This is going to hurt
Being the bearer and receiver of bad news suck in equal measure, but there are a few things that make delivering and receiving it marginally easier. Here's what we learned.
My Dad Jack’s relationship with fitness had been patchy at best, but in yet another attempt to get fit at the ripe age of 66, he headed to the local pool to swim laps. The man swam to Rottnest years before but wasn’t looking to break any records that day, just to blow the cobwebs out and turn the arms over. Halfway through his first lap he was struggling, and by the time he touched the tiles at the other end, he was gasping for breath. Knowing this was beyond lack of cardiovascular grunt, he went to his GP who ordered a CT scan to see what was going on.
“Have you ever come into contact with Asbestos?” the radiographer asked.
Dad’s stomach dropped. A question like that couldn’t be good.
“Ah, yes – many years ago…” he trailed off, assuming his response in that setting was unlikely to elicit any sort of diagnostic clarity, and that he’d instead need to undergo the torturous wait for results that comes only from another doctor’s appointment, usually some days (that feel like weeks) later. His suspicion something was wrong deepened when a hospital stay was ordered to drain six litres of fluid off his left lung, which had been accumulating for some time but the impact of which made itself evident quickly. Testing confirmed his diagnosis: mesothelioma - an aggressive cancer that occurs in the thin layer of tissue (mesothelium) around internal organs, caused by exposure to asbestos, typically taking between 20 and 60 years to develop. In my Dad’s case, it was 50.
4000 kilometres away I was blissfully unaware of his plight, instead riding high on a wave of media coverage, positive reviews and celebrity endorsement for my first book which had been released on the same day Dad was admitted to hospital. My husband and I and our two small children had travelled to Wagga Wagga, a tiny town a five-hour drive from our home in Sydney, to celebrate my husband’s graduation from his Master’s degree. After 3 years of studying every weekend (and many hours on the tools myself either solo parenting or editing his assignments) I forced him into a gown and cap and gathered the family to celebrate. It was a happy day, a proud day, and one that would end in despair.
Dad had texted the day prior asking for a quick chat soon, and I had arranged to call him after the graduation - asking if he was OK before signing off. In retrospect I realise he didn’t really answer me, but responded cheerily enough that it didn’t ring any alarm bells. He was clever like that. I’m a firm believer that anyone who can survive longer than two minutes after receiving a ‘can we talk’ message without speed-dialling the source to get the lowdown in detail deserves a medal. I am not that person. Yet, wanting to give my husband his moment in the sun, I allowed myself to remain caught up in the moment in front of me, missing Dad’s ninja-like avoidance of answering whether everything was, in fact, OK. Which of course when we connected later that evening, I would found out it was not.
Him: “Sweetheart, I have some bad news.”
Me: “About what?”
Him: “About my health.”
Me: “What’s going on?”
Him: “I have mesothelioma.”
Me, panicking and prematurely firing off a poor guess: “Blood cancer?”
Him: “It’s cancer of the pleura – the lining of the lung – from asbestos exposure…”
I immediately felt hot and prickly and like I’d stepped outside of my body, but – as I tend to do in crisis – tried to orient myself in space and time by snapping into action, putting him on speaker phone so I could quickly google what we were talking about, and more importantly what he was looking at. He slowly walked me through the details as I asked a million questions and tried to maintain some level of decorum. Dad, no doubt mustering every inch of courage he had and looking for the silver lining already, insisted he felt “wide awake” and “blessed” for the wakeup call. And me? I cried all night, knowing deep in my bones that, eventually, I was going to lose my Dad.
In all Next Of Kin posts, you’ll find our best attempt at some ‘tips’ from the perspectives of carer and patient. They are in no way exhaustive nor groundbreaking, but they’re the things we can put our finger on that helped (or would’ve) at that point in time, for what they’re worth.
Tips for the receiver of bad news, from Casey’s perspective:
1. Write everything down. As cortisol floods your body and your nervous system prepares for war, your memory will be impacted. You (and they) will be grateful for the notes later. I just pulled mine up, 2+ years later, to write this.
2. Google will serve up more information than you want or need. Some will be valuable, informing questions to ask at upcoming appointments. Some will be useless – wrong, out of date and muddying the waters of fact with fiction. Some again will be treacherous; delivering fear or hope which can be equally dangerous where wrongly applied. Choose your sources – reputable institutions such as Harvard, the Mayo Clinic and World Health Organization can give good context, and closer to home healthdirect, Better Health Channel and peak bodies like The Cancer Council, Dementia Australia and The Heart Foundation are all good places to start. Steer clear of chat rooms, Facebook and personal blogs – you can use them later once you have the vital information under your belt. And if your Aunt Sheila’s friend’s cousin’s dog cured their totally-unrelated cancer with organic panda saliva enemas from www.randomcures.com – take that advice with a big pinch of salt.
3. Try not to make it about you, delivering hard news is hard enough without the deliverer having to manage your reaction as well. It’s okay to be emotional if that’s what comes up for you, but don’t make them console you when they’re already carrying the burden. Thank them for telling you, acknowledge how hard that must’ve been, and know that it’s OK to go away, digest, and circle back later. Breathe and slow down, even though your heart feels like it wants to make a run for it. The best thing you can do for them right now is be a safe space to share the diagnosis and the feelings that go along with it.
Tips for the deliverer of bad news, from Jack’s perspective:
Before I told anyone (including Casey) I contacted a counsellor I had worked with previously who I knew had had a dance with death too, navigating prostate cancer. He confirmed three things I had kinda figured:
1) There is no sugar-coating this variety of shit - so be gentle but direct with the news. Don’t beat around the bush.
2) You know your people best, but in my experience it’s best to tell loved ones alone, separately from others. Let them have their own experience of emotions and ask their own questions. This isn’t right for everyone; older couples who tend to live in each other’s pockets may derive comfort from not being alone while receiving bad news.
3) Be careful who and how many people you tell in the early days. There is a tendency for such news to bring out a ghoulish aspect of human nature, full of curiosity and questions they probably don’t understand the implications of asking. These ghouls love peddling bad news too, so my counsellor’s sage advice was to keep it close, especially in the early days, to conserve my energy for my own deep musings.
I am deeply indebted for these insights. Somehow the news, its detail and severity flowed out into the world in a way that never became a burden to me. Quite the opposite.
Next Of Kin is written by health journalist Casey Beros and her Dad, Jack Wilde, to create a space where patients and carers can become better Next Of Kin for each other and the world at large. If you know someone who would benefit from following our journey, please send this onto them. You can follow Casey on Instagram here and find out more about her work here.