The family rarely needs you to be their friend. As a general rule, the family has a lot of friends. What they really need is someone who looks grave and important, who looks like they know what they’re doing, right there at the bedside, telling them exactly what’s wrong and what is going to happen.
I mean, it doesn’t hurt to be a nice person. That’s great as long as everything’s going according to plan and the patient isn’t actually sick. Your intern can be the nice person. But the most important thing I learned in residency is that when shit goes down, all anybody wants for their loved one is a genuinely serious-looking, order-giving, no-shit-taking, Doctor standing right. there.
Sure, you can be nice and also in-charge. But if you’re walking into a room for the first time, the family usually feels better seeing someone who’s in-charge and also nice. It’s a crucial distinction.
You shouldn’t be the first one to say the word “dying” to the family. But you should damned well be the first person to write “dying” in your note. It’s a strong word. Your attending has the option to cross out this note in their addendum, but odds are you’re right, and they won’t. If you really believe it and none of the other teams have had the guts to write it, but everyone’s saying it – this is a good first step when you feel powerless.
Fellows have no power if they’re wrong. Call them on it. Useless as an intern, but good to remember past a certain point in PGY-2 when you’re fully aware that they are full of shit and you are graduating.
Enjoy the seniority while you can. Because in just 9 short work days, you will be back to the bottom of the barrel.
Welcome to fellowship.