thinkingtentotwentyyears.Youhearthattimeandtime
again. And I’d be the same way if I were in their shoes.”
You’dthinkdoctorswouldbewellequippedtonavigate
theshoalshere,butatleasttwothingsgetintheway.
First,ourownviewsmaybeunrealistic.Astudyledby
thesociologistNicholasChristakisaskedthedoctorsof
almost five hundred terminally ill patients to estimate
howlong theythoughttheirpatientwouldsurvive and
thenfollowedthepatients.Sixty-threepercentofdoctors
overestimated their patient’s survival time. Just 17
percentunderestimatedit.Theaverageestimatewas 530
percenttoohigh.Andthebetter thedoctorsknewtheir
patients, the more likely they were to err.
Second, weoftenavoidvoicing eventhesesentiments.
Studies find that although doctors usuallytell patients
whenacancerisnotcurable,mostarereluctanttogivea
specific prognosis, even when pressed. More than 40
percentof oncologistsadmit toofferingtreatmentsthat
theybelieveareunlikelytowork.Inanerainwhichthe
relationship betweenpatient and doctor isincreasingly
miscast in retail terms—“the customer is always
right”—doctors are especiallyhesitant to trampleon a
patient’sexpectations.Youworryfarmoreaboutbeing
overly pessimistic than you do about being overly
optimistic. And talking about dying is enormously
fraught.WhenyouhaveapatientlikeSaraMonopoli,the
last thingyou want to do is grapple with the truth.I
know, becauseMarcoux wasn’t the only one avoiding
that conversation with her. I was, too.
Earlierthat summer,a PET scan had revealedthat, in
additiontoherlungcancer,shehadthyroidcancer,which