Who is Terminally Ill?

The media is abuzz, describing Elizabeth Edwards' medical condition as terminal. We've all known she has metastatic breast cancer. Why are they now calling her condition "terminal"?

Healthy Survivors benefit when they know exactly what words like "terminal" mean in specific settings. This knowledge innoculates them against the dangers of sensationalist stories about celebrities, a topic I discuss in Only 10 Seconds to Care and in the column, "Star Power."

On my April 24th post, I discussed the complexities of the term "cure" and how Healthy Survivors benefit by distinguishing its meaning in medical, social and political settings.

So, too, it helps to know that in medical contexts "terminal" denotes an active and progressive disease that is expected to result in the person's death (because no treatments are known that could cure or control the life-threatening process). A second meaning quantifies a time frame: That death is expected to occur in less than six months.

I have the impression that in social situations "terminal" means "the end of a section or series" (known colloquially as "the end of the line").  In other words, in social settings "terminal" connotes actively dying, if not imminent death. Journalists who use the adjective "terminal" to sell more papers and magazines do it at the expense of patients who don't know the medical definition.

Healthy Survivors recognize whenever a medical term is being used in non-medical settings to talk about a medical condition. As always, knowledge is power.

Comments

[lori hope]

Wendy, I watched Ms. Edwards on Larry King last night and was appalled at his insensitive questions and remarks. I Tweeted about it - great use of that technology. Though the audience isn't huge, it was a tremendous outlet for me!;-)
Thank you for bringing this up - I may blog about it too if I can find a few minutes today.
And again my thanks for all you do!
Always hope,
Lori

[Pat Foote]

Wendy, what is going on with doctors now telling patients they have so many months to live?!! Two patients I know were told by their doctors that they had less than a year. I was told 28 years ago that I had an 18% chance to live 10 months, but later I was told that I was "the statistic" and it gave me hope.

[Wendy S. Harpham, M.D.]

Good question. I will address in a post this week, after the graduation fesitivies are over.
Thanks for your patience.
With hope, Wendy

[Doug]

"Life itself represents a nonequilibrium condition" - J.F. Pankow

Consider for a moment what life is - it's a temporary thing. Pankow is discussing this in the context of thermodynamics - our bodies are made up of carbon compounds that are unstable in an oxygen atmosphere and will, without the assistance of our bodies, degrade.

Another way to look at this is that life itself is 100% fatal. Thus, we are all terminally ill! Rather depressing but hard to argue with. The obvious question then, would seem to be how long do we have?

Instead of fretting about how long I have, whether I will relapse, etc, I instead embrace the concept so elegantly stated by Viktor Frankl and say that it does not matter how long we have, but what we do with that time.

For me, cancer and survivorship became easier when I accepted that I am not totally in control of how long I have to live. I am in control of how I choose to go about living. I choose to make good decisions about trying to continue living (wearing my seat belt and driving in a sane manner, keeping up with my oncologist, etc) but also to make the most of my life.

[Wendy S. Harpham, M.D.]

Dear Doug,

Thank you for this eloquent comment. A key theme of my books is that triumph after cancer is not measured by how -- not how long -- you live.

I've heard many poetic variations on this theme over the years, such as "It's not how many breaths you took that count, but how many moments took your breath away." (or something like that)

With hope, Wendy

[Brenda casey]

I attended Wendy's book signing for "Only 10 Seconds to Care" last week. I was so impressed with the audience and how each and every one of the attendees had entered Wendy's life and been a part of her journey: many physicians that she has consulted over the years, nurses, physician assistants, friends, family and other survivor's.

I felt such a sense of pride to be in that honored group that has been fortunate enough to be in Wendy's life. I saw her 2 beautiful grownup daughters and Ted. I am lucky, I was her first chemo nurse and have been her friend for almost 20 years!
Brenda

[Wendy S. Harpham, M.D.]

Dear Brenda,

Thank you for this. It was emotional for me, too -- pure joy. I was able to give voice to my heart, sharing how much your care has meant to me and Ted all these years later.

With gratitude and hope, Wendy