Thursday, December 06, 2007

Gambler's Dilemma

There's a strange paradox in leukemia/lymphoma world -- the more aggressive disease has a higher acute mortality rate, but also a greater sensitivity to chemotherapy which offers the possibility of a cure. Meanwhile, the chronic disease is more indolent (median survival is 10 years), but essentially incurable.

**This is purely a thought experiment, but in pathology lab today, the professor remarked that we are lucky that life does not force us to decide whether we (or patients) have the acute or chronic disease -- but that since survival differences between both disease eventually wash out...there is no clear answer to the question. Would you rather have a severe, sudden disease with a shorter median survival period but the possibility of salvation...or the slowly fatal chronic disease that offers you more time? A reckless gambler might bet on the first horse, the deliberate tortoise (or conservative gambler) might choose the latter.

Personally as a young, grudgingly optimistic gambler, I am more inclined to choose the more aggressive disease since it offers me a shot at being free and clear -- despite the more dismal median survival.

Paul also decided that he would rather have the acute disease, remarking, "Invariably fatal just doesn't sit well with me."

But, isn't being alive invariably fatal?

What do you think?

1 comment:

kim said...

Albert asked me this too. My first instinct is slowly fatal.