You’re sitting in the doctor’s office. The test results are in. The doctor comes in, you’re scanning their face to see if it’s good news or bad news. They’re about to tell you your fate. The doctor tells you that your disease is in its advanced stages. They tell you that with proper treatment options, your best outcome is about two to three years. Two to three years is all you hear. Two to three years to live. Maybe you just bought a house, or had a kid. Maybe you just got married, you had your future planned out. Now you only have two to three years. What will you do now? In Part One of this series, I made the case for carrying on as usual. In Part Two, I want to explore why carrying on is the obvious thing to do and how it may serve to reorder our lives now rather than after a dire prognosis.
What is it about receiving a dire health prognosis that scares us so much? Is it knowing that we’re going to die? Most people know they’re going to die—they’ve known this since childhood. No, it’s something else. Maybe it’s knowing that it’s happening sooner than you thought? Prior to receiving the prognosis, you assumed you were going to live to old age but with one major caveat—that you may not. Since the prognosis, a new assumption has formed: now it’s assumed you won’t live to old age, but there is still a remote possibility you may beat it and live a long life. Your assumptions have changed, but uncertainty remains. It’s the same uncertainty you’ve lived with your whole life. Of course, there is the very real implication of needing to undergo treatment and face disability and hardship related to your ailment. But again, this was always a possibility before your prognosis. You’ve been sick before. You seek treatment, you try to get better.
Consider a world without our beloved doctors. In this world, there is no one to examine our symptoms and tell us we have x amount of time to live. A farmer gets sick. At first the farmer feels fine enough to carry on working in the field. She works in the field, but maybe feels a bit more tired than usual. She goes on like this for a few months, over the span of a number of months her work days gets shorter and shorter. Then one day the farmer decides she’s too tired to work in the field entirely— maybe she sends one of her children to replace her. She’s realizing that something is gravely wrong. Perhaps she has an intuitive thought that she doesn’t have much longer. She spends the rest of her days housebound— she’s too tired and too sick. Then one day, about eight months after the first signs of her mysterious ailment, she passes away. She got sick, she carried on farming to the extent she physically could, and then she died. This reveals that in the absence of a prognosis there was never any reason to do anything other than what she was already doing. She carried on exactly as she had been until she couldn’t.
I’m skeptical of the narrative that a prognosis should serve as a call to action—a call to suddenly change the course of your life to live it fully. Right now, you may have only ten months to live. Perhaps ten months from now you will die in a car accident—a morbid thought, I know. Despite this, you’re probably not living like you only have ten months to live and you’re probably okay with that. So then when the doctor says you have ten months to live what new information has the doctor actually given you?
Receiving a dire health prognosis should change nothing. You were okay with your life before, so why should it be any different after a prognosis? It shouldn’t. Disease obviously introduces physical limitations that need to be managed. Certain diseases demand rigorous treatments with debilitating side effects. You deal with your symptoms as you would any other time you’ve been sick, you try to get better, but the prognosis should in theory not stop you from doing or wanting to do what you’ve always done before because nothing about your situation has really changed.
Even though a prognosis should change nothing, this insight is still very much a call to action. It reveals that if you can’t tolerate the idea of doing what you’re doing now after a dire health prognosis, then it means that you shouldn’t be doing it now. The point is, we should be cultivating a full and meaningful life that we’d be happy to carry on with even after a dire health prognosis.
This is different from the popular motto live life like it’s your last day. The problem with this motto is that it doesn’t take into account what you’re already doing. This motto allows us to put it off until the day we realize that our lives are limited by a dire health prognosis. What I’m saying is that you’re already living life like it’s your last, because every day already could be your last. A diagnosis doesn't hand you a new timeline. It hands you the truth you've already been living by. Carry on. But carry on honestly.