The Four Rules.

Occurring during my third and final year of internal medicine residency, this tough case remains one of the most memorable in my nearly 20 years as a physician. After I wrote this essay for an issue on end-of-life care for my local hospital's magazine, it disappeared, only to resurface in my inbox over 15 years later. With a timeless message that is more relevant than ever, I am proud to share this essay with a larger audience, as it provides a template for clarity, honesty, and empathy when delivering bad news, and a powerful reminder to simply show up and be present when it matters the most.