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[ Birds singing ]
>> When I had my second
recurrence,
I asked my oncologist
for prognosis information.
It was about 50/50,
it was my outlook.
And this was a little bit hard
for me to take
because it didn't seem very
sincere or well thought through.
>> In 2007 the doctor came
and told me after surgery,
after Vanessa's surgery,
that she had stage 4
colon cancer.
We appreciated the doctors
knowing that it was serious
and that they were going
to do the best possible
treatment for us.
We didn't need
to know anything else
besides that.
>> No, no.
>> I don't think it was good
for us.
>> My son and my daughter went
with me for the diagnosis.
I was given five months to live.
I thought expletive, expletive,
no human being has the right
to tell another human being how
long you can live.
>> Talking about prognosis
for people with a cancer
that has you know not
necessarily a great prognosis,
it's pretty scary.
Many people have this tremendous
resilience that comes
out when they can start
to grapple with what they're
up against.
And if we don't provide the
right kind of communication,
they never have the chance
to do that.
We're often waiting
for this question
about prognosis
or how long exactly do I have
to live?
And you know
that question never comes
because the patient is asking
about the future
in a different way.
They're asking am I going
to make it to the graduation?
Can I take the trip?
Can I make plans?
For almost everybody,
talking about the future is
really important.
And the challenge for me is
to figure out what's the piece
of information that I can bring
from my medical expertise
to their question.
>> What I've been looking for is
to know you know what are the
odds that I'm going to survive?
There's just a comfort
that comes along with knowing
where I fit and what I need
to do to succeed and survive
and to continue
to parent my kids
and all the things I want to do
with my life.
>> Dr. Back
and I have talked about death
and my personal philosophy is I
will know when I'm going to die.
And I've said to him many times,
I will tell you
when I am going to die.
And I just finally decided well,
I'm going to take each day
and each day that I'm given
to live is a gift
and I'll just live it
as best I can.
>> He said you've got two kids
and we've got graduations coming
up a high school grad
and college grads
and let's fight real hard to see
if we can make those.
So that gives you a goal
and maybe a manageable goal
to be there
for certain ones of those.
>> So what I'm trying
to do is say how ready are you
to talk about the future?
In what way could we talk
about the future together
that from my point
of view will help you
get prepared,
and from their point
of view won't be too scary.
[silence] If I could give
patients one piece
of advice I'd say tell your
doctor exactly how you want
to hear about this.
So Vanessa and Roy approach this
very differently.
She did not want any
of the gory details.
He wanted to know all
the statistics.
So what I would do was have
separate conversations offline
with Roy.
>> I follow Vanessa's lead.
You know I accommodate her
desires and interests
in knowing information.
And if I need
to have information then I could
seek it out either
from the doctors
or do my own type of work.
>> For me being
in the dark is more
of a problem then having
information that's maybe not
the best.
In the case of working
with Dr. Back specifically he
tried to go a step further
to say for this hurdle you've
got this percent chance
of getting through it
and that just helped me to kind
of get the bigger picture
for what my challenge was going
to be.
>> I think the job isn't for us
to fuzz the truth or soften it,
necessarily, although we have
to be kind about it.
I think our job is to be there
for whatever the emotional
response is later and to expect
that and to realize that's part
of our job as healers.
What statistics can tell you is
that they can give you an idea
of the range that most people
with your condition have.
You know what statistics can't
tell you is exactly
when something will happen
to you as an individual.
Sometimes when doctors say the
average survival is 12 months,
patients think
that means I have exactly
12 months.
And that's rarely the case.
Usually the 12 months is an
average of many patients,
1/2 of which have lived more
than 12 months and 1/2
of which have lived less
than 12 months.
So take the good part of them,
do some planning
but don't get hung
up on exactly how much time you
might have because we can't
predict that.
>> What's a tube of toothpaste?
Well it says I have made it
another month or six weeks
because I get
to start a new tube
of toothpaste and the tube
of toothpaste is my guideline
to wow, I made it another few
weeks or another few months.
>> So for me what I've tried
to do with the past is just jump
back into my life,
get my job back, go back to work
and take care of my kids
and my wife
and just appreciate what
I've got.
>> I have a choice here I
can make.
I can make myself miserable
and cry a lot and be sad
or I can decide to have a blast,
be happy and use the time
to do wonderful stuff
that makes me feel good
and hopefully makes you guys
feel good.
>> One day Vanessa told me
that a friend had painted a
portrait of her and I said oh,
can I see it?
Her sleeve is unraveling
and she's knitting.
And I said what are
you knitting?
And she said I don't know.
And to me that's the metaphor
of her life now.
She's working on it.
She's not exactly sure how it's
going to turn out.
[ Birds singing ]
[ Silence ]