No One Can Help You Decide
“You search your heart, your head, and wait for the right course to make itself known to you. Or you simply flip a coin, roll the dice, pick your metaphor. No one else can really help you decide.”
The following essay is from the NPR My Cancer weekly podcast:
I trust my doctors. I think they are doing everything they can for me. But one of the most shocking things in this whole process was the first time I heard the doctors say, "We don't know." How could that be? I always thought the doctors would know exactly what to do. But they don't.
That's not a criticism. It's just that, in the world of cancer, no one can know ahead of time how you will react to a given drug or treatment. They have studies, they have averages, but none of those things help when it comes down to one individual — when it comes down to me.
They lay out the options, give their recommendations and then ask, "So what do you want to do?" How can you make that decision? There is a relatively new drug that shows real promise in fighting colon cancer. But some studies seem to show that it can cause bleeding in the brain in people who had brain tumors before. Like me. You don't need to know much about medicine to know that bleeding in the brain is a bad thing.
This coming Friday, I'm going to have another brain scan. If it's clean, then my doctors are suggesting that I consider that drug. They think that the chance of bleeding would be minimal. That's the easy part. Here's the hard part. Bleeding in the brain essentially means stroke. That's pretty scary. A stroke on top of cancer would be more than anyone could probably take.
So how do I decide? How do you weigh the risks of shrinking the tumors versus a stroke? In the end — after all the words, the studies, the graphs — you're left alone with a decision to make.
A lot of you wrote in to my blog last week when I found out that my cancer had spread. The notes were all wonderful. I had written that I had to decide between two different types of chemotherapy, each with its own unpleasant side effects. Again, it's sort of unclear whether either will be all that effective, you really don't know until you try.
But all of you were unanimous on one thing. Just make the best decision you can, and then move forward and don't look back. Don't agonize over the decision once you make it. No second-guessing.
I've always been a pretty decisive person. When I was running Nightline, I would try to make decisions right away. Part of the reason was that there was always another decision that had to be made after that, and another one after that one. But those were decisions about journalism, which I do know something about.
These cancer decisions are different. You search your heart and your head, and wait for the right course to make itself known to you. Or you simply flip a coin, roll the dice, pick your metaphor. No one else can really help you decide. And yes, some of these can be life and death decisions.
At least on this one, I have about another week to think about it. But a stroke? I'm willing to gamble, but that's about as high stakes a game as you'll ever find.
7:11 AM ET | 08- 7-2006 | permalink

