The Value of Certainty, Part 2

Continued from Part 1.

Those of you that follow me on twitter know that I’m in Michigan for the summer. I’m here because a couple months ago, my mother was diagnosed with stage 1A Hodgkin’s lymphoma. Quick cancer lesson: Hodgkin’s is a blood cancer, and typically more predictable than its non-Hodgkin’s cousin. There are four stages, with the lateness of the stage reflecting how far the cancer has spread. The ‘A’ designation means that Mom wasn’t showing any outward symptoms like night sweats, fevers or weight loss.

What started out as a swollen lymph node became an “oh shit” series of events, though we’re lucky that the doctors caught it so early and the outlook for full recovery is good. My parents were living in Shanghai at the time, and after getting the same prognosis from three different hospitals, they decided to come back to Michigan for chemo and radiation therapy. Because Dad has a job that requires him to travel back and forth between the States and Asia, my younger brother is just finishing his junior year of high school and I can work from anywhere, my coming back to help her through the entire treatment was a no-brainer.

Plan, meet wrench.

The day Mom scheduled the times for her two-plus months of chemotherapy and radiation, she was finally able to land an appointment with a fourth, well-respected hospital she had previously (unsuccessfully) tried to get time with. Here’s where things got complicated: the doctors at the fourth hospital reviewed the previous tests, conducted their own, and came to the conclusion that there wasn’t enough evidence to call it cancer at all! Their recommendation? No treatment, just monitor the situation closely.

We had to make a choice — in one scenario, we would (and were about to) endure chemo and radiation (no stroll in the park by any means), and in the other, we’d take the risk that it really wasn’t cancer and pray that nothing happens (or if something does happen, that we don’t catch it too late). Like in my thought experiment, it was a choice between the certainty of shorter-term suffering and the uncertainty of a possible longer-term, severe suffering.

Somewhat worse than food poisoning.

A majority of you who responded to the previous post chose the first scenario. The cloud of uncertainty surrounding the second scenario was the dealbreaker. Even those of you who chose Option B did so in a way that maximized the amount of control you had over the situation — some of you said you would stay away from certain foods and others based it on previous experiences with food poisoning. Still others joked around about the credibility of the source!

In the real world, things aren’t nearly as black and white. There is never absolute certainty—cancer treatment comes with its own set of dangers and potential problems: susceptibility to infection, risk of secondary cancers and so on. In the end, after asking plenty of questions, it came down to a choice over which uncertainties we could live with and which ones we couldn’t.

I think this tradeoff underlies any decision we make. Sometimes we barely even think about it, while in situations like this one, we spend a lot of time thinking about it. We essentially trade one set of uncertainties for another, and our values are the fulcrum of the scale we weigh these choices on. Some of us stay at full-time jobs because we dread the uncertainty of not having a steady income. Others venture off on their own because they can’t stand the uncertainty of not being in control of what they work on. Entrepreneurs don’t take risks; they’re just afraid of different things.

This past Monday, Mom, had her first of four chemo sessions. Parts of the Detroit-area hospital doing the treatment look like they were taken from the interior of a spaceship designed during the cold war. They hand out buzzers in the waiting area like they do at Shake Shack.

We’re still learning and getting used to the side-effects of chemo. Some days go by like nothing happened at all, while on others Mom says it’s like she’s pregnant all over again. My little brother flies in at the beginning of July and I’m looking forward to spending time with him too. This summer is going to be one of the most difficult of our lives, but I think, at the same time, we can make it on of the best.

I’ll end with the comment sasq left on the last post:

I say option a, because when you’re done with the curse, food will taste so much better.

Amen.