Part of my role as a genetic counselor has been to explain test results to patients and their families. That means I’ve been the bearer of bad news on many occasions. Even though this part of the job is undoubtedly the most difficult, it hasn’t diminished my love of the profession.

It’s not all bad

I’ve spent most of my career getting to give good news. Most babies are healthy babies. Most cancer is not hereditary. Most test results are normal. I’ve jumped up and down with joy and choked back happy tears with patients. I have received thank you cards and baby pictures from happy clients.  

What I didn’t expect when I started this job, was the amount of appreciation I would get from the patients who did not get the news they wanted to hear. The ones who would not get to send that birth announcement. The ones who now fear that their children may have to face the same cancer they’re battling now. The ones who have every right to be angry at the world are often the ones that are the most grateful. What they needed in that moment was to have someone that would listen without judgement, explain options without pushing, and respect and facilitate their choices. Though we are not therapists, our training as counselors does prepare us for these moments. 

From pain to empowerment

What we might call “bad” news can sometimes be empowering. Finding a diagnosis can allow a person to take preventative measures, or have a better understanding of how to prepare for the future. It can also allow their family members to take steps to minimize their risks. Parents who thought that they did something to cause their child’s condition can sometimes let go of that guilt when a genetic explanation is found. To a family that has been searching for a diagnosis for a long time, just having an answer can be a relief. 

Coping with the job

As fulfilling as it may be to help someone through one of their darkest hours, it is still not easy. For me, having other GCs to connect with is key. No one else understands the job quite like GCs do. Trying to explain the background needed to understand a situation to a non-GC can be draining in itself. And then, they may have a hard time getting past the shock of the situation to be able to empathize. The stories from work are sometimes too much for my husband, so I need those understanding GC friends to vent to. I’ve also developed a dark sense of humor that only GCs appreciate.

Even with good friends to talk to, emotional burn-out can still happen. Identifying what self-care works for you is important. Sometimes a change in practice is beneficial. Prenatal, pediatric and adult clinics all have their own types of stressors which may or may not be well suited for an individual at that point of their life. There are also many settings a GC can work in that involve less or no patient contact, which tend to take less of an emotional toll. As our field expands, our options for finding the right fit get better.  

Breaking tough news to someone is never easy or enjoyable, but it is an important part of being a genetic counselor. We can’t take away a person’s pain, but the way we handle the situation has the potential to empower them and make a lasting impact.