Posted by My OB said WHAT?!?.
May
27
Posted by My OB said WHAT?!?.
“I Can’t Imagine How Hard This Is For You, But When My Dog Died…”
“I can’t imagine how hard this is for you, but when my dog died…” – NICU Resident to mother with a sick baby.
There are 35 comments to this post.
There are complete dolts out there everywhere who truly think their pets are children and don’t understand how anyone else doesn’t get it. Now…I love my dog, but there is no comparison to my kids. End of discussion…
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My daughter died 10 years ago, at two hours old. I did get comments like this from people, but I think (now) that they actually wanted to help, not to belittle the mom’s lost. “Your baby might die, but my house plant is wilty” or whatever is really the person trying to find a connection so the mom won’t feel so alone.
I mean, it FAILS because a dog, your broken bicycle, or even having a sick husband is not the same as having a dead or dying baby. But I think in cases like this your average person just doesn’t know how to comfort the mom.
**Having said that,** a NICU nurse should not be just an average person because s/he should be accustomed to dealing with sick and dying babies and the parents of sick and dying babies, and therefore the nurse should have a few better lines in the repertoire than “I know how you feel — my dog died.”
Try this:
1) I don’t know how you feel, but I imagine this is the most wrenching thing you’ll ever go through
2) I’m so sorry this is so difficult. I will do everything I can to help you and your baby
3) My name is Janet Smith, and if you ever have questions or concerns, you call me at THIS number and it will ring at the nurse’s station, and you can ask for me, and I will get answers for you. Even if you just feel worried and want me to go check on your baby and blow him a kiss for you, please call. We know this is difficult.
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Jane Reply:
May 27th, 2011 at 5:14 am (Quote)
Ack — when the page reloaded I realized it was a resident, not a nurse. We’ll cut a resident more slack, but the resident needs to learn now how to use helpful words rather than something the mom could perceive as belittling to her baby’s situation.
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Johanna Reply:
May 27th, 2011 at 10:18 am (Quote)
Great advice Jane. Before experiencing a loss of my own, I never quite knew what to say in this type of situation. Now I know that “I’m so sorry” “I love you” or “I’m here if you need anything” are the most important things to hear (but only if it’s heartfelt.)
I actually had an amazing resident when my daughter was stillborn. I saw him in the hospital and again in a follow-up appointment, and both times he asked if we minded if he was there, and started the conversation asking both my partner and me how we were doing emotionally before he mentioned anything medical. You could tell he really cared. I hope that he holds onto that compassion throughout his career.
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Kayla Reply:
May 27th, 2011 at 1:03 pm (Quote)
You are absolutely right, Jane. One of the basic principles of psychology is to distinguish the fine line between empathy and sympathy. When people hear of a terrible situation that is unfamiliar, they immediately try to empathize through a personal experience and end up making comments like this one.
It is much better to just be sympathetic and compassionate and not try to draw a parallel between unrelated situations.
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unless this ends with:
“when my dog died, it knocked me silly for months. I can’t even get my mind around what it must feel like for you to be worried about your *baby*–I mean, I love my dog, but…a BABY. I’m so sorry you and your little one have to go through this.”
But somehow, I’m thinkin’…not so much.
And you know, even if it did end this unlikely way, all the mom’s gonna hear is “my baby (somehow) = your PET?”
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Amber (Firewife) Reply:
May 28th, 2011 at 10:54 am (Quote)
I was thinking basically the same thing. If both baby and dog died, and if it wasn’t a comparison making them equal, but rather something along the lines of “I know how my dog dying felt, and I know that losing a baby much be much worse than that,” then that would be acceptable to me. In fact, I’ve used similar comparisons when telling someone that I could feel some small portion of their pain, but I did not fully understand it.
I have had more than one miscarriage. Also, recently my oldest canine baby (who was like a child to me) died. I’m not one of those people who takes my dog everywhere and pampers my dog, but she was my baby and I loved her dearly. Honestly, her death was harder on me than the miscarriages. Perhaps because she had been with me for over a decade, and she actually saved my life when she was a puppy. Perhaps because with all but one of the miscarriages, I did not know that I was pregnant until I miscarried. I may never know exactly why her death hurt worse. However, (the point) I would never be so brutal as to imply that my dog’s death was just as hard as the death of a child! Just because it was like that to me does not mean that anyone else would feel the same way! This is where common sense and tact come into play!
