Discussing a serious illness with a patient and family.

Learning of a serious illness is unique news. Nothing certain can be known about how it will affect the hearer's outlook on the future before a conception is established about the hearer's expectations and how he/she has understood the issue. For example, a person who has been expecting muscle tension to be an explanation for back pain but hearing that a cancer metastasis is the underlying cause, will inevitably be in shock. The healthcare system is not able to influence everything, but is usually given one possibility to make a good first impression when telling about a serious diagnosis. Various lists of issues to be taken into account have been devised to help this. They do not, however, replace effective interaction, which is a matter of skill but can also be practiced. It is possible to anticipate the reactions of the hearers, as long as they remember that feelings are feelings and facts are facts.