From January 2010
I am a cancer survivor. I was diagnosed with terminal non-secretory Multiple Myeloma and told I had six months to live without effective treatment. After months of chemotherapy failed to produce any effect, I was referred for stem cell transplant as a last ditch effort. It turned out that I was not a candidate for this procedure for a variety of reasons. Since chemotherapy was not producing any noticeable effect and the side effects were excruciating and debilitating, further therapy was abandoned. Exhausted and weak, sick and disoriented, I was told I might make the Christmas holidays if I was very lucky. It was July and I went home to die.
I gave away most everything I owned, collected all debt and asset information and filed it with the logins and passwords for all of my various accounts for easy Executor access, and bid my friends and family goodbye. The next few months found me in dire physical condition, but holding my own. By the time my prognosis came up for expiration I was feeling better. A few months with no chemotherapy had drastically reduced the Peripheral Neuropathy that plagued my feet and hands, and was slowly relieving the feeling of exhaustion. Six months after I was supposed to have been dead I was alive and well. That’s not to say I stopped suffering the pain and symptoms of the cancer, they have continued and slowly escalate as time passes. But unlike I did when hearing my prognosis whilst suffering the side effects of chemotherapy, I no longer felt like I was going to die.
This has had the unexpected effect of rendering my life anticlimactic. All of my things were gone and all of my friends had become accustomed to a social life without me, not that my mobility permits a lot of recreation these days anyway. The effect has been to place me in a Limbo where attempts to have some kind of life are thwarted and my demise. With the first prognosis now more than two years past, my existence has taken a tasteless flavor and its colors become different shades of gray.
The art of prognosis is not supposed to determine the expiration date of patients. Instead, it grants a rule of thumb for the type of attack an oncologist might use to form a strategy to overcome a cancer. It is true that statistical numbers may be applied that display how many onset cases and how many patients perished in the different categories of those strategies. It is tempting to see them as predictors but they are not. So those physicians who try to “be straight” with their patients may end up doing irreparable damage to a life already wrecked by illness. My oncologists were trying to be helpful and had the best intentions in telling me what they did. But better they’d have suggested that I engage in preparing for the best as well as preparing for the worst because people are not statistical guesses.
My prognosis readied me for my death, and when death didn’t come I found myself totally unprepared for life.
There are times when a prognosis being used as a gauge of lifespan is appropriate. Certain human illnesses are so voracious and tenacious that their course is certain regardless the victim, and it’s good to know when to have your affairs in order. But a survivability quotient is not a survivability predictor in any case; every physician has stories of amazing last minute rallies that brought the patient back, just as they do stories of those who perished much more quickly than expected. So it is much better for physicians to prepare their patients for the full range of survival contingencies than inadvertently sentencing their patient to death row.