Life Prognosis Quotes

THE MAXIMS OF MEDICINE Before you examine the body of a patient, Be patient to learn his story. For once you learn his story, You will also come to know His body. Before you diagnose any sickness, Make sure there is no sickness in the mind or heart. For the emotions in a man’s moon or sun, Can point to the sickness in Any one of his other parts. Before you treat a man with a condition, Know that not all cures can heal all people. For the chemistry that works on one patient, May not work for the next, Because even medicine has its own Conditions. Before asserting a prognosis on any patient, Always be objective and never subjective. For telling a man that he will win the treasure of life, But then later discovering that he will lose, Will harm him more than by telling him That he may lose, But then he wins. THE MAXIMS OF MEDICINE by Suzy Kassem

Before asserting a prognosis on any patient, always be objective and never subjective. For telling a man that he will win the treasure of life, but then later discovering that he will lose, will harm him more than by telling him that he may lose, but then he wins.

... omniscience about life and death is not within a physician's purview. A doctor should never write off a person a priori.

I had no illusions that now, in some final and dramatic flash of revelation, we would understand one another. We were done. It was a fact of my life--intractable and sad--that our relationship had been a failure. Still, with her prognosis came one last chance to be her daughter. [p. 163]

My greatest fear was appearing stupid; a fear I will carry with me for the rest of my life—a tattoo across my forehead only I can see. All I wanted was to be invisible.

My dearest, I write this letter by candlelight as you lie sleeping. And though I can't hear the soft sounds of your slumber, I know you are there, and soon I will be lying next to you again as I always have. And I will feel your warmth and your comfort, and your breaths will slowly guide me to the place where I dream of you and the wonderful man you are. I see the flame beside me and it reminds me of another fire, (with me in your soft clothes and you in your jeans) of me and you. I knew then we would always be together. My heart had been captured, and I knew inside that it had always been yours. Who was I to question a love that rode on shooting stars and roared like crashing waves? For that is what is was between us then and that is what it is today. You are my best friend as well as my lover, and I do not know which side of you I enjoy the most. I treasure each side, just as I have treasured our life together. You have something inside you, something beautiful and strong. Kindness, that's what I see when I look at you, that's what everyone sees. Kindness. You are the most forgiving and peaceful man I know. God is with you, He must be, for you are the closest thing to an angel that I've ever seen. We have lived a lifetime most couples never know, and yet, when I look at you, I am frightened by the knowledge that all this will be ending soon. (For we both know my prognosis and what it will mean to us.) I see your tears and I worry more about you than I do about me, because I fear the pain I know you will go through. There are no words to express my sorrow for this, and I am at a loss for words. So I love you so deeply, so incredibly much. Know that I love you, that I always will, and that no matter what happens, know I have led the greatest life possible. My life with you. I love you. I love you now as I write this, and I love you now as you read this. And I am so sorry if I am not able to tell you. I love you deeply. You are, and always have been, my dream.

Today when I see a patient with CML, I tell them that the disease is an indolent leukemia with an excellent prognosis, that they will usually live their functional life span provided they take an oral medicine, Gleevec, for the rest of their lives.

What’s the kindest thing you almost did? Is your fear of insomnia stronger than your fear of what awoke you? Are bonsai cruel? Do you love what you love, or just the feeling? Your earliest memories: do you look through your young eyes, or look at your young self? Which feels worse: to know that there are people who do more with less talent, or that there are people with more talent? Do you walk on moving walkways? Should it make any difference that you knew it was wrong �as you were doing it? Would you trade actual intelligence for the perception of being smarter? Why does it bother you when someone at the next table is having a conversation on a cell phone? How many years of your life would you trade for the greatest month of your life? What would you tell your father, if it were possible? Which is changing faster, your body, or your mind? Is it cruel to tell an old person his prognosis? Are you in any way angry at your phone? When you pass �a storefront, do you look at what’s inside, look at your reflection, or neither? Is there anything you would die for if no one could ever know you died for it? If you could be assured that money wouldn’t make �you any small bit happier, would you still want more money? What has �been irrevocably spoiled for you? If your deepest secret became public, �would you be forgiven? Is your best friend your kindest friend? Is it in any way cruel to give a dog a name? Is there anything you feel a need to confess? You know it’s a “murder of crows” and a “wake of buzzards” but it’s a what of ravens, again? What is it about death that you’re �afraid of? How does it make you feel to know that it’s an “unkindness �of ravens”?

