Breast cancer

One of my wife's oldest friends, JE, who she's known since high school, has been dealing with metastatic breast cancer. She has it in her bones and, probably, elsewhere. I've been playing this voice of reality for my wife, cluing her in to the fact that the outlook is not good. JE is savvy about the science/medicine and has already been through the wringer having survived the first five years of this (I think she's about 7 or 8 years since her original dx). She's been outwardly projecting a calm, but mildly optimistic view of her prognosis, but ultimately I can't know how she really feels. This is all a little uncomfortable for me to have to sit through, having watched my mother die of breast cancer, but in the middle of it, I feel I can at least offer JE, as well as my wife, some advise on how to look at this with an eye toward, at least, not slipping into depression over it and, at best, maximizing the chances (whatever they may be) of surviving it.

I am admittedly, to everyone who happens to discuss medicine with me, cynical about how most (not all) doctors approach medicine, which demonstrates more often than not that (1) they tend to play the percentage game, ignoring any symptom suggesting a particular patient is not in the "typical" 95% of the population, (2) they are invariably more concerned about ego than the patient's best interest, (3) like it or not, they are driven by money, unless they are working for Medecins Sans Frontieres, and I don't know any that are, and (4) medicine, despite all the evidence to the contrary, still has an enormous amount of "art" involved, and the field is populated much more by barely competent technicians than it is by artists.

And yet, despite all this, I try to be optmistic about medicine to those around me. I just remind them to be realistic.

The take home message on this is do what you can, when you can and don't forget to realize that life is so painfully short that you absolutely cannot take it for granted. Do, say and be what you need to now.