Cancer Vacation Reading

I usually spend a fair amount of time on vacation reading. Cancer vacation has proven no different, and I've spent most of my reading time with Atul Gawande's Being Mortal. Gawande's a surgeon in Boston, among a bunch of other things, and Being Mortal is about how the practice of medicine has basically screwed up how we die -- or rather, how we approach death. 

Let's just say, the man is not a fan of nursing homes.

Nursing homes aside, one of the most interesting bits he talks about is the work of Laura Carstensen, a professor at Stanford who's come up with socioemotional selectivity theory. In short, based on a bunch of psychological surveys and experiments, Carstensen figured out that the decisions people make about how to construct their social networks and live their lives are less a function of age, culture, class, etc., then the are a function of how much longer the individual expects to live. Twenty-year-olds respond very differently than eighty-year-olds, but survey a bunch of twenty-year-olds with terminal diseases and they'll respond like eighty-year-olds. Similarly, construct an experiment that has eighty-year-olds reasonably believing they'll live twenty more years and they'll respond to surveys like twenty-year-olds. 

Fascinating stuff, particularly in light of what the oncologists will and won't say about my life expectancy. At my very first appointment I was told I had six months to live without chemotherapy, and possibly five years on chemotherapy. Since then, though, it's been nearly impossible to get any sort of prospective life expectancy from any of the doctors. They hem and they haw, and throw out stories of patients with Stage IV colon cancer living ten years plus -- Sib4 is particularly fond of those -- but then they start throwing out qualifiers and hedging their bets, making it nearly impossible to figure out a reasonable set of expectations. 

I mean, it's probably a fair bet that I'll never collect on my Social Security -- and to all of you worried about the generally overblown projection that Social Security will go bankrupt before you're ready to retire, you're welcome -- but it's a lot harder to figure out how long the money I've got needs to last, One year? Five years? Ten years? The answer has a pretty direct impact on the choices I make, but getting an honest answer is impossible.

I suppose it could be worse. My remaining life expectancy could be what it is for most people my age: anywhere from thirty seconds to sixty years. Comparatively, planning for a range of thirty seconds to five years seems a walk in the park. 

Plus, I don't have to worry about winding up in a nursing home.