Cold calling patients with bad news can be excruciating. At those times, instinct is all I can rely on | Ranjana Srivastava

Difficult news conveyed compassionately and sensitively doesn't alter the facts but does change the patient experience

Can I get your professional opinion?" my friend asks. In the 30 years since medical school, we have exchanged many opinions but a constant has been the curveball questions thrown up by patient care. Questions that don't have a clear answer that nonetheless test us.

A new patient from last week has unexpectedly returned a biopsy showing cancer. The man typically defers his appointments, citing an inflexible work schedule. His first visit was delayed by a month and he doesn't intend to return for the results any time soon. But suddenly, he doesn't have the luxury of time. To plan treatment, the tumour board will need specialised tests. The tests can hardly be ordered without the patient knowing why.