For Crying Out Loud

I hear you.
You're not a wet blanket.
I feel that drive to forget the odds often as well (from others, and from myself).
Also, you have a tendency to come across as painfully practical to the rest of the world (I happen to really like this characteristic of yours :). You're also frequently detached from issues in ways that some people might not be able to fathom (although, I can't comment on your detachment from cancer). Your doctor, in his or her experience, might only see people living happily if they completely deny the existence of cancer and the likelihood of death. You, obviously, need/want to incorporate reality into your hope and optimism and outlook on life in general.

Thanks for getting it . . . and me.

I can see your point of view and your doctor's. Believing is a powerful thing. So is reality. Choosing what you believe sometimes has its effect on reality.

I'm in sales, and as such I have become fully aware of the power of believing. In your reality it might be true that the chances of getting a stain on something might be small, but I, as your salesperson, must believe our fabric protection is going to be useful to you in order to make you believe and get the sale. The second I don't believe you need it, my chances of selling it to you is slim and your chance of believing is next to nothing. Sometimes I have to choose to believe even when reality makes me want to waiver.

It is important that your doctor believes in you, and believes in your ability to survive this. She is selling you on your success. You can buy into that fully (possibly consciously blinding yourself to certain realities), or you can just work towards that success and choose to wait and see the outcome. Perhaps you believe the outcome will be the same eitherway, but most all studies show that beliving has a powerful impact, why not take advantage of that?

Perhaps it's like prayer and meditation: when you finish you should take whatever decision you have made and act on it as if your prayer has been answered. Time will show the veracity of the answer.

I think your doctor just wants to make sure you don't lose track of your lottery ticket. As my junkmail says: "You may already be a winner"

Well, I am my mother's daughter. As Kristen put it "painfully practical" (just ask my husband, whom I've left multiple times saying "honey, we have the rest of our lives, it's only a few months. . . .")

I believe my mother already is a miracle. The fact that you're still with me makes me very, very happy. I am happy, in a slightly twisted way, that you have cancer as it smacked me in the face and made me work through ALOT of stuff emotionally. I'm glad I got forewarning and was able to work through this stuff with you ALIVE. Sometimes it is hard to remember that you may still be gone in a year or two, because you seem so damn healthy right now. But I too feel like I need to trust in God but tie my camel. And truth be told, if this has made me realize nothing else it is that everyone I know and love has an equal chance of dying before or after you. Yup, you might be dead in a year, but so might Daddy - from whatever. I guess what I'm saying is that cancer has brought death to my life. It has ended my immortality. I no longer think it is far away, evil and I am impervious. And I'm okay with that. I think that I am better ready to cope with death (not that I won't be devastated). It also gave me a wake up call - how long will my life be?

I guess to continue Valerie's analogy, I might buy the fabric protection, but I'll also buy something that's less likely to show a stain and a fabric that is more washable than delicate.

But man, do I pray everyday that you're the ONE. And that is fairly easy for me be believe because you already shouldn't be here. You already seem to be the one.

Hey, Maman.

Here are some things to consider:

1. Statistics concerning just about every health situation are gathered and analysed on a timescale which precludes them from taking into account current developments. So it may very well be true that 32 out of 33 patients diagnosed with pancreatic cancer in 1990 had died by 1995. That's a useful statistic but it needs to be taken in context - it's 15 year old medecine they were practicing.

2. Statistics about people suffer from a problem where errors arise from the distribution of the independent variables (this is called homoskedasticity, for anyone who's really, really interested). "So what?" you might ask. Well, here's what: if the distribution of smoking, drinking and age are not corrected for, then that statistic has less meaning to you. Since we don't know the underlying distribution once smoking, drinking, obesity and age are corrected, we can't make judgements about the applicability of the statistic to you. In other words, if the average age of people diagnosed with pancreatic cancer is 82, they only have a 10% chance of making it five years anyway, so the pancreatic cancer only makes a 7% difference in mortality rate - which doesn't seem so scary, does it? It is highly unlikely that there are other cancer patients who have smoked or drank less and many are probably overweight - because most Americans are. So your chances are better by some unknown amount, but I'd guesstimate them at around an additional 15%.

3. Every statistic has a distribution. In this case, the independent variable is time. The more time passes, the more of those 32 people perish - which increases the chances that the survivors are the ONE person who will make it. Even if it's still true that 32 out of 33 people diagnosed with pancreatic cancer will die within five years, the good news (for you, not them) is that now, a year since diagnosis, 28 of them are already dead, meaning that your chances are now 1 in 4 on that basis alone.

