number one bummer Wrote:  I've had to deal with death notifications before. It is extremely important to use the word "died." Certain cultures and the human mind in general will hold out hope, or not understand, if you use indirect terms such as " he didn't make it" or "she passed on."

This is one of the worst things people do now - everyone, even sensible people, says 'passed away'. It is so important not to deceive yourself, or those you're dealing with. People die, animals die, this fact must be confronted for the reality it is. This is one of those instances where a small distinction in the words you speak can indicate two very different states of mind and ways of looking at the world.

Post: #7

There is nothing great about this little essay. It is a self-consciously literary production (indeed it was written for a University of Iowa non-fiction writing workshop by this female physician who had developed an interest in the disgustingly named and conceived field of "narrative medicine"). The clipped, staccato tone which is supposed to be de rigeur when it comes to treating matters of great solemnity is tiresome and gives one a strong sense of the ultimate stupidity of intelligent female literary writing.

There is an insuperable stupidity in the idea that the most ostensibly serious and intimate subjects must be handled in a style that is so harshly mannered, overdetermined, and unnatural, with an affected tone of barely controlled hysteria. It makes one long for the shruggingly sensible take of a good male doc with no literary pretensions.

This woman's emotions are thin and brittle, and the mannered presentation is meant to suggest a depth of feeling that is not really there. Her rules and instructions with their false precision make a fetish of certain exaggerated rigors and discretions that are the stock in trade of the contemporary literary intelligentsia. She -- and others like her -- regard death as an unanswerable fact that proves out the void at the center of life itself, and the whole kabuki dance of supposed delicacy that one is called upon to perform in its face is meant to bring one into proper relation with such final truths.

In reality, the black women in Philly that she talks about would probably be better served if they were informed of the shooting deaths of their wayward sons by some obese black nurse who sings in a gospel choir and who would burst into tears and used whatever words and expressions that first came into her mind. There would be a thickness and density of feeling there that would nourish them more than the harshly delineated brittleness and studied rigorous tact of this female doc. But in either case, there is no need to exaggerate the importance of the exact words and manner in which bad news is delivered. It's an unpleasant task, it must be done, and the precise way in which it happens is of no special or lasting importance.

The follow-up to this article should be: how to tell a certain kind of medical Philly hag that Trump has been elected president. That would be a far more rewarding subject, and an opportunity for the expression of emotions of some real intensity. I would look forward to reading it.

Post: #8

(02-11-2017 02:50 PM)The Lizard of Oz Wrote:  It makes one long for the shruggingly sensible take of a good male doc with no literary pretensions.

Post: #9

I liked the article. I didn't think the author was trying to be dramatic, and I didn't see the prose as contrived. I'm assuming the author has a lot of experience in this sort of thing and knows what she's talking about.

I don't know anything about her job, but I do know something about breaking devastating news to people. There is a right way to do it, and a wrong way. And yes, it does matter how you tell people things. The protocols and techniques she described were developed from long experience, and they're used for a reason.

This article reminded me a little bit about the movie "The Messenger" (2009). Woody Harrelson plays a soldier whose job it is to visit the homes of war casualties and inform the family of their son's death. He goes into great detail about the precise protocol of how to do this. It's a lot more complex than you would imagine. For one thing, he tells us "you should never touch or hug" the family members. He gives good reasons for this.

Anyway, I just wanted to mention the movie, since it's related to the topic at hand.

But the article here is good.