“So what’s your prognosis?”
If I had a pound for every time someone asked that question, well, I could probably fund a feet-up, rub-down weekend at Champneys.
But I’m just going to say it – it royally p***** me off!
I made the choice not to ask for my oncologist’s prognosis as to my impending mortality. Why? Well, firstly I wasn’t hopeful that I would hear anything I really wanted to hear. Just a cursory google about lung cancer survival had shocked me enough to know that. On top of which there were other serious issues I was dealing with, so I wasn’t in a hurry to hear the news.
I was also conscious of how our own minds can lock, stock and barrel influence the well being of our physical selves. How our beliefs can impact our health both for the good and negatively. I was mindful of the possible consequences of self fulfilling prophecy. If I am told I only have until Christmas, I could potentially limit my opportunity to survive beyond that, because I have so completely surrendered my authority not just to the disease, but to the medical establishment? I read a famous account about a man who was diagnosed with liver cancer, he hoped to make it to spend one last Christmas with his loved ones which, happily he achieved, but sadly passed away soon after. An autopsy later showed that tests had shown a false positive reading for the progression of his disease. In fact, very little cancer was present in his body at all. The question is, was it his expectation of his own death that in fact killed him?
Making a prognosis is not easy. To my lay person’s mind it is at best an educated guess based on a cohort of statistics. In my case, the statistics for lung cancer are taken most recently from 2010, so they are out of date. They reflect an older population, as at that time this is where lung cancer was most commonly found. In lung cancer terms, I am considered quite young.( Yay, knew I’d find a positive if I persisted) So the median, may not be as applicable to my situation, as I am not someone who is 70 with a lifelong history of smoking. And statistics don’t factor in what else one is incorporating into one’s healing journey such as lifestyle changes addressing nutrition and exercise, addressing stress levels and depression, or taking supplements, alternative therapies and treatments, counselling etc and nurturng not just the physical and mental, but one’s spiritual life. Which research tells us, feeds into a person’s well being enormously, and therefore could potentially influence healing outcomes.
But back to prognoses – and just as everyone’s experience of cancer is unique to them , so is the decision to ask the doctor to prognosticate. I know that people want to understand what lies ahead for many reasons: practical matters have to be put in place, affairs put in order, maybe take that dream trip you’ve always put off, or what about those who want a prognosis in order to defy it, to exceed expectations, and to continue running right through the tape and beyond the finish line and into numerous triumphant laps of honour – gold medal hanging proud. For the doctors, having an idea of prognosis should enable them to establish the right options, and best care that is needed at every stage. Yes, they can get it wrong – they are human trying to do their best against a disease that has the skill to transform, hide, return, and persist and has outwitted the best brains for too many years.
So back to why I am royally p***** orf.
I think the question lacks sensitivity, compassion and understanding.
“What is your prognosis?” is akin to asking someone the question “how long do you have left to live? How long before you might die?”
It isn’t a casual question. It is profoundly personal, intimate and private.
Yeah, right. Not pleasant is it. At least, that’s what it feels like over here. I am quite convinced that you don’t mean offense. But it is deeply painful to hear. Please, please could you maybe be a bit more mindful if ever that question forms in your brain, and not let it escape your mouth. It might just be a passing question, or even a genuinely concerned question, but please think, engage your brain, and remember that there is someone who, despite looking absolutely bloody gorgeous on the outside is actually doing their damndest to keep on keepin on.
OK rant over. Keep well.
Oh, and I sincerely apologise if the cartoon offends. I find that sometimes black humour keeps the gremlins at bay.
Love always xx
Below is an article from the Guardian 2015 https://www.theguardian.com/lifeandstyle/2015/jun/02/doctors-predict-patient-die-prognosis-wrong
And for a less ranty evening do join me in London on Thursday January 18th.