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medical decisions represent a gamble

Image by Michal Parzuchowski on Unsplash.

I’m primarily a copywriter. When I write a sales page or create an offer, I’m quick to write at the bottom, “Results are not guaranteed.”

There are just too many variables. For instance, we can create a brilliant sales letter…but if the market isn’t there, sales won’t happen. There may be a competing product that offers more for less. Or if I write the copy, the design can destroy the buyer’s interest.

Other professions include guarantees. Lawyers cannot guarantee the outcomes of trials or processes. A theater can’t guarantee you’ll like the movie or play; they often include disclaimers about changing actors who perform in a production.

I think of this practice when I read articles that promise, “You’ll live longer if you do these 5 things.” 

These articles should come with a disclaimer. You can eat vegetables, exercise regularly, train your brain, and enjoy interacting with friends…and still die early. You can play fast and loose with your health and get lucky.

I know a man who lived a superbly healthy life. No medications. Slim and fit. Walked several miles a day. Involved in his friends and church. At 79, he began getting dizzy spells. He could no longer enjoy most of the things he wanted. Doctors couldn’t find a cause or a cure. He’s miserable in an assisted living facility.

Then there was the 81-year-old woman who smoked like a chimney, could never be called “slim and trim,” and limited her exercise to gardening. She lived in her own house with her husband, dog and cat, When I knew her, she remained vital and lively. Her family had all died of heart disease; she was going along just fine.

So…how do you evaluate advice to eat right, exercise, and visit the doctor?

On the one hand, we have Ezekiel Emanuel. He believes it’s not worth pursuing a long life. Too many bad things happen after age 75. He’s not advocating suicide or assisted dying, but he says at that point you can reject health screenings and refuse treatment if you’re diagnosed with something serious.

After all, if you get cancer, you can get treatment. But surgery comes with risks. You’ll need three to six months to recover fully. If you choose chemo or radiation, you’ve got a long road ahead. By the time you recover, you could get something worse.

You could be saved from cancer but get dementia. You may be forced to spend your remaining years in a nursing home or assisted living, where you run a risk of being neglected or even abused.

Then there’s Pascal’s wager. If you studied philosophy you might remember Blaise Pascal, a medieval philosopher looking for ways to promote the existence of a deity.

One argument went like this. You’re essentially placing a bet. Suppose you decide to become a believer. You gain benefits of belief, If you die and God turns out to exist, you’ve won. If you die and there’s no God, well, you’ve had the benefits of a life of belief.

Of course, the argument is simplistic. It assumes just one religion, for instance.

But for our purposes, we can use it as a metaphor for making decisions about living healthfully. If you eat well and exercise, you’ll feel better, even if you don’t live as long as you expected.

Ultimately your values lead to your decision on how to live.

I use this approach with smoking. One doctor told me, “At a certain age, which you’ve reached, you could start smoking and nothing really bad will happen. At this point, it won’t affect your longevity. At worst you’ll get a lung infection which is not too difficult to cure.”

Other doctors have told me this is nonsense. Regardless, I don’t smoke because (a) few places are available to enjoy a cigarette and (b) I value my ability to work out and stay fit.

So you have alternative ways to make your decision.

“It doesn’t matter anymore. I might as well enjoy my ice cream. If I don’t die of a heart attack I may die of something worse.”
OR
“I want to follow all the steps for a longer life. Maybe it’ll help…but even if it doesn’t, I’ll feel better and have higher self-confidence and self-esteem.”

Substitute any other algorithm. The takeaway is that in a world of no guarantees, you define your values realistically. You recognize that you’re making a tradeoff, not embarking on a predictable, guaranteed path to a longer life.

I still wish those recommendations for living longer would come with disclaimers.