202 Being a Doctor After Being a Patient
She felt she got this predilection for fatalism from her father.
I inherited his trait. He is the world’s worst pessimist: everything is
going to be terrible. Life is always bad. Yet nothing bad has ever
happened to him either.
Yet, Nancy slipped slightly here, saying, ‘‘nothing bad has ever hap-
pened,’’ when in fact, she had been battling cancer, now metastatic, for
two years.
At other times, Nancy had felt she might be ‘‘lucky,’’ and an ‘‘ex-
ception’’ to the odds. Despite the statistics suggesting a bad prognosis,
she suspected she might have ‘‘slipped by.’’ For her, ‘‘luck’’ meant de-
fying the odds.
In the beginning, I thought I had a bad prognosis, but maybe
skimmed by—maybe I’ll be lucky and it won’t come back. I
thought that until it came back.
Nancy tried to maintain a certain daily optimism, though having under-
lying fatalistic beliefs. On these matters, individuals can thus maintain
seemingly contradictory feelings, attitudes, and behaviors. Sadly, two
months after this interview, she died.
Others, too, verged on denial in automatically ‘‘assuming’’ they would
do well. Jessica, the pediatrician, felt that initially, she never ‘‘acknowl-
edged’’ her disease. ‘‘I never really thought I was going to die. The books
said 65 percent of people have at least five years. I always immediately
assumed I was in that 65 percent. It never entered my mind that I wasn’t.’’
Desires to minimize potential risks or believe in defying the odds led
to searches for supporting evidence. At times, their medical knowledge
abetted these physicians in dismissing risks. For example, Jacob read PET
scans, and consequently was able to dispute a radiologist’s perception of
a lesion. Though Jacob’s interpretation may have been accurate, he il-
lustrated a broader pattern of challenging other physicians’ unfavorable
prognostications.
The radiologist said, ‘‘There’s an abnormality here.’’ But I know
a little more about PET scans than most people, and realized I had a
muscle strain in the same place. So I was able to explain it away.
The possibility of multiple interpretations of data can lead these doctors
to dismiss problems, at times too readily or prematurely.