How do you poke a bear? I will grant you that conventional wisdom advises against it, but let’s say you had to—maybe you are part of a global initiative to vaccinate pandas for parvo or something. If you really must poke a bear, you need a strategy, the right tools, and some preparation. Otherwise, you might end up looking like Leonardo DiCaprio 24 minutes into The Revenant. Literal bear-poking may not come up often in your veterinary practice, but plenty of other “delicate” situations do. Communicating bad news is one of our biggest professional challenges, especially as client expectations, the emotional importance of pets, and the interpersonal skills required for younger pet-owning demographics continue to change. Many veterinary professionals might prefer to inject a grizzly rather than have a conversation about a poor prognosis with a “tricky” client. However, bad news has to be delivered, and if we want to avoid getting metaphorically mauled, we need to be smart about how we do it. The advantage of working with people rather than bears is you can talk to them—most of the time. Our species has these modified breaths of air called words that we exhale at each other. It is pretty much how society works. Language probably evolved for cooperation, but it also has enormous potential to unsettle our individual emotions and can even be intentionally weaponized. Ultimately, professional animal healers need words to deliver important information. Doing it well aligns the veterinary team and the client into the best possible relationship, benefiting the animal patient. Poor communication leads to misunderstandings, emotional escalation, and, all too often, unnecessary patient suffering. We have all seen it—a client confronted with harsh reality reacting in a way that makes things worse for their pet. The good news is there are evidence-based techniques1 that improve these conversations, strengthen the veterinarian-client-patient relationship (VCPR), and help lead to better patient outcomes. Delivering bad news is like sticking a needle into a bear–it is a stimulus with the potential to trigger a violent reaction. When hearing bad news, a client’s brain may undergo a physiological shift—stress hormones flood their system, the amygdala seizes control, and suddenly an angry bear grabs the steering wheel. Rational thinking takes a backseat. Unless, of course, you are strategic. So, prepare Step one: Think about it. Jumping into an exam room with a grim diagnosis and no plan is like charging into a dark cave with an uncapped needle—you are unlikely to leave without some scratch marks. Before stepping through the door, ground yourself. Take a breath. Make sure you memorize key information: diagnosis, prognosis, and treatment options. These are your reality guardrails. If the conversation veers off track, they will keep you anchored. Setting up the den When wildlife officials in Washington needed to catch a campsite-plundering black bear in 2004, they lured it in with honey, donuts, and a couple of cans of local beer.2 You do not necessarily need to use cheap booze to get your point across, but a spoonful of emotional honey can make the hard news smoother. A couple of phrases that demonstrate partnership and empathy (“Let’s work together to come up with a plan,” “This has to be tough on you,” etc.) go a long way toward building the trust and collaboration that will turn your potentially pugnacious client into a relaxed (if not inebriated) partner. Make sure to pick a private, distraction-free room where you can make them feel safe and secure. A bear in a peaceful creek full of salmon (or cheap beer) is much less likely to tear into your tent. Interviewing the bear Remember, people are (slightly) more complicated than bears. They want to be treated as individuals. Whereas the question “Do you prefer ‘brown’ or ‘grizzly’?” may not get you far with Alaskan wildlife, taking a moment or two to elicit the client’s point of view goes a long way to establishing trust.3 Does your client’s cat have a custom catio and drink Evian? Or do they live in a barn? Context matters. If a client has mentioned financial concerns 17 times and transported their pet in a duct-taped box, tread carefully before suggesting a referral to a specialist. Even just straight-up asking them how they want to move forward can be an extraordinarily powerful way to collaborate. One, two, three … stab! Okay, fine. Enough with the fluff. At some point, this poke is going to have to happen. In this case, we want to make sure the bear is ready for it. Unfortunately, with information, you cannot tap the clients’ heads and smear their noses with squeezed cheese for distraction. However, there is a quick one-two-three system for popping in