When Good News Falls Flat: Complications in the Delivery and Reception of Good News in Pediatric Neurology

This article considers interactional trouble that arises when the social distribution of knowledge and interpersonal relationships come together in the delivery and reception of good news in pediatric neurology visits for video-electroencephalography testing. Contrary to common perceptions of good news as easy to deliver and receive, I find that it is occasionally fraught with hesitancy in this context. Using conversation analysis, I explore what drives this trouble and argue that some of the difficulty associated with good news in this context arises from its structure: Physicians prioritize conveying “the facts” of the news over characterizing its valence. However, parents treat physicians’ assessments of the news as critical for the news delivery. When physicians fail to evaluate the information they present, parents tend to treat news deliveries as incomplete, which not only causes difficulties in their reception of the news but also leads to protracted news deliveries.