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Am I the only one who thinks this is insensitive not because it’s comparing a dead pet to a sick baby, but because it’s comparing dead to sick at all? A sick baby in the NICU is heartwrenching no doubt, but it’s not a DEAD baby. Someone talking about their dead pet and how that pain compares, especially a doctor who is supposed to be taking care of my baby and know his/her medical history, would make me think he/she was trying to tell me that my baby was dying.
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Amanda Reply:
May 27th, 2011 at 7:07 am (Quote)
Yes, exactly! That was my first thought here. Let’s not jump to conclusions!
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Lisa Reply:
May 27th, 2011 at 8:27 am (Quote)
Absolutely! The first thing I thought of as well. Not only would I be worried about my baby being sick and in the NICU, but now I would be worrying about what the doctors are not telling me. They did that to us with my mother-in-law…instilling false hope when there was none, so now my mind automatically jumps to “there’s something else going on here!”
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When you don’t have the right words, don’t make yourself into an idiot by using wrong words.
Silence is golden.
My son was 6 weeks old and was hospitalized with swine flu 2 years ago. He was nearly vegetative with fever and needed an NG tube because he couldn’t nurse or suck a bottle. His fever got up to 105.1 and would NOT break. The best visits were when nurses/moms would just be there.
Another bone I have to pick with this: notice that the baby is listed as being “sick.” The very last thing I would want someone to say is “when ________ died.” The possibility of my baby dying pervades every corner of my being. Please don’t talk about it.
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Molasses Mom had this to say,
May 27, 2011 @ 8:08 am (Quote)
Hi! OP here.
My daughter had a very scary birth and things looked very questionable for a couple of hours, but she rapidly improved and we went from conversations about whether she would possibly be headed to a different city for ECMHO (sp?) to her being off the ventilator completely within 24 hours. This conversation with the resident happened when my baby was off of *all* respiratory support within another 24 hours after that and exclusively (and successfully!) breastfeeding.
I had stayed up with my baby almost all night sitting in a chair holding her because she slept much more deeply in my arms than she did if out of my arms and her sats and respiration rate where much better being held, and she was doing beautifully but obviously really really wanted to be with her mom. The resident was trying to convince me to go to the Ronald McDonald House and sleep there instead of on a pull out bed in the “rooming in room” on the unit, and I appreciate that he was trying to be helpful, but that was the worst attempt at empathy that I’ve ever seen. My baby wasn’t dying, and comparing her to a dog is really not so bright. Luckily I was sleep deprived enough at that point to think it was absolutely hilarious instead of wanting to cry from sheer frustration, but geez.
That was a bad NICU stay though. What I submitted was far from the worst thing said by a neonatologist or nurse while I was there.
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Kat Reply:
May 27th, 2011 at 8:48 am (Quote)
I am SO glad your daughter is alright. That makes this comment all that much more bizarre and inappropriate. I’m glad it wasn’t added stress to you at the time, because you really didn’t need any!
I sometimes think our brains tend to filter things when we’re going through something earth-shattering. It’s a good thing too, because if we could remember every single “well-meant” but stupid and hurtful thing someone said to us during a difficult time, we might lose it!
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juliewashere88 had this to say,
May 27, 2011 @ 4:47 pm (Quote)
… So what came next? The quote just trails off.
I’m waiting for the part that’s so horrible.
She freely admitted she had no idea how hard this is. She wasn’t saying that having a sick child was like losing a beloved pet, it looked like she was going to talk about the feelings the situation caused because those could be relatable.
Some people do get very attached to their pets, even going so far as to call themselves parents of those pets. My boyfriend often talks about his deceased golden retriever as if it was a first love. He still grieves over her years later.
Not everybody likes animals, or loves them like they would other humans. I suppose that’s why bringing it up seems unintentionally offensive.
Yes, the effect was bad, not the words.
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jaed Reply:
May 27th, 2011 at 8:22 pm (Quote)
It’s not that the comment was malicious. Unlike some remarks posted here, the resident didn’t seem to have any bad intention in saying this.
It’s just that it is insensitive, clueless, and bizarre. In implying that he assumed the baby was going to die, and at the same time comparing the baby’s importance to a pet’s, he could have made a bad situation that much worse for a very stressed mother.
Not every stupid remark is deliberately cruel. But medical workers still need to think about what they say before they say it.
