On January 31, the New York Times Well blog published my comment on an article written by Dr. Sekeres titled “A Doctor’s Struggle With Numbers”. My comment is actually an excerpt from my memoir, Pressing My Luck. In the comment, I recall an incident that took place in 1976 when I was a medical student at Hahnemann School of Medicine (now Drexel School of Medicine) in Philadelphia. It was my first lesson in estimating a patient’s mortality. I was assigned to take care of a cancer-stricken female patient who had been hospitalized for months. During my round, her husband asked me how long his wife had left to live. In my naiveté, I unhesitatingly answered that she had three to four days left. The man responded that I was the only “doctor” with the guts to provide a straightforward prediction. Just then, I realized I was in over my head. I immediately attempted to retract my comment under the pretense that I was medical student lacking experience. He didn’t care and actually praised my gumption as it allowed him to better prepare for her imminent death. His wife died a few days later as I had estimated.
Today I would not make such a bold prediction. I agree with Dr. Sekeres that the best approach is to provide a patient with a best estimate range and counsel them on maximizing the quality of their life. You can read my comment on the original blog post HERE.