“Doc, I want your opinion. The medical oncologist told me I had a 50-50 chance of beating this. What do you think? ” I am often faced with these conversations but wondered how to help fearful Gertrude who has metastatic disease and is still doing well with aggressive treatment.

“Do you have a coin in your purse?” She pulls out a quarter. “So Gertrude, the other Doc essentially described your survival as a flip of the coin. Why not try it, OK?” First she is dismayed but timidly hands me the quarter. “Here we go, heads you are a survivor and tails you live a good life. Call it!” I says these words so fast and flip quickly before she processes that I didn’t say live or die. It hits the floor and we both look down. “Tails it is! you live a good life!”

Did I negate Gertrude’s concern and misguide her? She is 80 years old, the disease will take its toll and some side effect from it will shorten her life- how long? I don’t know. She keeps tolerating therapy and does well. She already is a survivor so “heads” is right. She can still live a good life so “tails” is as well. Docs shouldn’t be in the business of scaring people to death.

“Gertrude, everyday we each have a zero or 100% risk or hope for survival. No body lives 50% and so as long as you do well, you are living your best life.” Worry and fear will only ruin what time she has left. Careful to not ignore end of life discussions, I often send patients to hospice who are finishing the fight. What I object to is the vagueness of percentages that have no meaning but to insight fear. And so, our little game today gave Gertrude a lift and I am reminded how words can heal. Speech “therapy” comes in all forms. Physicians may hold the tools for wellness but we do not hold the key for life and so for my practice, I refuse to steal what isn’t mine to give or take away.

It is important to think, read and speak healing words over our drama. My best advice is to give yourself 100% chance everyday.