Countdown to Death

My May 13th post, Who is Terminally Ill?, prompted Pat to ask, "Wendy, what is going on with doctors now telling patients they have so many months to live?!!"

Unfortunately this is nothing new. And it makes me more than a little crazy. 

Nobody on earth --  even the top expert in a specific disease --  cannot predict the future. The best any physician can do is offer a prognosis: an educated guess based on knowledge of similar past patients in similar circumstances. [If you've never read it, I hope you can find a few moments to read a popular essay by Stephen Jay Gould entitled, "The Median Isn't the Message."]

Physicians do patients a disservice by offering predictions. Hearing "You have x months to live" can lead people to feel and act hopeless, as if life has become a countdown to their death. 

Predictions can set up patients for disappointment, anger, and other negative feelings if, in fact, the prediction proves wrong (the patient dies more quickly or more slowly).

I've heard innumerable stories of patients who used a doctor's dire prediction to mobilize a fighting spirit: "I'll show that blankety-blank doctor who is going to die in six months!" These patients sought out additional medical opinions or entered clinical trials or simply did everything they could do to take good care of themselves. Some indeed survived beyond anyone's wildest expectations (some of these even living to ripe old ages). And some, sadly, still died "on schedule."

Healthy Survivors know that prognoses are not predictions. They are simply educated guesses based on statistics about past patients with similar problems. In my next post I'll discuss why any physician would say to a patient, "You have x number of months to live."

Comments

[Debby Bruck]

First off, only G-d knows the life story of any individual. He is in charge of life and death. He even created time, so he rules time.

When we make predictions, especially about the timing of events, it is a guestimate - and it make or may not come to pass. Of course, every one will die from their earthly body at some time. So we know that it will happen. "About" what time? That's another story.

We can learn a lesson from the old testament when during the plagues Moses said the death of the first born would occur "around" midnight. Not precisely at midnight. Why? Read this little blog post by Tim O'Hearn. http://www.minuteswithmessiah.com/minutes/roundmidnight.html

Debby Bruck

[Lisa Cunningham]

I heartily agree with you! My mother-in-law stubbornly refused to accept her guesstimate as a death sentence. She never stopped looking for ways to live. She lived six years after being diagnosed with stage three colon cancer. Never accept your death sentence.

Only God knows when we will die.

[Wendy S. Harpham, M.D.]

Dear Debby,
Thank you for the interesting post about by O'Hearn about "time."

Dear Lisa,
Yes, the examples of people outliving their physicians' predictions are legion. Thank you for sharing about your m-i-l.
Now I'll post about why physicians might offer predictions in the first place.

With hope, Wendy