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  8. Editor’s Invitation: Uncertainty

Editor’s Invitation: Uncertainty

Dear Pulse readers,

I think it’s fair to say that we’re living in uncertain times.

A pandemic, urgent calls for racial justice and an election year all cry for our attention against a backdrop of global warming. The stakes are high. The outcomes are still unknown.

At the same time, in our personal lives, we need to make choices based on the information at hand. It’s not always easy.

My wife and I recently decided to spend a vacation week in a rented home, and we invited our two grown daughters to join us.

Was that a wise decision?

Our daughters share an apartment in Brooklyn with two roommates.  They all have the good fortune to work from home, and they’re all conscientious about mask-wearing. Still, they do meet up with other friends sometimes, and occasionally they find themselves in situations where others are not wearing masks.

As we planned our vacation, we had to decide whether spending time with our daughters was worth the risk.

We decided that it was.

Here’s how we handled it:

During our indoor time together in this rented house, we opened all the windows, wore masks and tried to maintain social distance. No hugging. No kissing.

We ate our meals outside on the patio.  Outside, the masks came off, but we still tried to maintain some distance.

The operative word is “tried.” We mostly did maintain social distance, but there were moments when we didn’t quite.

Were we playing it safe–or being foolish?

Certainly, our strategy wasn’t 100 percent safe. But was it safe enough?

In medical school, my classmates and I were taught by example to have command of our facts–and to project certainty. I learned pretty quickly that I wasn’t so good at the latter. Still, after years in practice, it feels right, once I’ve carefully assessed a patient’s symptoms, to offer reassurance that her headache isn’t caused by a brain tumor.

This requires stilling the little voice in my own head that pipes, But what if you’re wrong?

I recently had a patient who complained for months about a pain in his left upper torso. It had all the features of musculoskeletal pain–and I got an X-ray to reassure him that there was nothing bad going on in his lungs or bones.

He wasn’t reassured. “It hurts so much. What’s causing this?”

We went through an assortment of pain medications, none of which helped very much, until he finally presented to the emergency room. There, the doctors couldn’t find anything bad on the left side of his chest–but one scan incidentally revealed a tumor on the right side of his abdomen.

He had cancer.

Nobody thought that the right-sided abdominal tumor had anything to do with the left-sided chest pain, but still, the reassurances I’d previously given my patient ring pretty hollow right now.

In medicine, you approach uncertainty and offer reassurances based on likelihoods–knowing that, as terrible as it feels, you will sometimes not get it right.

This month’s More Voices theme is Uncertainty. How have you dealt with uncertainty as a patient or family member? As a health professional? Or as someone trying to stay safe in the time of COVID-19?

Send a story of your lived experience to More Voices.

For more details, visit More Voices FAQs–or you can go directly to the More Voices Submission Form. Remember, your story should be 40-400 words. And no poetry, please.

Sincerely,

Paul Gross
Editor

 

 

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