In the article by Wenrich et al1 about communicating with dying patients, the authors discuss reasons why physicians might find such communications difficult. An additional reason is that of physicians' fear of patient and/or family anger directed at them (whether that anger is due to actual or perceived physician failing, or due to displaced feelings such as guilt). It is also important, when interpreting patient reports of inadequate physician communication, to acknowledge that patients sometimes simply do not hear what they are told. These 2 points are not intended to be excuses—it is a physician's responsibility to attempt to overcome communication barriers—but rather to point out relevant factors not discussed in the article.