• What Are My Chances?

    Brad Flansbaum tipped me off to this first person account of a Cancer researcher (Peter Bach) writing about his wife’s diagnosis with Breast Cancer. I will be following this story (in NY Times Well blog under ‘The Doctor’s Wife’). Christian Sinclair has an interesting post focusing on how much patients and families want to know about prognosis after a Cancer diagnosis.  There is a vivid moment in the March 21, 2011 post in which an esteemed Cancer researcher says to another (Peter Bach, the writer, husband) about the chance for a relapse of his wife’s Cancer:

    All of this progress meant that the chance that Ruth’s breast cancer would come back was a lot lower than it might have been years ago. But what was that chance, anyway? It was the obvious question, and we put it to her oncologist at our first appointment with him. He paused and then offered a peculiar answer. He said we should realize that it didn’t matter. It would either happen or it wouldn’t.

    Sinclair notes that a patient asking about chances and prognosis is not only an opportunity to provide a number:

    It (patients asking this question) seems like a free pass to begin opening a general conversation about what to expect and how best to prepare, but many doctors still miss this opening as the doctor in the story did.

    As Sinclair notes, the comment section has many interesting responses to this physician’s response to the question, “What are my chances?”

    • That strikes me as extremely unsettling… even offensive. A doctor has two roles in a situation like this– to do everything he can to save my life, and to keep me informed about those efforts. The doctor in this story refuses to do the latter, and in so doing, heavily implies that he won’t do the former. If my doctor is telling me that information doesn’t really matter, and I’m either gonna die or I won’t, then why the hell am I wasting my time talking to him?

      • I’m with you to the extent his answer begged more information about the prognosis. However, he is also opening up the opportunity for the patient to think more about how she will spend what time she has left…Something we all would do well to ponder on a regular basis. There is always much to live for, or not!