Family Meeting Rules

1. Turn your cell phone ringer off, or at least set it to vibrate.  Or just answer on the first ring.  If you speak softly, no one will notice.

2. Set the tone right away, by repeatedly looking at your watch and acting like you have somewhere else to be.  Talk fast.  Keep things moving.

3. Always book a room that's already occupied with something either remarkably frivolous or extremely sad.  "Oh, yes, we'll start the family meeting about end-of-life care for your mother just as soon as these residents finish up their planning meeting for next week's costume party.  The intern about to talk to you about DNR status will be dressing like a sexy cat."

4. Please don't make eye contact.  Someone might think you're listening.

5. Make sure at least three people are on speakerphone.  Doesn't matter who they are.  Makes everything a lot clearer.

6. Do not call the patient by the correct name, ever.  The less you seem like you know, the fewer questions anyone will ask.

7. Never reveal your name and title.  "I'm one of the people on the team" is as specific as you should ever be about your role in the patient's care.

8. Small talk always makes a grieving family feel better, so be sure to interrupt their crying with questions about the weather.

9. Just like with fortune cookies, medical news is always more fun to deliver if you add the words "in bed" to the end of every sentence.  Usually it's accurate, too!  "He's having trouble sitting up... in bed.  We took his blood... in bed.  He's doing as much physical therapy as the hospital is able to provide... in bed."

10. Use medical jargon whenever possible.  "His creatinine is elevated," repeated over and over again is much more effective than just saying he's in kidney failure.

11. Contradict the other doctors.  You always want to seem like you're discussing the patient for the first time, now, in front of his family, and that none of you agree on the same plan.

12. Use words like "death" and "dying," whether or not they apply to this particular patient at this particular point in time.  After all, everyone will die eventually.

13. "How quickly will he be ready for discharge?  That depends on how much you're looking to donate to the hospital.  Cash only."

14. Doctors are too important for follow-up.  "A medication list?  That's the social worker's job.  Checking his labs again... uh, let's say that's also the social worker's job.  She'll also be performing CPR if his heart stops."

15. End abruptly, and without warning.  In the middle of a question, if possible.  Run out of the room.  Hide in a closet.  Never be seen again.  Feign ignorance that this meeting ever happened, and accuse anyone who insists otherwise of being crazy, especially the patient himself.  "We talked about you?  Nope, no one ever talked about you.  You're hearing things.  More Haldol, stat!"

Follow these rules and your family meeting will go, uh, about as well as most of them do.