Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Clinging to Hope


A patient’s family wasn’t ready to accept that their loved one wouldn’t recover. From the encounter, I learned that sometimes it may be appropriate to delay such conversations for a little while. 

As a visiting medical student at Johns Hopkins from India, I had the opportunity to shadow many inspiring residents and fellows. One encounter stands out in my mind, which was a family meeting led by a palliative medicine physician.  


I was invited by the palliative care physician to be present for a family discussion on the prognosis and the goals of treatment for their loved one. Deep down, the family knew that recovery wasn’t possible, but they weren’t quite ready to acknowledge or accept it. The palliative care doctor sensed this. As the conversation progressed, the physician also realized that the family didn’t want to know any more information about their loved one’s prognosis. The doctor accepted this and met the family where they were at by simply listening. 


Exercising judicious discretion in the dissemination of diagnostic or prognostic information to loved ones requires a discerning approach; heeding the preference and readiness of disclosure is paramount. In this instance, it was clear that the family was still clinging to the hope that their loved one would recover.  


For the rest of the conversation, the physician simply listened quietly. The doctor would wait until the family was ready to have further discussions about end-of-life decisions another time. From this physician, I learned the importance of listening with empathetic ears, as well that sometimes the right thing to do is respect and accept a family’s need to cling to hope. 







This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.