When I was a young boy I would often ask my generally generous mother for something I wanted, and I knew there were three possible answers: yes, no, and maybe. The objective was to get a quick yes. A no was disappointing, and I was well aware that a maybe was usually a no in disguise—a delayed negative.
Still, maybe left some room for hope, so it was preferable to a definitive no. Even probably not was better than just plain no, and probably not, but maybe, especially when followed by we’ll see, was my implicit authorization to at least wonder whether that mish mash of maybe might ultimately convert into a yes if I played my cards right.
… a definitive answer allows me to move forward with some kind of conviction, while maybe leaves me immobilized …
Now, as that same boy trapped inside the body of a grownup I.T. guy, I’m even less fond of maybe. I like systems, certainty, and completeness. I prefer black and white, right or wrong, on or off. Two plus two should predictably equal four every time. I don’t do as well with uncertainty, and in most cases I would like a yes or no rather than a maybe or probably.
Maybe makes me mostly miserable, and probably, well, that’s an equally pitiful and pathetic answer to any question posed. And while I may not like negative news or disappointing dismissal, at least a definitive answer allows me to move forward with some kind of conviction, while maybe leaves me immobilized, in limbo, and unable to plan the next step.
This is especially true in the area of my health, which I understand is almost always a gray area by its very nature, and is therefore laden with ifs, ands, and buts, which all boils down to maybe after maybe after maybe, with an occasional probably.
This is perfectly illustrated in the context of prostate cancer. Does this typical conversation bring back memories?
My PSA is 4.7. Do I have prostate cancer?
Maybe, but probably not.
Now it has risen to 5.8. Am I okay?
Maybe, but let’s do another test.
The test is positive. Do I have cancer?
Maybe not, but let’s do a biopsy to be sure.
The biopsy is positive. Is prostate cancer going to kill me?
Probably not. We can treat it.
Will the treatment cure my cancer?
Probably. We caught it early.
Will I have any unpleasant side effects?
Probably not, but maybe. No guarantees.
Such is the infuriating language of health care. We want to know where we stand, but it’s nearly impossible to get to the bottom of things. Nobody has a crystal ball, so I have to concede that it’s reasonable that most answers begin with maybe or probably. But even if it’s justified, we don’t have to like it, do we?
Throw in a few we just don’t knows, and that about sums up the kind of answers we routinely have to accept about our health status. In fact, you can ask just about any question about your health and the answer might sound a lot like this famous (or infamous) quote. Imagine asking how things are going with your health issue of concern, and hearing this from your doctor:
Although this sounds a lot like some of my doctors, those are the words of former Secretary of Defense Donald Rumsfeld. He is a politician, not a physician. But love him or hate him, don’t his words remind you just a little of at least one of your many doctors? It’s not much of stretch to imagine those words coming from the mouth of just about anyone on your medical team. Suppose your doctor looked exactly like Rumsfeld, and you asked him whether your health was headed in the right direction. Would you like this response?
So Sue Me
One thing we do know—a known known—is that nobody wants to be sued, and everybody can be sued. So every doctor and pharmacist must be careful to avoid stating anything as an absolute, which would be heard as a guarantee. I find it useful to watch their body language and facial expressions to glean the real meaning behind the words, just as Dr. Cal Lightman (Tim Roth) did in the TV series Lie to Me. Sometimes those body language clues are intentional, hoping to convey truth where words must obfuscate to avoid liability. After all, nobody is sued for winking (so far).
Side Effects? Maybe.
If there is a flagship for maybe, it is the label on most medication. Have you taken the time lately to read the possible side effects of the prescription or even the over-the-counter drugs you take? There must be a universal template for this list, because they all sound strangely similar. The all-encompassing laundry list includes standard conditions like headaches, muscle aches, dizziness, and so on, but I particularly enjoy the inclusion of opposites. Diarrhea and constipation. Fatigue and sleeplessness. Runny nose, stuffy nose. And then there’s my favorite side effect of all: death. Yes, I know, I know. I can die from anything at any time. I could choke on that tiny tablet of baby aspirin I take daily.
So will the pills help me more than they’ll possibly hurt me? Of course, you already know the answer: maybe, but probably not. Would surgery help? What about radiation, chemotherapy, hormone therapy, or yoga? Maybe, maybe, maybe, maybe, and maybe. Or in some cases the answer could possibly be probably. Side effects? Can’t say for sure.
… I am stuck within a maze of maybes in which each turn may or might not lead me down the best road
Although it was as true before my prostate cancer diagnosis as after my treatment for it, I am now hyper-aware of the unpleasant fact that uncertainty is unavoidable. As much as I would love to have a well-defined, unambiguous road map for life, I am stuck within a maze of maybes in which each turn may or may not lead me down the best road. Uncertainty is a sure thing.
Is this blog post likely to remove the uncertainty or change the nature of the answers to my medical questions? Probably not. But maybe. Did Mom prepare me well enough for life’s miserable maybes? We’ll see. Did your mom prepare you? Email me. I definitely want to know how your mom did!