Talking about the unthinkable: perinatal/neonatal communication issues and procedures.

Clinician-parent conversations in perinatology and neonatology are demanding. They take place over a period of time and ask much of the clinician. Many parents insist that they want thorough explanations so they can understand the medical information and its impact on them. These cases involve copious amounts of medical and resource information and parents cannot assimilate it all at one time; thus, these conversations are extended dialogs. Conversational skills that seem essential for clinicians in this work include giving bad news, sharing information, and expressing empathy. Underlying the conversational skills are those habits that form the complete physician: curiosity that leads one to learn the parents' values; the skill to help parents apply these values as they make difficult decisions; patience to listen to and stick with these suffering people who are full of strong emotions; and finally, the courage and endurance to confront these difficult situations day after day.