184 Being a Doctor After Being a Patient
To live purely in the moment, as if each day may be one’s last, may also
be infeasible for extended periods. ‘‘Living in the moment’’ all the time
may not be practical if one lives for many years. Planning for the future
confers benefits, especially financially. As Paul said, ‘‘What may be good
for a twenty-year plan might not be best for five years. It causes incredible
tension.’’
A few attempted to live with this unpredictability by incorporating it as
part of their lives (i.e., by having the uncertainty itself become the given,
the norm). Jerry, for example, said he eventually became comfortable
with his hazy horizon—to the degree that, after getting ill, he completed
law school. Yet at the same time, he described the attendant mental costs.
The uncertainty just becomes a part of your life. But it is tiring. I’ve
thought, ‘‘I wish I could just get sick.’’ I just didn’t have the en-
ergy to keep living, waiting to get sick. It takes energy to be opti-
mistic: I run out of steam.
Stoically, others attempted not to think about the future at all. Due
to the unforeseeable, Nancy, the endocrinologist with metastatic breast
cancer, stopped pondering the future, though even that decision pained
her. She maintained a striking acceptance and calm, born of courage. Her
response evoked the writings of Seneca, the Roman philosopher, who
argued that humans should live each day as if it were their last—because it
might be (2).
I try to stop thinking about the future. Because just when you think
you see how it’s going to go, something changes. That’s traumatic.
I have some trips scheduled til June, but not beyond. When things
happen, they will be dealt with. We’ll be on top of it—do as much
as we can. Hopefully, I won’t suffer very much.
In the face of such ambiguity, others bargained for particular ends. Larry,
the anesthesiology trainee, hoped, given his unclear prognosis, to be well
enough to finish residency—seeking some certitude, justice, and order.
Assessing Risks and Benefits
Ill physicians changed how they viewed and approached statistics con-
cerning the risks and benefits they faced. Increasingly, subjective factors