So what would you have done then Mr Shute??

Well, you'll have read Julie's account of what was the most horrendous day of our lives. I truly, truly would not wish this on anyone. Julie's perspective mirrors mine precisely.

I wanted to add this bit though. We're grateful beyond belief to all of the teams that have given Julie and myself extra time together but I want to share my thoughts on the patient's and their partner's view of how news is broken to them. To clinicians and nursing staff reading this I fully appreciate you have to do this day in day out and without the emotional involvement with your patients, but there has to be a better way than how Julie was informed indirectly and whilst alone and over the phone that she had cancer, I just ask you to consider if there is a better way....

So our circumstances were this. At the original consultation one of the options Julie's surgeon gave us was to remove part of the tumour whilst she was under anaesthetic and have the biopsy results confirmed during the operation before proceeding.

I know from past experience too as I sadly lost my father to Brain Tumours/Cancer many years ago that on the day of surgery his team confirmed his tumours were malignant so, despite being informed Julie would have her surgery and we would be called in a week after for the biopsy results, the reality is they could have been relayed on the day of the surgery. I fully understand why it is better not to in some instances, It is better that a patient spends their time recovering and getting back to good health rather than being distracted and further upset by the devastating news to come.

We were told Julie would have a review a week after her op and at that point the team would inform us of the biopsy results. That is fairly reasonable and had that happened I would not be writing this now.

The reality is Julie received a call the day before the aforementioned biopsy result meeting. Julie explained the conversation as in one of the specialist nurse team at Walton had called to inform Julie that an appointment had been made for the day after (So Thursday) with the Clatterbridge Team. Clatterbridge is our local (and most excellent Cancer Centre) Julie explained how she felt when it hit her after she'd put the phone down. There was no other conclusion resulting from this call other than she had cancer..... Julie had her best friend June in the house but what if she had been alone? What if she was elderly, what if she was bordering on suicidal? Thankfully she was none of those things So was this truly the best way to deliver this news? No compassion, no explanation, no checking Julie understood the consequences, no assurance? Truly this is poor communication in anyone's language! I'll explain more and then I'll offer an alternative - it's easy to be critical but it would be fair for medical staff to say "Well what would you have done then?"...

OK Julie called me at my office, I didn't take it in initially but when she explained "So I've got cancer then". My reaction was I needed to be with my wife but I was fuming as I packed my things away. How dare the message be delivered in this way. So I called the hospital and spoke to the specialist nurse politely and ran through the scenario as it happened, the upshot was she accepted this wasn't the best way for this to have occurred and had a degree of empathy for us. I told her I'd raise it with Julie's Surgeon in the meeting to get the biopsy results.

So Wednesday came and we arrived in Walton Outpatients department, we waited for ages. When we got into the meeting, two nurses and one of Mr Farah's registrar surgeons who apparently had been in theatre too introduced himself. Before he started I thanked him for giving us his time and I informed him I wanted to express my disappointment at the way Julie had been 'delivered bad news the previous day'. This is one of the few times during Julie's illness and treatment that I've clashed with anyone. The justification was "Well once we knew it was malignant we had to move fast" and he was not moving from that perspective. I told him I understood and was grateful they had moved so fast but I still felt (and to this day)this was handled appallingly. There had to be a better way, there is in my view at least one better way!

Before I go on to 'the better way' Its hard for me to deliver this critique especially to a team that saved my wife's life and has given me and our families added time with Julie, time to be honest we did not expect. I'm not whining for the sake of it, I truly believe patients & their families deserve better than this, Hospital Staff and the Senior Management maybe even Government Ministers in fact anyone who has never been on the end of this devastating news needs to give serious consideration to how patients are told 'bad news'. I'd add the manner in which the same Doctor/Surgeon broke the absolutely heart breaking news to us (that Julie's form of cancer was incurable/Terminal) was done with such amazing compassion so this wasn't a Doctor personality thing it is a 'System Thing'...

I can imagine the scenario in advance of all of this, a team meeting going through patients cases and Julie's case comes up, this lady has Grade IV GBM, we need to contact Clatterbridge and arrange an appointment for her ASAP, she'll be needing Chemo & Radiotherapy.. One of the specialist nurse team agrees to make the appointment and relays that to the patient......... Sounds simple, it is but it does not consider how the patient will take this news or their circumstances, health, age, are they alone or with a carer/partner.

"So, what would you have done then Mr Shute?" a hypothetical question for I've never been asked but here goes.

How about this: On admittance to the ward, pre surgery as was the case the surgeon or one of his registrars and or one of the accompanying nurses visit the patient they explain about the procedure and recovery process and adds at the end of it "If all goes to plan we expect to discharge you in four to five days, at that point we will be arranging for you to come back in next week for your biopsy results. As a precaution and do not be alarmed by this we might also be making an appointment for you with the Clatterbridge Cancer Team for you, this does NOT mean you have Cancer it is precautionary and its standard procedure in cases like yours....."

I hear the arguments "We can't make appointments and then not use them" no one is asking you to, just forewarn patients it might happen...

Lord forbid it ever happens to anyone but I'm certain medical staff or not you would not want your partner, Husband, Wife, Mother or Father inadvertently delivered the news that they had cancer whilst on their own or over the phone....

I'd welcome feedback in the comments on this, we've got over 2,000 readers of the blog, to date I think two comments across the blog. I'd seriously welcome feedback on it. We want to help others on this road, I may be proceeding with blind arrogance of me thinking I'm right and everyone else thinking 'what an idiot', please help me/us out here thanks so much.