Cheer Mrs. Edwards' choice, but chart your own course

April 01, 2007|By Jessie Gruman

Elizabeth Edwards' response to her latest cancer diagnosis offers useful lessons and cautions for the rest of us. The wife of former Sen. John Edwards has decided on her course: to receive treatment while continuing to participate in her husband's quest for the presidency. I applaud her stance because she is responding to a difficult situation by considering carefully all of the contingencies of a complicated public life and will now move forward with confidence that this is the right way for her.

But her solution isn't necessarily the appropriate one for others with similarly serious diagnoses. It would be unfortunate if she became a role model that they measured their decisions against.

Most of us who have received a life-threatening diagnosis find some of our choices about how to respond quite limited. For example, many of us aren't lucky enough to have such a supportive spouse, or can't afford to quit the work force.

Our situations may be quite different, particularly if we are dependent on employer-provided health insurance. For most working people, whether we are insured or not, there is no choice but to stay on the job. And even then, many Americans don't have access to the broad menu of sophisticated medical care that is available to Mrs. Edwards.

Her continuing, enthusiastic support for her husband's campaign includes an interesting twist. He's campaigning to unite what he describes as two Americas and reduce the gap between the haves and the have-nots.

Many of us strongly support that goal. In my interviews with several hundred patients confronting similar devastating diagnoses, I learned how constrained the world of the have-nots is when one is facing the prospect of complex ongoing medical treatment, and how fearful the more fortunate are about falling into that daunting world. That's not a problem Mrs. Edwards will have to contend with.

After considering the resources available, she has "made the choice to live," as she puts it, through a series of actions that are right for her.

All Americans should endorse her decision and hope that she lives a long and happy life.

One beneficial consequence of her decision to speak openly about her illness is that it may encourage others to think about how they would respond to such a health crisis. But after a serious diagnosis, almost all of us also make the "choice to live," even if our lives will be shortened. Hers is not the only way.

In making the "choice to live," some of us will continue to work, others will be too ill to do so, and a few of us will quit our jobs and head off to Tahiti. Some of us will first carefully gather medical information from a variety of sources before we chart our course, some will follow the advice of the first physician we see (regardless of his or her expertise), and some will devise a course of treatment that draws from different healing traditions. Many of us will lean heavily on friends and family while we are ill, while some of us guard our privacy and go it alone.

I'm rooting for Mrs. Edwards' success, as I am also rooting for Tony Snow, the White House spokesman, who announced last week that his cancer has returned. Two such high-profile recurrences coming so close together confirm my view that this is a universal human issue that bridges partisan politics.

However, there is no universally appropriate response to a life-altering diagnosis. Each of us must evaluate our situations, as Mr. Snow and Mrs. Edwards have done, and then build on the few certainties we possess to weave together a deeply personal response to our illness with the kinds of support we find helpful, with all the grace we can muster and with all the dignity we deserve.

Jessie Gruman, president of the Center for the Advancement of Health, has survived four life-threatening diagnoses and is the author of "AfterShock: What to Do When the Doctor Gives You - or Someone You Love - a Devastating Diagnosis." Her e-mail is jgruman@cfah.org.

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