My kids often call me “Debbie Downer.” I tell them this is not so. I’m realistic, the devil’s advocate looking at everything from all sides, and I’m honest. This, they tell me, is a downer.
Perhaps they are right, but that is the way I think—I have never been good at white lies. I feel that if you ask me for my opinion I should give you my opinion, the good, the bad, or the ugly. Now this does not mean I am totally devoid of tact—I have, over the years, learned to temper this honesty with compliments and distraction techniques.
Honesty is not always a bad thing: I am also the person who tells you that you have something in your teeth, yanks toilet paper off your foot, or pulls out that skirt, which you somehow tucked into your panty hose, before you leave the restroom.
So how does honesty enter in to treating incurable metastatic cancer as it relates to Kübler-Ross’s well-known stages of grief?
Is it the best policy to be honest with our patients? I think so. Good relationships, especially therapeutic relationships, have to be built on trust and honesty. During this time of upheaval, patients need to be able to have something solid they can count on, someone they can trust, someone who will tell them the truth, even if that truth is a downer.
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