Source: Wikimedia by: Sei Lee I wanted to alert folks to a wonderful "Piece of My Mind" article in JAMA (Mar 17, 2015) by a pediatrician about difficult conversations. As I was reading it, there were numerous phrases and sentences that poignantly rang true. The manuscript revolves around the author and his wife’s experiences following a spontaneous abortion. Providers didn’t want to tell him the bad news, despite the fact that the ultrasound was strongly suggestive of bad news. Providers used strategies that sounded all too familiar to me. "Uncertainty can be a 'get out of jail free' card for providers, momentarily allaying fears while punting the difficult conversation down the road." "Hope is a powerful tool that physicians have wielded incautiously throughout the history of medicine." As a palliative care provider, I’ve witnessed many clinicians use hope and uncertainty to avoid hard discussions. Instead of talking about wha