I like to listen to podcasts and lectures during my morning dog walk. This morning I listened to Jocko Podcast, specifically episode 58. The episode opened with Jocko reading a powerful essay by Dr. Naomi Rosenberg titled "How to Tell a Mother Her Child is Dead". The essay is stark, direct, and powerful. While the surface level provides instructions for how to deliver terrible news of a child's death, there are lessons to take away in how to deliver any hard news:
- Rehearse delivering the news out loud
- Be polite upon meeting and shake everyone's hand
- Indicate up front that "I have bad news"
- If related to a person, it is never "the patient", or "the employee", or "him". ALWAYS USE THEIR NAME
- Provide the information as clearly as possible
- Always deliver the truth and do not sugar coat the answer
- Avoid sharing excessive information or answering questions which were not asked
- Stay around for support as long as it is necessary
- Expect emotional reactions and allow them to happen
- Keep your feelings in the room and do not take your frustration out on others
I highly recommend listening to Jocko read this essay, and the original text is included below.
How to Tell a Mother Her Child Is Dead
By NAOMI ROSENBERG
SEPT. 3, 2016
Philadelphia — First you get your coat. I don’t care if you don’t remember where you left it, you find it. If there was a lot of blood you ask someone to go quickly to the basement to get you a new set of scrubs. You put on your coat and you go into the bathroom. You look in the mirror and you say it. You use the mother’s name and you use her child’s name. You may not adjust this part in any way.
I will show you: If it were my mother you would say, “Mrs. Rosenberg. I have terrible, terrible news. Naomi died today.” You say it out loud until you can say it clearly and loudly. How loudly? Loudly enough. If it takes you fewer than five tries you are rushing it and you will not do it right. You take your time.
After the bathroom you do nothing before you go to her. You don’t make a phone call, you do not talk to the medical student, you do not put in an order. You never make her wait. She is his mother.
When you get inside the room you will know who the mother is. Yes, I’m very sure. Shake her hand and tell her who you are. If there is time you shake everyone’s hand. Yes, you will know if there is time. You never stand. If there are no seats left, the couches have arms on them.
You will have to make a decision about whether you will ask what she already knows. If you were the one to call her and tell her that her son had been shot then you have already done part of it, but you have not done it yet. You are about to do it now. You never make her wait. She is his mother. Now you explode the world. Yes, you have to. You say something like: “Mrs. Booker. I have terrible, terrible news. Ernest died today.”
Then you wait.
You will not stand up. You may leave yourself in the heaviness of your breath or the racing of your pulse or the sight of your shoelaces on your shoe, but you will not stand up. You are here for her. She is his mother.
If the mother has another son with her and he has punched the wall or broken the chair, do not be worried. The one that punched the wall or broke the chair will be better than the one who looks down and refuses to cry. The one who punched the wall or broke the chair will be much easier than the sister who looks up and closes her eyes as they fill.
Security is already outside the room and when they hear the first loud noise they will know to come in. No, you will not have to tell them. They know about the family room in the emergency department in summer in North Philadelphia. It is all right. They will be kind. If the chair cannot be sat in again that is all right. We have money for new chairs every summer. If he does not break your chair you stay in your chair. If he does you find a new place to sit. You are here for the mother and you have more to do.
If she asks you, you will tell her what you know. You do not lie. But do not say he was murdered or he was killed. Yes, I know that he was, but that is not what you say. You say that he died; that is the part that you saw and that you know. When she asks if he felt any pain, you must be very careful. If he did not, you assure her quickly. If he did, you do not lie. But his pain is over now. Do not ever say he was lucky that he did not feel pain. He was not lucky. She is not lucky. Don’t make that face. The depth of the stupidity of the things you will say sometimes is unimaginable.
Before you leave you break her heart one more time. “No, I’m so sorry, but you cannot see him. There are strict rules when a person dies this way and the police have to take him first. We cannot let you in. I’m so sorry.” You do not ever say “the body.” It is not a body. It is her son. You want to tell her that you know that he was hers. But she knows that and she does not need for you to tell her. Instead you tell her you will give her time and come back in case she has questions. More questions, or questions for the first time. If she has no questions you do not give her the answers to the questions she has not asked.
When you leave the room, do not yell at the medical student who has a question. When you get home, do not yell at your husband. If he left his socks on the floor again today, it is all right.