the painful news as painlessly as possible. Ask permission. Just ask them if you can tell them what you are about to tell them anyway. It seems unnecessary, but it works wonders. (“Can I go over your pet’s findings?”) Warning shot. One of the most important steps in delivering bad news is giving the client a heads-up. If you walk in and say, “So, anyway, Fluffy has cancer,” you are asking for trouble. Instead, start with something like: “I’m afraid I have some difficult news about Fluffy.” This allows clients to brace themselves emotionally. It does not lessen the impact of the news, but it prevents them from feeling blindsided. Chunk and check. The chunk is the bad information that you have been warming the client up for the whole time, and the check is to make sure it came across. The bear rolls up its sleeves, and the needle goes in. Explain things quickly and clearly (“The bloodwork shows Mr. Raisin’s kidneys have end-stage renal failure.”). Then check, pull the needle out, look at the bear (without appearing terrified), and ask, “Does that make sense?” This is nearly as foolproof as you can get for delivering bad news. Your job is not over yet, but at least the relevant information has been administered surgically. What is left is just a bit of a cleanup, and making sure the bear does not feel like it was just injected by something from a Walgreens parking lot. Sit with them Then, just sit there (you may feel stupid doing this, but I promise it works) and let go of any purposeful intent to do anything. Empathy is the hardest thing in the world to teach, so all I will say is this: If you want to help your patient, look at the person’s world you just rocked and stop trying to fix their bad feelings. Just be there with them, the same you would sit calmly and non-threateningly with a nervous animal. Good empathy sounds like: “I can see how much you love Bella, and I know this is incredibly difficult.” Bad empathy sounds like: “Yeah, that sucks. Anyway, here’s the bill.” Do not shut down grief. Do not amplify anger. Acknowledge sadness and any other emotion that comes up. Everything the client feels here is valid.4 This does not mean you have to agree with everything their panicked little amygdala is going to confabulate at this point–remember your reality guard rails–but just give them a moment to go through it. Be there, like a bad news lifeguard, in case they need help getting out of the deep end. When in doubt, imagine how you would want someone to talk to you in a vulnerable moment—and do that. The finish line Before you leave the bear alone to rub its sore shoulder, you want to make sure it understands why you just stabbed it. This is easy enough with a little summary–they came to you for answers, and you gave them the answers, which happened to be sucky answers in this case. If you just leave it at that, though, you will come across like a pessimistic Smokey the Bear, doubting even your ability to prevent forest fires. No–you need to give them some reason for optimism, which helps alleviate the situation. It does not have to solve anything, but a lot of the time, people just need to feel that they are trying something. Make sure you take one final moment to rephrase everything and invite any more questions. If you have been successful, the bear will amble off back to its bear cave for winter, poked and perturbed but pliant, ready to trust you the next time the need arises. Conclusion Delivering bad news is never easy, but with preparation, empathy, and clear communication, we can minimize suffering—both for our patients and those who love them. Because, at the end of the day, we are not just veterinarians, we are guides in some of the most emotionally fraught moments of people’s lives. If we do it right, we will not just avoid getting mauled, we will help our clients make the best possible choices for their beloved companions. So, go ahead, poke the bear! Greg Bishop, DVM, is a small animal veterinarian and a part-time veterinary technology instructor in Portland, Ore. Dr. Bishop also creates the monthly cartoon series “The Lighter Side.” The author’s opinions do not necessarily reflect those of Veterinary Practice News. References Shaw JR, Coe JB. Developing Communication Skills for Veterinary Practice. John Wiley & Sons; 2024 Mar 26. https://www.latimes.com/archives/la-xpm-2004-aug-20-na-drunkbear20-story.html Shaw JR, Lagoni L. End-of-life communication in veterinary medicine: delivering bad news and euthanasia decision making. Veterinary clinics: small animal practice. 2007 Jan 1;37(1):95-108. Cipolla M, Bonizzi L, Zecconi A. Factors affecting the client-veterinarian communication and breaking bad news in companion animal practice in Italy. Dog behavior. 2017 Sep 26;3(2):1-2.
