Despite the innovations of companies like Eli Lilly, there remain limits to the miracles that modern science can muster. Embracing the failure of life’s natural course has been discussed a number of times here – Cry For His Pain, Glorious Failure, Goodbye Steve. MSNBC also featured an article titled, “Too much optimism may be bad for cancer patients.”
“An optimistic outlook is often believed to have a positive impact on cancer. But researchers now say that optimism, like anything else, can be overdone. And “unrealistic optimism,” which a new study has found to be common among patients enrolling in early phase drug trials, may have a serious downside. The problem, some experts say, is that unrealistic optimism may lead patients to sign up for very early stage trials when the patients might make other choices if they really understood and completely absorbed the true risks and benefits.”
“If you want to think you are going to be the one in 50 or one in 100 people who gets helped by a therapy, I’m not going to take that away from you,” said Dr. Adam Brufsky, associate director for clinical investigation at the University of Pittsburgh’s Cancer Institute…By the time patients are signing up for Phase I trials, their only other option is palliative care. Some people choose that. They say they want to spend whatever time they have left doing what they want and not coming in for treatments and tests. But others say they want to go down fighting.”
“For Dr. Thomas Strouse, the real concern is that unrealistically optimistic patients might ignore or decide not to report side effects fearing they’ll be dropped from the trial. This might lead to patients getting less pain management, said Strouse, a professor of clinical psychiatry at the University of California, Los Angeles. It could also result in skewed side effect results. The other fear is that patients won’t opt for hospice care — and a better quality of life in their final months or weeks — because they haven’t admitted to themselves that they won’t get better, said Dr. Lynn Schuchter, chief of hematology/oncology at the Abramson Cancer Center at the University of Pennsylvania.”
I would add another rationale for tempering optimism in the face of tragic illness – misguided alternatives. Most of the time, a powerful component of the ‘Alternative Medicine’ charade is the ‘power of positive thinking’. In fact, in many cases, the only real benefit from the alternative treatment is the positive thinking itself. The prescription for ‘positive thinking’ and ‘positive energy’ may not cure anything, but at least you feel more, ermmm, ‘positive’. You ‘feel better’ because, well, you have made yourself ‘feel better’. That might be fine for some minor ailments, but with serious disease, just ‘feeling better’ is not necessarily being ‘truly better’. It is a bit tragic that Steve Jobs was seduced down this path opting for alternative medicine under the fatally distorted path of over optimism in its effectiveness.
It’s okay to feel bad, and it might even be good.