Thursday, May 10, 2018

Rob Buckman, SPIKES, and How We Break Bad News



I still clearly remember the first time I heard the name Rob Buckman.  It was in fellowship when I was led to his book called "How To Break Bad News: A Guide for Healthcare Professionals" and what became the single most important mnemonic in my career as a medical educator: SPIKES.   SPIKES not only gave me the language to break bad news to my patients, but also gave me a way help learners navigate some of the most difficult communication challenges in medicine.

Now, well over a decade later, I still use SPIKES every time I teach about breaking bad news, but I don't think about Dr. Buckman much.  That changed on my car ride home.   I was gearing up to listen to one of my favorite podcasts, 99% Invisible, and up popped the title of the next episode "Breaking Bad News."  I paused for a second, thinking "what is a podcast about architecture and design doing talking about breaking bad news?"

Well, the podcast was absolutely amazing and I highly recommend listening to it (and sharing it with trainees).  I not only learned about the history of breaking bad news in medicine, I also learned a lot about the life of Rob Buckman.  For example, Dr. Buckman was not only the granddaddy of breaking bad news, he was also a comedian.  Take a look at these two clips of Dr. Buckman (and yes, that is the Monty Python Cheese Shop Sketch with John Cleese):





So, sit back, relax (unless you are driving), and walk down palliative care history lane.  Maybe the next time you give a talk using the SPIKES mnemonic you may break into a British accent and ask for some Wensleydale.

by: Eric Widera (@ewidera)