What My Patient Taught Me: 10% Is a Lot

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It was a gloomy, snowy day. Living the life of a fellow, I walked into clinic ready for quite a busy shift. With my pager going off repeatedly after a sleepless night, the day promised to be dreadful. Yes, I was convinced I carried the world on my shoulders. At least that’s what I felt. And with that weight, I entered the patient’s room…and there he was, “my new patient,” smiling and serene. I couldn’t help but relax my face and smile back.

He was a pleasant, thin gentleman, accompanied by his wife. I quickly noticed his fenestrated tracheostomy. I found out later he had metastatic laryngeal cancer and had undergone laryngeal resection with chemo and radiotherapy. He was coming to see me to follow up on his subsequent hypothyroidism. In his ever-calm tone, he said, “My doctor” — his oncologist, I imagine — “told me that I have a 10 percent chance of survival.” In the same breath, and with his beautiful smile, he added, “Ten is a lot, doc!” Lifting up both hands, he counted on each of his fingers: “1–2–3–4–5–6–7–8–9–10. See? Ten is a lot!” With every number, his face seemed illuminated even more, as if feeling a step closer to recovery. He didn’t know, or maybe didn’t care, whether his 10 percent chance of survival was over one, five, or 10 years. Or maybe less.

All through the years, my memory of him and his words still follows me. It’s so strange how everything, even numbers, can be relative. Ten can be a good number after all! When it comes to odds of survival, it’s certainly superior to all nine numbers that come before it, even without including zero. But when it comes to percentages, 10 is a long 90 points off from 100. Is it relatively low or relatively high? Or maybe just enough?

Often times, we get lost in the small worries of our daily lives and forget to appreciate greater things. Like other doctors, I get easily absorbed by the clinic and hospital work. I forget to stop, breathe, and look around to see the bigger picture — the 10 percent. Is it only a difference between being pessimistic or optimistic? Or it is just our way of life? How often do our patients impress us with their poise and serenity despite their medical problems, concerns, and long medication lists? Even in the face of uncertainty, they offer to lift our spirits with their positive approach to life.

I wish I could tell you more about my patient. I would have loved to relate a long story with a happy ending, but that was the first and last time I ever saw him. I’ve forgotten all the other details of his medical history, and his face has started to fade. But his words remain engraved in my head. I can still hear him counting from 1 to 10 on his fingers. And I know he was right. With the right perspective, ten can be a lot.

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