By Dr Joseph Hawkins, Consultant in Palliative Medicine, Clinical lead for End of Life Care, Ashford and St Peter’s NHS Foundation Trust. Twitter: @JoeHawk75825077
The following was recorded directly from an acting seminar in North Wales on how to act like a specialist doctor. The text has been presented in an easy to read format:
In the latest of our ‘how to’ seminars we will be covering the specialty of palliative medicine. This strange quirk of a specialty is rarely seen on the screen as dying is generally only popular viewing when it’s either not shown or violent. However, contrary to popular expectations most dying IRL (in real life), occurs quietly and after a prolonged illness. So as medical dramas continue to rise in popularity it is only a matter of time before palliative care gets its own Dr House, Dr Hospice maybe?
Now the key things you need to know about palliative medicine are that they hate it if you don’t say die, death or dying. So try and say one of these as often as possible. They are often also very apologetic, so bear this in mind. Additionally they like to touch their patients.
As with all of our seminars we will now give a demonstration. John will play the part of a 95 year old patient also called John and Janet will play the part of the Palliative doctor.
John: Doctor-tell me straight, what’s happening?
Janet: Head tilt at 10%: what do you think is happening, John?
John: looks sad: I feel like I’m reaching the end.
Janet: reaches out and starts patting John’s leg. Do you mean you feel like you’re dying, John?
John: stuttering– I, I didn’t expect this am I dying? I’m so young, I thought I had more time to travel and do more.
Janet: head tilt now at 20%: John, I’m so sorry. I noticed that you used the same language that I reflected- dying. Sometimes we are the best judge of when we are going to die, be dead, no longer alive. Do you think that this is what is happening, John?
Janet: now aggressively patting John’s leg.
John: I guess I have had cancer and heart failure for ten years, it just feels so sudden, is all. I think I am, aren’t I? Dying I mean.
John: starts crying.
Janet: now rubbing John’s leg, head tilt at 40%.
Janet: I am really sorry John, this must be very sad and I can see your shock at the news.
John: Sighs- you are right, it is a shock but I appreciate your honesty.
Janet: All part of the job John, and I’m truly sorry that you’re dying and that we’ve had to have this conversation.
Janet: Stands and gently pats John’s cheek before giving his hair an affectionate tousle.
Janet: Good bye John, I’m truly sorry that I’ve had to give you this news. I probably won’t see you again-
John: Interrupts- because I’ll be dead?
Janet: yes, probably, I’m sorry.
Janet: sorry. EXIT scene.
I think we can all agree that was a masterful moment of acting from both John and Janet and now we all know how to act like a palliative medicine doctor for TV.
Next week: geriatricians- expect to be asked where you live and how to count the months backwards a lot!
Also in the series: cardiologists- we don’t just do long tubes, sometimes we use tiny amounts of electricity too!
Gastroenterologists- top and bottom doctors but hopefully not at the same time!
Neurologists- we don’t understand this either!
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