The Riddle of the Sphinx
After seeing a string of frail, exhausted patients I looked forward to my next appointment, which was with a man who had received radiation therapy for an early stage seminoma several years ago. He now was approaching his 30th birthday and I intended to use the occasion to congratulate him not only on his cure but on his exceptional overall health.
He sat across from me and stared at the wall as I recited a list of superlative results. His blood pressure, weight, cholesterol, lab tests and x-rays were all as pristine as a Marine Corps sergeant’s. By the time I finished my praise, though I detected a sullen look crossing his face.
“You don’t seem very happy with this good news,” I replied. “Is something bothering you?”
He crossed his arms and looked right at me. “What makes you think I want to be healthy? I could care less about that - in fact, I completely ignore everything they say you’re supposed to do to stay healthy.”
I tried not to look surprised as I prepared to answer him. This attitude in cancer survivors has been well documented. Psychological distress leading to depression and anxiety has been called “the legacy of cancer“, and usually does not lead to impairment. I questioned him further.
“What could you be doing that is unhealthy? Your physical exam results are super.”
He let a smile flicker for an instant. “Too bad for me. Listen, I don’t want to live to be old. I saw what happened to my father, who’s now dead. I see my mother going downhill fast - I am not going to let this happen to me.”
“So you’re not watching your diet like we’re all supposed to?”
“Not a chance - I eat junk food constantly.”
“Do you ever exercise? Do you wear seat belts? Drink alcohol?”
“Doc, I live for now. I mean, I’m working and all that, but I’m also partying. I’m not hanging around long enough to end up in a nursing home, lying in my own urine.”
Well, there is something to be said for avoiding that. I tried to reason with him, using the approach that he since had been cured of cancer he owed it to himself to take care of his body now. This had about as much effect on him as if I had been speaking Farsi.
I expressed my concern over his bad habits, but also told him that unless we doctors stand out in our patients’ driveways with picket signs we can’t control what they do in their own homes. Despite his neglect, he was in good shape, with a better LDL cholesterol level than mine, and no family history of premature coronary artery disease. As we shook hands and headed out to the desk I could not resist the following retort:
“You’d better buy some long-term health insurance anyway - I think you’re going to live to be an old man.”
He stopped and turned. “How do you know that?”
Now it was my turn to smile. “Well, assuming you’ve inherited your parent’s excellent genes, I can think of only one way to guarantee yourself an early death - and you aren’t doing it.”
“What is it, Doc?”
Like the Sphinx of antiquity, I left him standing there staring at my mysterious, leonine face. He’ll figure out what vice I’m referring to soon enough, and hopefully he’ll understand how wonderful it is that he has avoided it.
And he doesn’t lie either…
Minerva
Comment by Minerva — November 4, 2005 @ 11:41 pm
In my usual bid to remind everyone that non-smokers get lung cancer too, I am reminding all that even though most lung cancer patients were/are indeed smokers, there are increasing numbers of people who develop lung cancer who have never smoked. It is essential to be conscious of your body and report any unusual symptoms to your doctor, and be persistent even if you have never had the ugly tobacco habit.
Comment by Feisty — November 8, 2005 @ 1:17 am
I found this amusing as I am a longtime cancer survivor,and can relate. That is, as far as I know-waiting latest test results. It really makes one want to enjoy the day, and not worry about all the ‘healthy habits’–tho’ I do feel a little guilty as I live on junk food, eat all the sweets i crave, and guzzle my coffee. At least, I don’t have too many BAD habits–but, after watching the health issues for so long, and eatting lowfat, and cutting out the sweets,exercising, and then, seeing my husband die suddenly of heart trouble–I really don’t CARE what THEY say anymore! But, must admit, am not doing it, as this guy is, to die any younger–just enjoy the life i have!
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