I hated funerals. I hated any rite of passage that emphasized how fleeting and fragile our physical lives were. I hated that children died. Even knowing what I knew about life and the afterlife and the momentary condition of our existence on earth, I hated it. It was better on the other side. I knew that. I’d been told by countless departed, but I hated this part nonetheless. And just for the record, telling the living how their loved ones were in a better place rarely helped. Nothing helped apart from time, and even then, the long-term prognosis was sketchy. Most recovered. Many did not. Not really. Not fully.

it nevertheless makes the prognosis look more hopeful, as I have often observed. In border-line cases such as this a real psychological understanding is often a matter of life and death.

I hadn’t slept in more than a week. Moments after I fell asleep, I felt my mother’s hand on my leg. “He’s gone.” He had clung to life knowing I was there beside him. He needed me to leave, to allow him to die.

Once I had been diagnosed with a terminal illness, I began to view the world through two perspectives; I was starting to see death as both doctor and patient. As a doctor, I knew not to declare “Cancer is a battle I’m going to win!” or ask “Why me?” (Answer: Why not me?) I knew a lot about medical care, complications, and treatment algorithms. I quickly learned from my oncologist and my own study that stage IV lung cancer today was a disease whose story might be changing, like AIDS in the late 1980s: still a rapidly fatal illness but with emerging therapies that were, for the first time, providing years of life. While being trained as a physician and scientist had helped me process the data and accept the limits of what that data could reveal about my prognosis, it didn’t help me as a patient. It didn’t tell Lucy and me whether we should go ahead and have a child, or what it meant to nurture a new life while mine faded. Nor did it tell me whether to fight for my career, to reclaim the ambitions I had single-mindedly pursued for so long, but without the surety of the time to complete them. Like my own patients, I had to face my mortality and try to understand what made my life worth living—and I needed Emma’s help to do so. Torn between being a doctor and being a patient, delving into medical science and turning back to literature for answers, I struggled, while facing my own death, to rebuild my old life—or perhaps find a new one. —

Logically—for what had a more gloomy prognosis than life?—every morning one should say to one’s friends: ‘I grieve for your irrevocable death’, as to anyone suffering from an incurable disease, and was the universal omission of this minimal gesture of sympathy the model for their reluctance to discuss the dreams?)

(Logically–for what had a more gloomy prognosis than life?–every morning one should say to one's friends: 'I grieve for your irrevocable death,' as to anyone suffering from an incurable disease, and was the universal omission of this minimal gesture of sympathy the model for their reluctance to discuss the dreams?)

What’s the kindest thing you almost did? Is your fear of insomnia stronger than your fear of what awoke you? Are bonsai cruel? Do you love what you love, or just the feeling? Your earliest memories: do you look though your young eyes, or look at your young self? Which feels worse: to know that there are people who do more with less talent, or that there are people with more talent? Do you walk on moving walkways? Should it make any difference that you knew it was wrong as you were doing it? Would you trade actual intelligence for the perception of being smarter? Why does it bother you when someone at the next table is having a conversation on a cell phone? How many years of your life would you trade for the greatest month of your life? What would you tell your father, if it were possible? Which is changing faster, your body, or your mind? Is it cruel to tell an old person his prognosis? Are you in any way angry at your phone? When you pass a storefront, do you look at what’s inside, look at your reflection, or neither? Is there anything you would die for if no one could ever know you died for it? If you could be assured that money wouldn’t make you any small bit happier, would you still want more money? What has been irrevocably spoiled for you? If your deepest secret became public, would you be forgiven? Is your best friend your kindest friend? Is it any way cruel to give a dog a name? Is there anything you feel a need to confess? You know it’s a “murder of crows” and a “wake of buzzards” but it’s a what of ravens, again? What is it about death that you’re afraid of? How does it make you feel to know that it’s an “unkindness of ravens”?