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I am a med student. I really struggle with “bedside manner.” I freely admit that I have always been good at science, I’ve always been good a books, and knowing what to do. I always have been someone who knows the correct thing to do when a situation arises. But, I have never known what to say when someone else is struggling. It has always been something hard for me, and how am I supposed to learn without every once in awhile making a mistake? I have no people skills. I’m working on it, but I’m not there yet. And if I said this, it would not be the worse thing I have said when trying to comfort someone. It’s not that I don’t feel compassion for them. It’s not that my heart doesn’t leap out of my chest for them. I just have no idea how to say it. Bear with them while they learn. They really were trying to be kind.
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Holly Reply:
May 28th, 2011 at 7:48 pm (Quote)
Sorry, not to be rude or hateful but this is one of those things where you have to learn to sensor yourself and hit the ground running. You don’t get to learn how to have a heart WHILE talking to a NICU patient.. recovering or not. This is something you either have, don’t have or need to figure out BEFORE you start interacting with patients! When someone is in a crisis is NOT the time for you to “learn” what is and is not ok. Read these posts and figure it out now. Please. Not when you crush a parent and they go and commit suicide because you effed up and said the wrong thing at the wrong time and it hit them at their very lowest moment and they can’t seem to comprehend how to go on with life and you say some stuff about your dog dying. Luckily *this* parent’s child was not dying… Luckily, she was recovering. Had it been different…. yea, not acceptable.. Not acceptable even here but yea. Also, a good way to get decked by a parent in crisis! Parents in crisis are not firing on all working cylinders so to speak. Comparing their precious child to your PET.. yea, the one you tossed in the garbage after it died most likely, yea, not acceptable 
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Amber (Firewife) Reply:
May 29th, 2011 at 5:35 am (Quote)
Karen, this is a personal message to you in an effort to help you with this.
If you have no clue what to say, then please say just what you said in the last few lines:
“I have so much compassion for you, and my heart leaps out of my chest for you, but I just do not know how to say exactly what I feel for you.”
Please, memorize that and use it as a standard answer in such times. Trust me, someone who is grieving or sad or in pain will appreciate that statement.
I have given a lot of thought to the “resident just doesn’t know what to say” scenario.
I have also given a lot of thought to the fact that med school basically deprograms sensitivity and reprograms it with facts and figures and the ability to handle crisis as fast as it comes at you.
Trust me, I get it. I grew up in a fire family, became a volunteer firefighter and went to EMT school myself, and ended up marrying a firefighter/EMT (not intentionally – fell in love with him before I knew he was a firefighter – I just can’t escape the life). Those of us in fire service and EMS don’t get as much training on handling a crisis as doctors do. We are born with that ability to handle things (the good ones are, anyway), and jumping to action is our natural instinct. That is why we aren’t trained on it – those doing the training don’t see it as something that needs training.
The problem is that most of us also struggle with the softer side of it as well. We tend to show no emotion, on and off the job. But the good ones, we LEARN to comfort those who are suffering, grieving, sad, etc. It is part of the job.
So, my point: Learn. Learn before you have to interact with patients. There is no acceptable excuse on this. You have admitted that you struggle with it. Knowing and admitting the problem is most of the solution. At least memorize a standard answer like the one above for now, until you can better express what you feel. Consider it part of your job – because it IS part of your job to comfort the suffering, grieving, sad, etc. If we can do it, then so can you!
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Sheva Reply:
May 29th, 2011 at 6:13 am (Quote)
Karen, you can’t learn at the expense of the people in pain. And you can’t expect a grieving family to ‘bear with you’ while you figure out how to express compassion. That’s unrealistic.
You are the one that has to bear with them, and not make their pain any worse than it is. Because trust me, your words can be the difference between years of re-living the agony and pain, and solace that soothes the soul and keeps the heart alive.
Good luck with your schooling. You sound like you’ll be a great doctor, and that you care a lot. Just say you care, and leave it at that. I’m so sorry, my heart is so full of pain for you, anything that shows caring. Don’t try to take their pain away, or try to show that you understand it. Just validate it, and acknowledge that it’s there and real. Thank you. And thank you for wanting to learn.
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Jane Reply:
May 29th, 2011 at 6:19 am (Quote)
I highly recommend “A Caregiver’s Guide To Perinatal Loss” and Limbo & Wheeler’s “When A Baby Dies.” Both have good and compassionate suggestions of things to say, do, and avoid. In many cases, it’s the gestures that matter most to the patients (such as booking the six-week postpartum checkup for a time when no pregnant women will be in the waiting room.)
