Ask permission.

Don’t assume you know what your patients wants to hear, and when. Ask permission before sharing information or advancing the conversation. My fellow and I met someone recently who had made enough tough decisions for one day. He didn’t want to talk about prognosis, or what a transition to comfort focus might look like.

It wasn’t “denial” or avoiding the issue, it was just fatigue. Ask permission before diving into another sensitive topic and check in. If your patient says “not right now,” then that’s perfectly fine. There are very few topics in medicine that must be discussed right then and there. Come back later, give your patient some space.

Show your patients how much you value their individual processing pace, and that you prioritize it over your own agenda. It’ll make the next conversation that much more effective.