When as a doctor, have you ever lied to a patient about the problem?

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As a doctor, have you ever lied to a patient? Have you wondered whether (or how) you should confront such untruths?

I’m not always honest with patients about the impact my job, and their illness and trauma, has on me. Patients need a doctor who cares, but they need containment, they need their doctor to be able to cope with everything they’re sharing and hold it all together for them. Sometimes a patient will ask, “how do you cope with hearing all this trauma, all day every day?”, and I can hardly say “I’ll think about you every day, worrying about how you are, until our next appointment”.

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I once told a patient, who had been through some terrible traumas in her life and was just learning to open up about them, that if I’d had a particularly heavy day at work I would talk to my cat about it, because he was a really good listener but couldn’t break confidentiality. I didn’t, at that point, actually have a cat, but it felt like the right response for her, and I’m guessing it was because when I left that job, she made me a thank you card, and bought Dreamies and a little toy for my cat to thank him! I do now have a cat, who is a terrible listener but an excellent distraction and snugglebum, and loves the toy that patient got him.

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I suppose the only other lie I’ve frequently told was back when I worked in physical health. A few times, I told relatives that I was certain that a dying patient could hear and understand what was being said, or that even if they couldn’t understand the words there was still enough understanding to hear the tone in “I love you” and feel it, even when it seemed hugely unlikely that the patient had any awareness or consciousness left at all, if I thought the relative needed their goodbyes to be heard. And hey, maybe sometimes I was right, and the patient got to hear one more “I love you”.

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