And I’m going to copy what I said above as suggested things to say:
Try this:
1) I don’t know how you feel, but I imagine this is the most wrenching thing you’ll ever go through
2) I’m so sorry this is so difficult. I will do everything I can to help you and your baby
3) My name is Karen Lastname, and if you ever have questions or concerns, you call me at THIS number and it will ring at the nurse’s station, and you can ask for me, and I will get answers for you. Even if you just feel worried and want me to go check on your baby and blow him a kiss for you, please call. We know this is difficult.
Practice in your mirror at home during a calm time and then when you need to be compassionate, it will just slip out.
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Karen Reply:
May 29th, 2011 at 3:32 pm (Quote)
I really appreciate the advice, every one.
On those who expect me to never make a mistake, I’m sorry that that’s just not going to happen. I feel bad when I say something that comes out the wrong way or could be construed as insensitive. However, I don’t hold myself responsible if they commit suicide, because that is their choice, and I am doing the best I can. I feel terrible, and I grieve for that, but I am religious and I believe that I will be able to stand before God guiltless on that one. I fully admit that I need to work on how to talk with them. I’m aware of that, and I am working on it, and that’s why I appreciate the suggestions. But are you going to tell me that you’ve never said the wrong thing to someone? You’ve never made your child, spouse or sibling mad because you said something in the heat of the moment. I do feel bad when I misspeak, but it isn’t practical to expect that someone will have mastered that completely before ever speaking to a NICU parent. Most recently, I got told off by a parent for being insensitive because I was asked why I thought God was doing this to them (we are allowed to give religious opinions if we are asked) and I said, “I don’t know why this is happening to you, but I’m confident God has a reason.” Apparently that’s insensitive. But that’s what I’d want to hear. I’m not going for insensitive. I’m really not. However, I have made mistakes. And I know it will not be the last time. Not by a long shot.
Thanks for the advice. This is mostly responding to those who seem to be under the impression that I should not be allowed to speak to patients if I ever, ever, ever misspeak.
I do want to comfort them, and that’s part of the Hippocratic Oath. I know that. But I would rather make a mistake that fails to comfort over a mistake that results in a death. And I think that we can all see why.
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Jane Reply:
May 29th, 2011 at 3:59 pm (Quote)
If you’re dealing with NICU parents or with parents of a baby who died, then you will by definition be dealing with a woman who is hormonal and in shock. So it’s to be expected that at least one will bite your head off for being insensitive when you weren’t being insensitive at all.
I think most of the above comments boil down to this: it’s to be expected that in your line of work you are occasionally going to have to deliver bad news, or to have to deal with individuals who have received bad news It’s a situation of “with great power comes great responsibility.” As a doctor, you’ll be perceived as standing in the gateway to health, and you have a responsibility to take care of your patients, both when you can help and when you cannot. If the only way you can take care of them is by looking out for their hearts, then that’s what you have to do.
And that’s why it pays to be prepared. To rehearse your responses. Play-act them with another medical student so you can feel your way through it (and sometimes, try to be unreasonable with each other.)
No one expects perfection. But when you do say the wrong thing, it’s fine to say, “Oh, I’m sorry, I didn’t mean it that way at all!” and then say whatever you meant to say.
Rote lines are GOOD for this kind of situation. It’s when we go off-script that we end up saying all sorts of weird things.
But here, in case you’re worried about saying the “wrong” thing. When I spoke to a friend of mine the night my baby was diagnosed with anencephaly, I know she was flailing in her heart for something comforting to say to me, and what came out of her mouth was, “Well, there are some beautiful cemeteries in your area.”
I wasn’t offended — I knew she loved me. But I did look at the cemeteries as we passed sometimes between then and when the baby was born and died, and I’d think, This is a beautiful place.
And when I went to the first cemetery and put a reservation on the grave site, I remember thinking how UGLY the place was. The baby yard looked over a drainage ditch, and the little stones were haphazard and every which way.
And so help me, that ‘wrong’ thing my friend said, something she probably kicked herself over, prevented me from making a horrid mistake. Because her words gave me the strength to go to another cemetery, a beautiful cemetery, and make arrangements there instead.
**hugs** and good luck.
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Would it have been better if the doctor said “I know how you feel; my mother/spouse/grandma/aunt just died…” ? Probably not.
People love their companion animals as much as they love their children, so it’s not insulting that the death the doctor brought up was his dog’s death.
What’s insulting is that the doctor shifted the focus of grief to himself…”too bad for you, now let me tell you about my grief…” This is attention seeking, not empathetic!!!
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Add Your Comment.
Does not compare. Now shut up and go away.
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