It Pains Me to Say This

And he said, “I saw all Israel scattered on the mountains, as sheep that have no shepherd. And the LORD said, ‘These have no master; let each return to his home in peace.’” 1 Kings 22:17

In Urgent Care, which is usually all coughs and sore throats this time of year, it is unfortunately common to get a CT scan, revealing a new diagnosis of metastatic cancer. There is, of course, no good way to deliver this news. Still, no matter how awful it may be, it must be done and putting it off only makes it worse. Can you imagine your physician knowing this kind of thing and not telling you? Then, what if he or she waited until your death bed – I’m so sorry I didn’t tell you earlier. I know it was treatable, but it was just such terrible news. You just seemed so happy with my make-believe diagnosis . . .

Though it pains the provider to deliver the news and though it’s painful for the patient to hear, it is no kindness to withhold this sort of information. To do so would be unethical, immoral, and illegal. If you’re the one tasked with delivering the message, you ask yourself not If you should do it, but rather, How you should do it. Yes, it’s a miserable job to deliver bad news but for the good of the patient, it simply must be done.

This sad, regrettable tone is what I hear in Micaiah’s voice when I read today’s passage. In the story, Micaiah stood alone as the only prophet who foresaw the disastrous outcome for King Ahab if he attacked the Syrians. You will be killed (my paraphrase). Ahab’s 400 so-called-prophets predicted an easy victory, but Micaiah saw death for Ahab and so, he had to tell him. To have withheld this information must have been tempting for Micaiah, but Ahab needed to know the truth. Still, Ahab went to war, and paid for it with his life. Had Micaiah not told him, Ahab’s blood would have been on his hands.

What’s the lesson? There are those times when it may not be as simple as reading CT results, but still, I can clearly see an approaching disaster. At those times, I may be tempted to tell my patient all is going well, but that doesn’t help him (or her). What my patients need, is the truth. You’re not doing OK, and this doesn’t end well. You’re going to lose your job, your marriage, and maybe your life. It does the patient no good to tell him what he wants to hear. The truth may be uncomfortable, but if I know the truth and withhold it, then when that terrible future comes to pass, and I did nothing, some of that blood is on my hands.