cellular activity in your tumor . . . well, prognosis can range from six months to . . . um, it’s difficult to say. Although certainly there have been some successful cases . . .” “Okay then,” I said, grabbing my bag off the back of the chair. “I’ll be in touch.” “Elizabeth! I’d really like you to meet with a counselor—” I left before he had a chance to finish, the taste of cold pennies on my tongue, as though I’d consented to chemo and already started injecting liquid poison into my bloodstream. Oncologists, nurses, radiologists, palliative care specialists: I was all too familiar with the cancer routine, and I wasn’t interested. Not one bit. My twin brother, Paul, once told me that there’s healthy denial,

Before you examine the body of a patient, Be patient to learn his story. For once you learn his story, You will also come to know His body. Before you diagnose any sickness, Make sure there is no sickness in the mind or heart. For the emotions in a man's moon or sun, Can point to the sickness in Any one of his other parts. Before you treat a man with a condition, Know that not all cures can heal all people. For the chemistry that works on one patient, May not work for the next, Because even medicine has its own Conditions. Before asserting a prognosis on any patient, Always be objective and never subjective. For telling a man that he will win the treasure of life, But then later discovering that he will lose, Will harm him more than by telling him That he may lose, But then he wins. THE MAXIMS OF MEDICINE by Suzy Kassem Copyright 1993-1994 - THE SPRING FOR WISDOM

She was always saying, ‘I know I am dying from radium poisoning,’” remembered one of her physicians. “I convinced her she wasn’t; that she was going to get better. It is tact of a physician not to reveal a fatal prognosis.”17 Martland wasted no time enlightening the world about the evolution of radium’s MO. He had seen enough cases now to know that these latent sarcomas—which could leave a victim healthy for years after her exposure to radium, before coming horribly to life and taking over her body—were the new phase of this terrifying poisoning. He added: “When I first described this disease, there was a strong tendency among some of those interested in the production and therapeutic use of radium to place the entire blame on mesothorium… In the cases autopsied recently, the mesothorium has disappeared while the radium persists.”18 He could reach only one conclusion: “I am now of the opinion that the normal radioactivity of the human body should not be increased; [to do so] is dangerous.”19 It had to be, for each week another dial-painter presented another sarcoma, each in a new location—her spine, her leg, her knee, her hip, her eye… Irene’s family couldn’t believe how fast she was fading from them. But she still had grit in her. On May 4, 1931, as she lay dying in hospital, she filed a claim for damages

When you are depressed, you may have a tendency to confuse feeling with facts. Your feelings of hopelessness and total despair are just symptoms of depressive illness, not facts. If you think you are hopeless, you will naturally feel this way. Your feelings only trace the illogical pattern of your thinking. Only an expert, who has treated hundreds of depressed individuals, would be in a position to give a meaningful prognosis for recovery. Your suicidal urge merely indicates the need for treatment. Thus, your conviction that you are "hopeless" nearly always proves you are not. Therapy, not suicide, is indicated. Although generalizations can be misleading, I let the following rule of thumb guide me: Patients who feel hopeless never actually are hopeless. The conviction of hopelessness is one of the most curious aspects of depressive illness. In fact, the degree of hopelessness experienced by seriously depressed patients who have an excellent prognosis is usually greater than in terminal malignancy patients with a poor prognosis. It is of great importance to expose the illogic that lurks behind your hopelessness as soon as possible in order to prevent an actual suicide attempt. You may feel convinced that you have an insoluble problem in your life. You may feel that you are caught in a trap from which there is no exit. This may lead to extreme frustration and even to the urge to kill yourself as the only escape.

Penn, in so many ways, we’re so lucky. In so many ways, I’m grateful this is what our kid got, gender dysphoria instead of cancer or diabetes or heart disease or any of the other shit kids get. The treatment for those isn’t necessarily clearer. The drugs are harsher and the prognosis scarier and the options life-and-death but never black-and-white, and my heart breaks every time for those kids and those parents. But those are more or less medical issues. This is a medical issue, but mostly it’s a cultural issue. It’s a social issue and an emotional issue and a family dynamic issue and a community issue. Maybe we need to medically intervene so Poppy doesn’t grow a beard. Or maybe the world needs to learn to love a person with a beard who goes by “she” and wears a skirt.

