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Comment by mehwoot | Hacker News Reader

"To the oncologist who told me I couldn't survive: fuck you."

Goddamn I am so sick of people talking shit like this; "_They_ said I only had 3 months to live! I sure showed _them_".

What, you think they get fucking pleasure out of telling people they are going to die? They're just doing their job, and 95% of the time, they are right. You think they're rooting for cancer to beat you? Would you prefer your doctor didn't give you an honest opinion?

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Not only are they most often right, but doctors know to under promise and over deliver. Which is better: "You'll never have use of that leg again" followed by a success story due to hard work and PT, or "Don't worry brah, that'll be healed in like two weeks" followed by a long slog of missed goals, unmet promises, and malpractice lawsuits? "You said I'd be walking in two weeks, and it's been two months!" Enjoy your new lawsuit!

Based on your reaction, I am guessing you have never faced a serious illness like this with tedious, painful treatments. The senseless statistically unlikely occurrence of cancer in a young person is almost guaranteed to produce overwhelming anger. It's natural to express this, especially in the face of doubts.

source: I am 30. I am days from finishing a year of radiation, surgery, and chemo for cancer.

Well, I had similar thoughts to mehwoot's opinions. Doctors generally need to set expectations low. Some might not have the best bedside manner in doing so, but I feel like it's better than overpromising and underdelivering.

source: I am 42, and I had cancer when I was 16 (very similar to Lance Armstrong's prognosis, minus the brain cancer) and again when I was 37.

I agree. I think that this sort of thing is going to produce a "me against the world" mentality, and so I understand why these reactions occur. But although I understand it, I don't think it is right to say "fuck you" to the doctor who treated you, unless there is real cause for it. Their job is already hard enough.

Thank you for relating your story, I can see why anger is common among those facing (possibly) terminal illnesses.

I don't think they are right 95% of the time. Unless they just say "you are going to die because of cacncer" but if they said it to random person on the street they would be already right one time out of four.

How much can patient with treated cancer live varies greatly. Each cancer is at least few new species of life. Personal predictions are not possible, especially not before trying some treatments.

Even giving average survival is bullshit because you can't factor in all the things you know about given patient (or his cancer) into the average. Often there is very little to know about the particular cancer you have. Looking at cancer cells taken from the point of biopsy doesn't reveal much. Even sequencing DNA doesn't say much because 3 centimeter off the site of the biopsy, cancer cells can have different genome.

If you have cancer you don't know how long you are going to live. Same way as nobody does. And even if you beat cancer you'll still have more than 1 chance in 1000 of dying next year for whatever reasons like the rest of us.

Depending on the cancer type, oncologists let you off the hook after some years. As far as I know that more or less means that if you got cancer after that set period, this new cancer is considered unrelated to the first one. Don't know how much statistics are behind that, so.

And yes, I guess you have to be a very special peronality type to become an oncologist. Nothing to say of becoming a child oncologist.

Completly agree with the last sentence, only that most people consider cancer a special cause of early death that scares the hell out of them. At the same time nobody worries of comuting 30 miles one-way day to work, all around the year and don't give a shit if there's black ice half the time in winter.

Interessting how far human self deception goes.

I think being an onocologist is the most depressing profession one could go into. I mean, you have this disease that is hugely fatal, many of your patients die, you have lots of noise on survivability, sometimes you win, often you lose. You can cause lots of anxiety with a misdiagnosis or a prediction that doesn't pan out.

Not to mention if you did your job well, the patient thanks you by saying "fuck you".

Seems unlikely he remained his oncologist.

Depends on the person. I'm sure many people deal with it and get personal enjoyment out of (what they perceive to be) saving lives.

Sometimes you win against cancer but you lose from something else. A co-worker of mine, Nick, in his 20s had Hodgkin's disease was doing well but then suddenly died of pneumonia.

The bathroom urinals will never be the same without hearing Nick say "So this is where the dicks hang out!"

I think having hope even if it's terrible odds is far better than knowing you will fail. IMO, working in a nursing home or a hospice is far worse as that really is all about waiting to die.

> I think having hope even if it's terrible odds is far better than knowing you will fail.

I don't think doctors get to make that call anymore.

I think this is true.

I have a lot of friends that have started down the route to become a consultant oncologist but changed after a few years of training.

I hope you never get cancer. You might feel just as angry. It might not be necessarily logical (but then, maybe it was), but those dying and who know it, I can imagine, feel not only fear by grief. Grief they are leaving behind their loved ones. Grief of no longer being on this earth.

I'd not be so quick to condemn.

People also should not take out their anger and grief on their doctor. While it's understandable and we should cut them slack because of their situation, doctors deserve some slack as well.

There's a difference between "You're going to die" and "It is very unlikely you'll make it"

We have no idea what the doctor actually said vs. what the patient heard. One could imagine the doctor says "you are unlikely to make it" and the patient just hears "you are going to die."

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