The full content of Annals is available to subscribers

Subscribe/Learn More  >
On Being a Doctor |

Deflection of a Diagnosis

Paul Rousseau, MD
[+] Article, Author, and Disclosure Information

From Glendale, Arizona.

Requests for Single Reprints: Paul Rousseau, MD, 17 W. Vernon Ave., Phoenix, AZ 85003; e-mail, PalliativeDoctor@aol.com

Ann Intern Med. 2007;146(2):146. doi:10.7326/0003-4819-146-2-200701160-00011
Text Size: A A A

He sits there, a skeletal silhouette, his body reminiscent of a Holocaust victim, his eyes closed halfway to death.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Letter to the Editor
Posted on January 25, 2007
Paul C. Rousseau
VA Medical Center, Phoenix, Arizona
Conflict of Interest: None Declared

To the Editor

The Annals of Internal Medicine recently published a piece I wrote for the On Being A Doctor series titled "Deflection of a Diagnosis" wherein I described the difficulty a physician experienced informing a terminally ill patient that he was dying"”in fact, the physician was unable to tell the patient, instead, deferring the discussion until a follow-up visit scheduled a week later. I have since received a few e-mails critical of my management of the case, however, I was not the physician in the scenario, I was merely an observer detailing this physician's angst in delivering bad news to a fellow human being. My hope was that select physicians would objectively look at their behaviors after reading this narrative and change their patterns of practice to preclude such conduct in future encounters with terminally ill patients. That said, it is nevertheless hard to provide a "death sentence" to patients, particularly for young physicians who are still absorbing the art and wisdom of medicine that accrues with time and age. And certain patients are just not ready to hear the diagnosis the first time, and may require a second, or even third visit. But irrespective of the time frame involved, unless we are totally honest with patients, the physician-patient bond will shatter, and with that, hope for healing.

Paul Rousseau, M.D.

Conflict of Interest:

None declared

Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.