Prognoses are more of an art than a science.
Deborah, a trim 55-year-old female, was hiking with her husband when the coughing started.
She brushed it off, but as the cough became more severe, she had it checked out. The exam turned up more questions, so her doctor scheduled more scans. Soon she had an answer: Stage 4 Lung Cancer.
Deborah recalls that visit to the oncologist as a “wall of words — a half-listened-to recitation of treatment techniques, additional tests, second opinions and alternative perspectives.” What she didn’t remember hearing was a prognosis — how the disease would most likely progress and how much time she had left.
On the drive home, Deb turned to her husband and said: “I do not want to read, hear or know the time of my prognosis.”
When faced with a serious illness, making decisions about the flow of information is one of the most life affirming things you can do. It’s a way to declare: Hey, I am ALIVE, and it’s still my right to choose what’s best for me. Deb didn’t want to tick off each day on some dark timeline. For the next five years, she organized family trips and events. She lived three years longer than the prognosis she never knew.
Prognoses are based on the average experiences and life spans of patients who came before you. Any physician will tell you that coming up with one is more of an art than a science. And, doctors are often wrong. Studies have shown that physicians are particularly prone to overestimating life expectancy – especially when they like their patient.
Choosing not to know some of the details of your condition is a choice that until recently we were never given. Until the 1980’s, “Doctor knows Best” was the medical model and relieved physicians of any obligation to share a prognosis – or even a diagnosis with patients. Many people died without even knowing what killed them.
At the end of the day, or a life, we often don’t get to know everything before we have to make a choice. Sometimes knowing more may serve us less. Sometimes it’s better not to know.