Diagnoses

Why do people get so anxious going in for medical tests? What exactly happens during the tests and scans? There are four possibilities:

• false negative (e.g. report says there’s no tumor, but there’s in fact one);

• true negative (e.g. report says there’s no tumor, and there’s really no tumor);

• false positive (e.g. report says there’s a tumor, but there’s in fact none);

• true positive (e.g. report says there’s a tumor, and there’s really a tumor).

In the grid:

• the boxes at the top are what most like to hear: report comes back saying the person is healthy;

• the boxes at the bottom are what most dread to hear: report comes back saying the person is diseased;

• the boxes on the left means something went wrong, that caused the diagnosis to be wrong;

• the boxes on the right means it’s a great job, the diagnosis is how diagnoses are meant to be.

I would worry more about the boxes on the left than the boxes at the bottom.

If there’s a health issue, it’s already there. If there’s a tumor, it’s already sitting there. If the tumor is malignant, it is not going to turn benign overnight. That is, going in for a test or a scan, the outcome would either be a FALSE NEGATIVE or a TRUE POSITIVE. Between the two, I would prefer a TRUE POSITIVE over a FALSE NEGATIVE. So that care may be planned.

Praying for negative results (e.g. no tumor), in case of a false negative, means the tumor won’t get treated (which is probably the last thing the pray-er would like). Between a true positive and a false negative, anytime I would prefer the former, so that a good treatment plan can begin.

Some prefer to keep diagnoses a secret. I can think of some valid reasons:

• if disclosed others may become reactive (rather than responsive);

• if disclosed those who react may sensationalize the diagnosis;

• if disclosed others may seize the diagnosis, like a magnet, for projecting their own fears and insecurities-that is a self-dwelling reaction to an aversion;

• diagnoses are often mixed up with prognoses.

Cancer is a diagnosis, not a prognosis. It simply means cell replications have gone haywire. It tells nothing about how long the person will live or how painful the course will be. Year after year, decade after decade, cancer diagnoses and cancer prognoses diverge further and further away from each other. That is a feat.

As with other forks and junctures in life I think a diagnosis is a time for discernment. Not so much a time to fight for fighting sake. Not so much a time to be resilient for resilience sake. Not so much a time to be strong just because self-help books tell us to.