Just now this is one way I can deal with something going on.
Last night my father, who has a history of heart trouble(two open heart surgeries) went into the hospital again with chest pain. He’d been scheduled today for another angioplasty, after having had poor results on a stress test.
So after Dad was stabilized the doctor comes into the waiting room to talk to the family. My mother, two sisters, a brother in law, and a minister were present. “Dr. Jones” begins to explain to my mother, (a retired RN) the various treatment options open. Since Dad has been cracked open twice they are reluctant to do it again, because there is a fifty-fifty chance of “a bad outcome” if they do. There are three different meds they can give him, one fairly new. But Dad is over seventy-five, and with the new one there would be a greater risk of “a bad outcome”.
I know the doctor is trying to be gentle, and I appreciate that. But there were no children present, and we all know “Dr. Jones” meant “DIE”. I guess for a doctor a death is bad, maybe that’s why he said it that way.
My dad might die soon. Or he might get better again for a while, although there aren’t many grafting options left. He’s the best dad ever, and he never was one for pussyfooting around a subject.
His first heart attack, twenty-seven years ago, was on the day before Easter. A code blue was pulled on him on Easter Sunday. All he said about it was “If I was going to die, what better day for it?”
Sorry for the rambling, it’s just that “bad outcome” and “die” are not necessarily equivalent.
I’m really sorry that your father is so seriously ill, Baker. I suspect your own reasoning for the doctor’s phrasing things like that is accurate but I’m with you. It’s a bit grating when you suspect euphemisms are being deployed ostensibly for the recipients benefit but really are as much for the speaker’s benefit too.
My thoughts and very best wishes for your dad’s health.
Eleven years ago this week, I took my wife to the emergency room. She had suddenly redeveloped pneumonia after having just been released from the hospital days before, and her heart rate was dangerously high. They gave her some drugs to reduce her pulse. After a few hours, they declared her stabilized and told me to go home and get some sleep, they were admitting her. I should come back in the morning. It was about 1 AM. At around 2 AM, one of the emergency room doctors called me and said I needed to come back to the ER, my wife had “taken a turn for the worse”. What had really happened was the her heart had stopped beating, and they were unable to start it. A “turn for the worse” apparently means “died”.
I’m sorry about your Dad, Baker. I think doctors do their best at dealing with delivering bad news.
I suspect they wanted you to be able to get there before they told you of her death, rather than doing it over the phone, so they didn’t tell you the whole truth.
As for the OP, that may be the case, but there are probably plenty other “bad outcomes” that could happen as the result of surgery/meds, especially in someone already ill with cardiac problems. Stroke, clots, infection, etc.
It’s a tough decision in how to word something. Mention “death” openly and some families may freak out while others will just nod and appreciate the doctor’s candor. Plus even if the patient prefers the plain truth, the family members may be overly sensitive and panic at the least hint of something bad. Some family members are in the loop about everything that’s going on, and others aren’t, so if the doctor mentions something casually it may be the equivalent of a bombshell to those who aren’t up to speed (or are in denial) on everything that’s going on.
I myself dropped the bombshell on my husband that his mother had a DNR order on her chart during her last hospitalization for arrhythmia and pacemaker implantation. I realized that she and/or his dad had placed the order and we didn’t know until I saw that notation on the chart, so I told him. He was pretty shocked at first, but gradually came to understand the reasoning.
It is almost universal policy to NEVER inform family/loved ones over the phone that the patient has died. This is done for several reasons, primarily to prevent said family/loved ones from having a car accident on the way to the hospital. A long time ago, a nursing supervisor told me that when she was a new nurse, in the 1960s, she blurted out over the phone that the pt had died. The spouse committed suicide–didn’t even come to the hospital… eek.
Yes, dead is dead. We call dead people either dead or expired (which to me always sounds like supermarket fare, but I digress). However, health care personnel never know how a family/loved one is going to react to the word “die” or “death”, so “bad outcome” is used instead. Believe me, it’s not because Dr Jones can’t face it. It’s because Dr Jones has had a “bad outcome”(hysteria, threats of physical violence against him/her, fainting etc) when using strong words with family/loved ones before.
I am sorry to hear about your Dad, and I understand your frustration with euphemisms, but it is standard practice in medicine today (in the USA anyway).
Another phrase I’ve seen several times is “incompatible with life”. Like, you know, usually life gets along with everybody, but for some reason it decided to be a pissy drama queen and leave the party because it didn’t get along with massive chest trauma or total oxygen deprivation. Gah.
Glad you said “almost”. My mother died in a nursing home. They had absolutely no problem telling me over the phone that she died. I commuted to work in the next state by public transportation and it was in the a.m. but past rush hour when the transportation schedule is sparser; they reached me already at work. With me I was glad that they leveled with me–it coincided with the kind of person I am and also the fact that I didn’t have to go rushing there like a crazy person to see her before the end only to find that I was too late. Without going into unnecessary details, while she was in a nursing home, she wasn’t in a such a serious condition such that death was imminent.
Of course, you can always tell a medical person that you dislike euphemisms and would appreciate blunt candor, if that’s what you want. I think most of them would appreciate knowing that, so they don’t have to guess. They’re human, too, after all, and I doubt they enjoy people freaking out or getting pissed off - they have to deal with enough of that already, if you let them know how you want the news whether good or bad, well, that’s one less thing they guess and fret about.