We may need to take our labels and our experts far more lightly. Some years ago...[I heard of] a farmer who had done exceptionally well despite a dire prognosis. He had taken the same attitude toward his physician's prognosis that he took toward the words of the government soil experts who analyzed his fields. As they were educated men, he respected them and listened carefully as they showed him the findings of their tests and told him that the corn would not grow in this field. He valued their opinions. But, as he said, 'A lot of the time, the corn grows anyway.' What would it be like if more people allowed for the presence of the unknown, and accepted the words of experts in this same way? Like a diagnosis, a label is an attempt to assert control and manage uncertainty. It may allow us the security and comfort of a mental closure and encourage us not to think about things again. But life never comes to a closure, life is process, even mystery. Life is known only by those who have found a way to be comfortable with change and the unknown. Given the nature of life, there may be no security, but only adventure.

In the future, white supremacy will no longer need white people,” the artist Lorraine O’Grady said in 2018, a prognosis that seemed, at least on the surface, to counter what James Baldwin said fifty years ago, which is that “the white man’s sun has set.” Which is it then? What prediction will hold? As an Asian American, I felt emboldened by Baldwin but haunted and implicated by O’Grady. I heard the ring of truth in her comment, which gave me added urgency to finish this book. Whiteness has already recruited us to become their junior partners in genocidal wars; conscripted us to be antiblack and colorist; to work for, and even head, corporations that scythe off immigrant jobs like heads of wheat. Conscription is every day and unconscious. It is the default way of life among those of us who live in relative comfort, unless we make an effort to choose otherwise. Unless we are read as Muslim or trans, Asian Americans are fortunate not to live under hard surveillance, but we live under a softer panopticon, so subtle that it’s internalized, in that we monitor ourselves, which characterizes our conditional existence. Even if we’ve been here for four generations, our status here remains conditional; belonging is always promised and just out of reach so that we behave, whether it’s the insatiable acquisition of material belongings or belonging as a peace of mind where we are absorbed into mainstream society. If the Asian American consciousness must be emancipated, we must free ourselves of our conditional existence. But what does that mean? Does that mean making ourselves suffer to keep the struggle alive? Does it mean simply being awake to our suffering? I can only answer that through the actions of others. As of now, I’m writing when history is being devoured by our digital archives so we never have to remember. The administration has plans to reopen a Japanese internment camp in Oklahoma to fill up with Latin American children. A small band of Japanese internment camp survivors protest this reopening every day. I used to idly wonder whatever happened to all the internment camp survivors. Why did they disappear? Why didn’t they ever speak out? At the demonstration, protester Tom Ikeda said, “We need to be the allies for vulnerable communities today that Japanese Americans didn’t have in 1942.” We were always here.

It’s not easy to keep moving forward with a positive outlook. I have the sense that I’m teetering on a very thin line. When I take my pills in the morning, I imagine them working toward ensuring the 93 percent chance at life that I have. When I eat ice cream or a piece of birthday cake, I remember the 7 percent and picture the tiny granules of sugar dispersing into some vulnerable area of my body, feeding any possible lingering, hungry cancer cells the surgeon missed. To an outsider, 7 percent might seem like a great prognosis. Tig, why are you even going into this? This is great news! And it is great news and a great prognosis. But when it’s your prognosis, you never forget the 7 percent. You just keep going.

