Author contribution pending

Placeholder stub — to be written by a practicing hem/onc attending.

Suggested outline

1. The first-visit contract

   • What every new patient needs to hear before you leave the room
   • How to set expectations for treatment timelines, communication, and access
   • The three questions to ask every new patient

2. Breaking bad news

   • SPIKES vs. a physician-driven variant — what works when
   • How to write the note that gives you room in the next visit
   • When to bring a nurse navigator or palliative colleague in from the start

3. Family meetings

   • Who runs it, who sits where, what stays out
   • The pre-meeting huddle with the family
   • Managing family members who disagree

4. Goals-of-care conversations

   • When to have them (earlier than you think)
   • How to structure across two visits when the patient isn't ready
   • Documenting the direction without foreclosing it

5. The patient who wants everything

   • Recognizing the request behind the request
   • How to hear "do everything" without letting it drive futile care
   • Coordinating with the palliative team without abandoning the patient

6. The patient who wants nothing

   • Distinguishing informed decision from depression or denial
   • When to slow down, when to respect the choice
   • Family dynamics in this specific case

7. The follow-up that goes sideways

   • Anger, unmet expectations, the recovery visit
   • When to loop in your department chair or risk management
   • The apology that repairs vs the apology that inflames