The Median is Not the Message

[This blog post is dedicated to my friend Brian Gillan, whose wife Paula is also a friend of mine, a breast cancer survivor, and a great supporter of Cincinnati Cancer Advisors.]

I distinctly remember the panic I felt when I first learned that I had prostate cancer. The interval between when I was diagnosed and operated on was necessarily short. I sought three separate medical opinions and there was a uniform consensus that I needed to act quickly, which is not generally the case with prostate cancer.

I had plenty of time off from work after my surgery. Maybe too much time. So much time that it allowed me to fall down the rabbit hole into a dark place after trying to determine my prognosis. I assumed the worst, which was much more in line with my personality than it is now. I would assume the worst as a means of self-protection. If I assumed the worst and the news was better than that, then great. Time to celebrate! If the news was as bad as I assumed, then I was no worse off. I can’t imagine living that way now.

The main reason why I can’t imagine living that way now is due to an essay that my friend Brian Gillan sent me after one of our heart-to-heart conversations about life. The essay was entitled “The Median Is Not the Message” and it was written by an American paleontologist, biologist and scientist named Stephen Jay Gould.

Gould was diagnosed with peritoneal mesothelioma in 1982, a deadly form of cancer affecting the abdominal lining. The literature at the time stated that Gould’s disease was incurable, with a “median mortality” of eight months after discovery. Gould’s background in research put him in a good position to logically deconstruct what he was reading in the medical literature.

Gould noted that the median is not the average (as many people assume). It is instead the halfway point. Statistically, that meant that 50% of the people with his diagnosis would die within eight months and 50% would die more than eight months later. Gould was 40 years old at the time and in otherwise good health. He reasoned that the 50% that died in eight months or less were likely to have been elderly, with significant co-morbidities or other risk factors that did not apply in his case. Basically, he concluded that this statistic was meaningless to his case… i.e., it did not apply to his cancer.

Gould died 20 years later (not 20 months) of a completely unrelated lung cancer. Understanding his logic has allowed me to view these types of statistics with a heavy grain of salt. That said, I do use these often-gloomy predictions as fuel to live my life with urgency, passion and gratitude. I have since shared this essay with many other frightened patients and I hope it helped them too. Thanks for the share, Brian!

Until next time,