ST-9 This point is a bilateral point that is found on both sides of the neck and is located about 1.5 inches to the outside of the edge of the Adam’s apple of the throat. The fact that the point lays directly over the carotid artery allows strikes to have an immediate reaction to the flow of blood to the brain and head in general. It has a cryptic name in Chinese, Ren Ying,9 which means “Man’s Prognosis” and provides no clues to its location or use from a martial standpoint. Its proximity to the carotid artery allows this point to be one of the weakest points on the human body and regardless of the size and muscular strength of an opponent it is extremely sensitive. The superior thyroid artery, the anterior jugular vein, the internal jugular vein, the carotid artery, the cutaneous cervical nerve, the cervical branch of the facial nerve, the sympathetic trunk, and the ascending branch of the hypoglossal and vagus nerves are all present. Just the structurally aspects of all these sensitive and vital nerves, arteries and veins should place it high on the list of potential targets. I personally consider it as one of the most important Vital Points because of this alone. Additionally, ST-9 is an intersection point for the Stomach Meridian, Gall Bladder Meridian and the Yin Heel Vessel. Strikes to this point can kill due to the overall structural weakness of the area. Strikes should be aimed toward the center of the spine on a 90-degree angle. A variety of empty hand weapons can be employed in striking this point. Forearms, edge of hand strikes, punches, kicks, and elbow strikes are all effective. The same defensive tactics outlined under the SI-16 should be employed against attacks to this extremely vital point. CV-22 This is one of the two most important acupuncture points to the martial arts that is concerned with the hostile actions of life-or-death combatives. It sets in the horseshoe notch located at the extreme upper part of the chest structure and at the centerline of the front of the neck. Resting under it is the trachea, or commonly known as the “windpipe,” and a hard and vicious strike to this point can cause the surrounding tissue to swell, which can shut off the body’s ability to pull oxygen into the lungs. A hard strike to this point can be deadly. Attacking this point should only be done in the most extreme life-or-death situations. Energetically, the Conception Vessel and the Yin Linking Vessel intersect at this point. The implications of that, from a Traditional Chinese Medicine perspective, is included in this book. Additionally, the structure of the suprasternal notch is an excellent “touch point” for situations when sight is reduced and you find yourself at extremely close range with your opponent. This allows for utilization of this point in a self-defense situation that is not as extreme as full force strikes, as only a finger or two are inserted and rolled to the backside of the notch causing pain for the opponent.

Yet published research studies suggest that patients and family members want to be given information about life expectancy, even if prognosis is poor. Others have shown that those engaged in shared (as in with input from their doctor), informed decision-making are more likely to make decisions about dialysis and end-of-life care consistent with their personal values—often resulting in preferences for less aggressive care and more conservative management.

Cancer, in the realest way, can cost an individual their quality of life, even with a good prognosis.

I turn off the notification app for good, no longer needing to know exactly how many gone. After all, clinging to life is what we have always done best. We are still trying to hide from the truth of things and who can blame us.

One of the epithets the Buddha acquired over the years was “the Doctor of the World.” A reason for this is that the central insight and framework that he taught, known as the Four Noble Truths, is cast in the formulation of a classical Indian medical diagnosis. The format begins with the nature of the symptom. In this particular kind of psychological or spiritual disease, the symptom is dukkha, the experience of dissatisfaction; this is the First Noble Truth. The second element in this diagnostic format is the cause of that symptom, which the Buddha outlined as being self-centered craving, greed, hatred, and delusion. These are the toxins that Matthieu referred to, the negative afflictive emotions, habits, and qualities that the mind gets caught up in and that poison the heart; this is the Second Noble Truth. The third element is the prognosis, and the good news is that it is curable. This is the Third Noble Truth, that the experience of dissatisfaction can end; we can be free from it. The fourth element—and the Fourth Noble Truth—is the methodology of treatment: what the Buddha laid out as the way to heal this wound. It’s known in some expressions as the Eightfold Path, but it can be outlined in three fundamental elements: first, responsible behavior or virtue, living a moral and ethical life; second, mental collectedness, meditation, and mind training; and third, the development of insightful understanding in accordance with reality, or wisdom. These three elements are the fundamental treatment for this psychological, spiritual ailment of dissatisfaction. I should underline that the Buddha didn’t make any claim to have a monopoly on truth. When somebody once asked him, “Is it the case that you’re the only one who really understands the way things are, and that all other spiritual teachings are incorrect, all other paths are erroneous?” He said, “No, by no means.” It’s not a matter of the way the teachings are framed, the language or symbolism that one uses. It is simply the presence or absence of these three central qualities: ethical behavior, mental collectedness, and wisdom. If any spiritual path contains those three elements, then it will certainly lead to the possibility and the actuality of freedom, peace, a harmony within oneself, and an easefulness in life. If it doesn’t contain those elements, then it cannot lead to easefulness, peace, and liberation.

He tried to disguise how tired and ill he was, how depressing the thought of death was to him and how he spent his days and nights thinking up schemes of living beyond what the prognosis said. His hope, if not his heart, would find a way.

