Skip to main content

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)

Comments

Popular posts from this blog

Caring, and the Family Caregivers We Don’t See

Over lunch at a restaurant in Manhattan, my father and I talked about long-term care insurance and the emergence of senior centers and nursing homes across the U.S. that offer a variety of ethnic cuisines and cultural events, catering not only to a growing population of adults over 65, but also, to an increasingly diverse population of adults who call the U.S. their home. This conversation was different from many similar ones before it – we weren’t talking about my research; we were talking about our own lives.
My parents immigrated to the U.S. in the late ‘70s and early ‘80s, following their parents’ advice on professional opportunities that seemed unimaginable in India at the time. Although they considered moving back soon after to care for their aging parents and to raise children, they ultimately decided to stay in the U.S. As I chronicled earlier, my paternal grandparents lived with us until I completed middle school, at which point they returned to India and lived with my mater…

Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …

Top 25 Studies in Hospice and Palliative Care (#HPMtop25)

by: Kara Bishoff (@kara_bischoff )

Back in 2015 we wrote a post asking for input on what articles should belong on a list of the top 25 articles in hospice and palliative care.   We decided to focus on hospice palliative care studies and trials - as opposed to review articles, consensus statements and opinion pieces.

Here’s what we came up with. It was hard to pick just 25! We highly prioritized clinical utility and tried to achieve diversity & balance. Many others are worthy of inclusion. Take a look and let us know if you have suggested changes for next year.

Module 1: Symptom Management
Randomized, Double-Blind, Placebo-Controlled Trial of Oral Docusate in the Management of Constipation in Hospice Patients. Tarumi Y et al. JPSM, 2013.Once-Daily Opioids for Chronic Dyspnea: A Dose Increment and Pharmacovigilance Study. Currow DC et al. JPSM, 2011.Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomise…