How to Answer Mr. Herren’s Questions:
Dr. Lang has asked you to respond to Mr. Herren’s questions about his son’s condition. Research the questions as appropriate so you can provide answers that are based in science and easy to understand. You will rehearse your responses with Dr. Lang.

1. Review Dr. Lang’s email. It may be helpful to print the email and highlight the important points.


2. Listen to the voicemail from Mr. Herren to get a better understanding of his questions about his son’s condition.


3. Write down Mr. Herren’s questions.
   


• Listen to Mr. Herren’s voice message and write down the questions he has asked.


• Listen to the voice message again to confirm that you’ve understood exactly what Mr. Herren is asking. You can refer back to the voice message as necessary, but it may be helpful to use your written notes moving forward.
  


4. Research the issues surrounding Mr. Herren’s questions.
   


• Use the Resources available to help you understand the scientific explanations of Nick Herren’s condition and arrive at thorough answers that are easy to comprehend. In addition to the sources provided, you may choose to do further research on your own.
  


1. Take notes as you use the Resources. There is a lot of information to digest as you prepare to answer the questions, so it may be helpful to take notes.


2. Refer to the Skill Tutorial on Note Taking for guidance (in the left menu). Once you think you have gathered enough information, organize your notes in a structured way to help you draft your response.


5. Prepare your oral response to Mr. Herren’s questions. Use the notes you took from the voicemail to remind yourself what questions need to be addressed in your response. It is your responsibility to ensure that Mr. Herren has a clear understanding of his son’s condition, so be as detailed as you can while remaining sensitive to the emotional impact of the situation.
   


1. Review the advice in Dr. Lang’s email.
   


2. Outline your responses to Mr. Herren’s questions and any follow-up questions that you anticipate. You will use the outline to help you rehearse your oral response.
   


• Ground your responses in science. Assisting a family that is trying to cope with the consequences of severe trauma is not easy.
  It is helpful to provide scientific evidence on which families can base decisions related to their loved one’s care. It is essential that families develop a sound understanding of the underlying science so they can comprehend the advice they receive and make educated decisions.


• Refer to the Resources on Communicating with Empathy and Clarity. While it is important to ground your responses in science, it is equally important that you communicate with the family in a way that is appropriate for the situation at hand.
  


6. Review your work.


• Did you answer all of Mr. Herren’s questions?


• Did you provide a thorough response to each question?


• Did you ground your answers in science and explain the science in a way that Mr. Herren will be able to understand?
  


• Did you balance the science with an appropriate level of empathy?
  


7. Practice your oral response.
   


• Meet with your teammates and take turns practicing your responses to Mr. Herren’s questions. Think critically about your responses.


• Take this opportunity to practice seriously. It is a chance for you to get comfortable with your responses, build confidence, and get feedback from your teammates before you meet with Mr. Herren.


• One person can play the role of Mr. Herren while another practices answering the questions. When playing Mr. Herren, try to anticipate the way he would respond to the information presented. Then respond in character with the kind of feedback that Mr. Herren would likely give, in a tone appropriate for the situation (“What did you say? I don’t understand all of the medical words you’re using.” Or alternatively, “Thanks for clarifying the difference between coma and vegetative state.” etc.)


• Make sure each member of the team has a turn answering all of Mr. Herren’s questions. Since you do not know which questions Mr. Herren will ask which team member, each teammate needs to be comfortable answering all of the questions.


8. Respond orally to Mr. Herren.

• Schedule an appointment for your team to meet with your mentor at a time when you will be well prepared.


• You will respond to Mr. Herren’s questions as a team. Your mentor will pose questions to each team member during the course of the conversation. So each member of the team should be prepared to answer any of the questions Mr. Herren raised in his voicemail as well as any potential follow-up questions.

When referring to a Wikipedia resource, note that while Wikipedia is a valuable resource, unlike some other websites anyone can contribute to or modify the site (whether they're knowledgeable about the topic or not). As a result, the site is subject to constant change by questionable sources. Be sure to cross-check information on Wikipedia with other reputable sites to ensure accuracy.

The Field of Forensic Pathology

Forensic pathology - An FAQ on forensic pathology, including the difference between a medical examiner and a coroner.

Consciousness and Unconsciousness

Life and Death FAQ – The differences between life and death from a biological perspective, different stages in the process of death, and what happens to different parts of the body during that process.

Persistent Vegetative State – Familiarize yourself with the topic before proceeding to the other resources for more in-depth research.

Coma – An overview from the Mayo Clinic covers signs and symptoms, causes, risk factors, when to seek medical advice, screening and diagnosis, complications, treatment, prevention, and coping skills. 

The Glasgow Coma Scale – How the Glasgow Coma Scale is used to assess a patient’s level of consciousness.

Human Consciousness – A summary of expert testimony before a Senate committee provides a biological perspective on human states of consciousness including coma, the vegetative state, and the minimally conscious state. 

Audio Assessing Awareness – A radio interview where two university professors discuss how a "persistent vegetative state" is different from a "minimally conscious state," and how neurologists diagnose the difference. (35 minutes)

Audio Defining a 'Persistent Vegetative State' – An interview with a professor of neurology about the medical definition of a "persistent vegetative state," how people are diagnosed and treated, and the state of research into this area. (5 minutes)

Post-coma Unresponsiveness (Vegetative State): A Clinical Framework for Diagnosis – Provides a comprehensive framework of considerations for diagnosis of vegetative state (also referred to as post-coma unresponsiveness) from the Australian National Health and Medical Research Council.

Organ Donation

Organ Donation Facts – Overview of the organ and tissue donation process.

Organ and Tissue Donation – A detailed resource, including interactive lessons about the organs that can be transplanted

Understanding Death Before Donation – Definitions of death - brain death, cardio-respiratory death, non-heart beating donation - and how each affects organ and tissue donation.

Communicating with Clarity and Empathy

Physician’s Guide to Effective Patient/Family Communication on End-of-Life Care (PDF) – A helpful list of “do’s and don’ts” related to communicating with the patient’s family.

Communication failure in the ICU – A case study with advice for physicians on effective communication with a critical patient’s family.

Sharing Bad News Pocket Primer – Recommendations and tips for sharing bad news about a patient and/or family. (Download the PDF at the bottom of the page.)

Good Bedside Manner - Tips on how to build rapport and communicate more effectively with patients and their families.

What is empathy?  - Explains the difference between sympathy and empathy.

Different Types of Body Language - - This site outlines the difference between various types of body language and how you might use each to communicate your message.

Ask the Experts

What are some things to keep in mind when talking to a family who may need to make some difficult end-of-life decisions about a loved one who is in critical health?