136Matt is the light of my life. When he’s away the world seems a bit darker, as if the color of life has drained away.

wish to experience a tranquil dying without whining about or withstanding death. “Like birth,” my treasured collaborator Sandra warns in Death’s Door, “death is surely by its nature undignified.” True, but with the help of hospice at home I wish to avoid being cut, drained, wired, monitored, intubated, and ventilated within the artificial life support systems of an ICU. “To die ‘naturally’ is to find a way to have a graceful death when the prognosis is terminal and further treatments are of questionable value. It is not a rejection of medical science, but rather an attempt to use the sophistication of modern medicine to treat—in a different, better way—those who are seriously ill or near death.” I

Despite the illusion imparted by a diagnosis, people do not usually “have” an emotional issue in the sense of having a cold or a bacterial infection.8 Unlike medical diagnoses, few psychiatric diagnoses describe an underlying cause with a clearly useful course of treatment or a reliable prognosis. Depression, as one example, is not something people have, it is an experience, a way of experiencing oneself and the world. Some people characteristically—or in the shorter term, in an acute response to life events—have depressed feelings and sometimes live out the feelings in ways that are problematic and self-perpetuating.

Living in “prognosis time” is thus a liminal temporality, a casting out of time; rather than a stable, steady progression through the stages of life, time is arrested, stopped. Paradoxically, even as the very notion of “prognosis” sets up the future as known and knowable, futurity itself becomes tenuous, precarious.

A few weeks of fanfare and I'd drop show business, just like I had the guitar and my private detective agency. I hated having my life's ambition reduced to the level of a common cold. This wasn't a bug, but a full-fledged virus. It might lay low for a year or two, but this little germ would never go away. It has nothing to do with talent or initiative. Rejection couldn't weaken it, and no amount of success would ever satisfy it. Once diagnosed, the prognosis was terminal.

Four specific lines of evidence have become standard in psychiatry: symptoms, genetics, course of illness, and treatment. Symptoms are the most obvious source of evidence: most of us focus only on this evidence. Was Lincoln sad? That symptom could suggest depression, but of course one could be sad for other reasons. Symptoms are often nonspecific and thus not definitive by themselves. Genetics are key to diagnosing mental illness, because the more severe conditions—manic-depressive illness in particular—run in families. Studies of identical twins show that bipolar disorder is about 85 percent genetic, and depression is about half genetic (The other half, in the case of depression, is environmental, which is why this source of evidence is also not enough on its own.) Perhaps the least appreciated, and most useful, source of evidence is the course of illness. These ailments have characteristic patterns. Manic-depressive illness starts in young adulthood or earlier, the symptoms come and go (they’re episodic, not constant), and they generally follow a specific pattern (for example, a depressive phase often immediately follows a manic episode). Depression tends to start somewhat later in life (in the thirties or after), and involves longer and fewer episodes over a lifetime. If someone has one of these conditions, the course of the symptoms over time is often the key to determining which one he has. An old psychiatric aphorism advises that “diagnosis is prognosis”: time gives the right answer. The fourth source of evidence is treatment. This evidence is less definitive than the rest for many reasons. Sometimes people never seek or get treatment, and until the last few decades, few effective treatments were available. Even now, drugs used for mental illnesses often are nonspecific; they can work for several different illnesses, and they can even affect behavior in people who aren’t mentally ill. Sometimes, though, an unusual response can strongly indicate a particular diagnosis. For instance, antidepressants can cause mania in people with bipolar disorder, while they rarely do so in people without that illness.

Norman Cousins: The tragedy of life is not death but what we let die inside us while we live.

The tragedy of life is not death but what we let die inside us while we live.

What about my PhD?” I ask. He clears his throat, and I hear what sounds like a scoff. “There is no way you’ll be able to finish a PhD.” And there it ends. My prognosis. Our conversation. Life as I knew it.

And so one of the hardest times in my life began: me determined to save her in spite of the prognosis, me feeling responsible for the cancer, and then … … me not saving her and feeling like all the sunlight had been packed up and removed from the world.

Taking her hand, Grady held it close to his heart for a moment, then said, “Daisy, do you remember how I told you I would love you for the rest of my life?