So that means that your chances are 25%, plus another say 15% because of the fact that you don't smoke or drink and are the right weight, plus another unknown factor based on the fact that in the 15 years since the statistics were compiled advances have been made in treatment.

I'd say that - being realistic, not optimistic - your chances of surviving pancreatic cancer for the next four years are actually more in the 50+% chance.

This is not to belittle how far you've come because, to be honest, in October of LAST year...well, let's just say I wouldn't have recommended people line up to lend you money.

But I am saying that, while some facts are unknown, what we do know doesn't match the 3% statistic anymore. An honest reassessment is more like a coin toss.

The fact that you're at a national cancer treatment facility improves your chances as does the fact that your scans are now clear. Keep going so that they can find any new complications as they occur.

Also, go and read Stephen Jay Gould's essay on statistics and cancer. His doctor told him the same thing ("Don't be so pessimistic!") about a cancer with a worse survival rate. And he lived for another sixteen years.

So, Steph. i'm sitting here chatting with your absolutely beeeeautiful daughter about our lovely and overwhelmingly amazing mothers who are both recovering from cancer. she's telling me, and i read your latest post on your blog, about the dislike of pessimise your doctor(s) have or are having in response to how you see your current situation. i chuckled a little. i thought, 'how silly'. go ahead, Steph ... think about the fact that this cancer could consume your physical life! but, thank God that you know--as spelled out in the Revelation of Baha'u'llah and in the sentiments expressed in Lord of the Rings by Gandalf to Merry the Hobbit--"Noooo, the journey doesn't end here". I mean how glorious to have this reality that your soul is eternal. I say, tell these 'specialist of how not to accept death' about what Baha'u'llah, the King of Glory and greatest Educator and Physician of all time has said about death and life after death. It's time to tell the people! come on Steph., shout it from the mountain top, or at least the examination table in the doctors office. Really, these guys/gals need to hear about it.

With that said, you still have time to CHANGE THE WORLD, which in your current surroundings and situation are these people who are truely yearning, though they don't know it, to hear about this Message.

I hope you laughed a little. I did. Anyway, I wish I could have had more of a chance to talk with you when you come to visit Mara about a year and a half ago. This world is small; I think I'll meet up with you again for a more indepth and meaningful conversation.

I think one reason the doctor thinks I might be pessimistic is that he doesn't know (or ask about) my opinion of death. I am not frightened of it, nor do I dread it. I am quite okay with it, as Amelia points out, because I don't see it as an end but a transition. And, you know, untold millions of people have done it before me. Some do it 'better' than others, just like life. And I just feel better staring reality in the face than to have the cognetive dissonance of 'believing' that I will survive something that is against all odds.

Nathan, thank you for breaking down the stats for me. I was aware of those factors, but really don't know enough about stats to be able to figure it out. Of course, if we 'correct' for all the factors, I wouldn't have pancreatic cancer at all. But to be fair, I was already aware that I was in better than the 3% range, more like the 18%. Beyond that, I don't know if correcting for other factors is true. And if you do that, you also have to correct, in the other direction, for the size of the tumor, the lymph node involvement, the other organs involved and the positive margins. Did I mention the incomplete chemo treatments? Okay, so let's not go there right now.

I wasn't trying to be morose, get anyone's pity or wallow. I think I was trying to process and assess my mental health. Am I crazy for thinking there is a good chance I could die from this? No. Am I am bad person or paranoid for thinking I could die from this? No. The doctor is wearing no clothes. He wants me to join him in his magical thinking. I think he thinks I am too fragile to handle the thought of impending death without getting depressed. Or he needs to deny reality so he can handle a caseload of patients who die at an alarming rate. Whatever; I have decided it is about him, not me.

And I will be thrilled to meet my grandchildren, see them off to kindergarden and dance at their weddings. When I have them. I am making long-range plans. Like November and May. I bought the progressive lens glasses. Daddy and I are talking about buying a new car, for me, not for him. So, I am planning on staying around for a while. I'm just aware that I might not.

I don't mean to be morose or bring any of you down. I am not depressed or have a death wish. But I do have to face reality squarely. It is how I best deal with it. And I don't even care if my doctor is on the same page or not. What will be, will be, in spite of either of us.

What kind of car?