In a New York Times SundayReview piece, Paul Kalanithi, MD, a chief resident in neurological surgery at Stanford, describes cancer prognoses from two perspectives, both his own. The 36-year-old doctor writes about reading scans to help colleagues decide if surgery is the right course of treatment for certain brain-cancer cases. He details the important and difficult job of facing patients who ask questions about their chance of survival. Kalanithi also reveals what he learned about the question and answer processes since he was diagnosed with cancer eight months ago, and how he's learned to live with conviction despite a prognosis of uncertainty.
From the piece:
For a few months, I'd suspected I had cancer. I had seen a lot of young patients with cancer. So I wasn't taken aback. In fact, there was a certain relief. The next steps were clear: Prepare to die. Cry. Tell my wife that she should remarry, and refinance the mortgage. Write overdue letters to dear friends. Yes, there were lots of things I had meant to do in life, but sometimes this happens: Nothing could be more obvious when your day's work includes treating head trauma and brain cancer.
But on my first visit with my oncologist, she mentioned my going back to work someday. Wasn't I a ghost? No. But then how long did I have? Silence.
The path forward would seem obvious, if only I knew how many months or years I had left. Tell me three months, I'd just spend time with family. Tell me just one year, I'd have a plan (write that book). Give me 10 years, I'd get back to treating diseases. The pedestrian truth that you live one day at a time didn't help: What was I supposed to do with that day? My oncologist would say only: "I can't tell you a time. You've got to find what matters most to you."
Previously: Both a doctor and a patient: Stanford physician talks about his hemophilia, A patient's journey with lung cancer, Big data = big finds: Clinical trial for deadly lung cancer launched by Stanford study, Red Sunshine: One doctor's journey surviving stage 3 breast cancer, Cancer survivor: The disease isn't a "one-off, one-shot deal" and When the journalist becomes the patient