Verbal Therapy

Steve Versus Dying
4 min readDec 21, 2020


How advice from an ophthalmologist can help you deliver bad news.

Photo by Carl Cheng. Unsplash

Create hope, not fear.

The ophthalmologist said it casually. Like he was telling me I had a chunk of kale stuck in my teeth. “Something is going on with that nerve back there. I want to have you back in a month from now for a test to see if it’s glaucoma.” WHAT?

I’ve had this autoimmune thing going on with my eye for over 10 years now. It gets inflamed and sore. We’ve treated it with drops and, up til now, all I was told was that it was a treatable condition. To casually throw glaucoma in a sentence kind of rocked me a little bit.

This ophthalmologist was busy. And I know that people who have to give bad news as part of their profession often develop a bit of a tough exterior. It’s a self-preservation thing. I’ve done this myself. Plus, most doctors receive little or no training in communication skills during their residency. His words left me a little anxious though. Just a pile of crap with no instruction on how to clean it up.

I didn’t get a lot of information from my specialist so I decided to do some research myself.

I found out a lot about my condition but I also discovered an interesting practice from another optometry clinician, Reay H. Brown, MD, Atlanta. He’s developed a more helpful way to deliver challenging news. There’s healing power in the words we use.

Hard conversations: It’s not just people in healthcare. Everyone has to give bad news to someone we care about.

Telling friends and family that a loved one is sick or dying. Letting a friend know that their partner is unfaithful. Giving a termination notice to someone you supervise. If you have people in your life you care about, part of what makes that relationship meaningful is breaking difficult news.

There’s not a lot of training for this in our cultural or educational institutions. Unless you’re a grief counsellor most of us have to improvise.

Dr. Brown’s Verbal Therapy.

Although most of us don’t think about it a lot of the time, what we say to our patients – and how we say it – has a huge impact on whether our patients become hopeful, or fearful and depressed. Here, I’d like to offer some suggestions for using “verbal therapy” to keep your glaucoma patients positive and hopeful, as well as happy with your efforts on their behalf.

Don’t hide behind the data.

The facts are important. But sometimes people hide behind the data and the research because they’re too uncomfortable to speak to people’s emotional needs. Probe. Do they have any fears about the news you just delivered?

What you say and how you say it is part of the therapy.

What people remember is how you made them feel. Does the person have a solid grasp of the situation? Are they hopeful that there’s a path moving forward?

Have positive examples.

Is the person thriving in other areas of their life? Do you have examples of people who have beat the same condition? Found a new job? Learned to live with a loss?

Always stay on their side

People react to bad news differently. Some get angry. Others are in denial or get depressed. It’s easy to get defensive if the person starts to lash out. Don’t take it personally. Stay supportive.

Show your work

Review everything you’ve done to support the person to this point. And emphasize your continued support in the future. Are there any other experts or support agencies that can help?


People always have options. If you can’t change the situation you can change the way you think about the situation. Is this a dire condition or is it a challenge? You survived 100% of every other challenge you’ve had to reach this point in your life.

There’s overwhelming clinical research that supports how a positive mindset can help people overcome physical and mental challenges.

What is clear, however, is that there is definitely a strong link between “positivity” and health. Additional studies have found that a positive attitude improves outcomes and life satisfaction across a spectrum of conditions – including traumatic brain injury, stroke and brain tumors. Hopkins Medicine

“While most medical and public health efforts today focus on reducing risk factors for diseases, evidence has been mounting that enhancing psychological resilience may also make a difference,” said Eric Kim, research fellow in the Department of Social and Behavioral Sciences and co-lead author of the study. “Our new findings suggest that we should make efforts to boost optimism, which has been shown to be associated with healthier behaviors and healthier ways of coping with life challenges.” Harvard-Eric Kim

If your communication with people leaves them with hope, even if you’re delivering bad news, you can help them on the path to recovery.



Steve Versus Dying

Dad, husband, first responder, personal trainer, nutrition coach, resilience coach, animal lover. Will tolerate select humans individually or in small groups.