WCOE: Peter Bach’s “The Day I Started Lying to Ruth”

In a series of Well Blogs in The New York Times in early 2011, Dr. Peter Bach wrote about the experiences he and his wife Ruth had when she was diagnosed with breast cancer.   Through his honest, but sometimes raw observations about how the medical system and individual oncologists can help us manage a devastating diagnosis, Dr. Bach’s ability to eloquently  write about these processes when they fail us is informed in a way that few of us will know.  Dr. Bach is not only Ruth’s husband, but he is also a physician with broad clinical proficiencies.  Additionally, he directs Memorial Sloan Kettering’s Center for Health Policy and Outcomes and is a renown epidemiologist and expert in healthcare policy.

What caught our eye this week is an article by Dr. Bach published in the May 6th edition of New York Magazine–“The Day I Started Lying to Ruth.” In the blogs referred to above, Dr. Bach chronicled their shared experiences as they learned about Ruth’s diagnosis and how choices were made about what to do next.  In his most recent writing, we learn so much more about Ruth, their relationship, and how they went through their shared survivorship experience. One would want to think that to write as the well spouse of someone who is chronically ill with a poor prognosis is, at best, a catharsis of some sort for the author.  To do this as a physician and esteemed policy expert, allows the rest of us to recognize that no matter how much we know intellectually about the evidence and predictability of the outcome, we all cling to the hope that we or the ones we love, will be the exception to the evidence stacked against us.

Dr. Bach’s account of this process makes it more clear to all of us that while we are well and removed from the fear and other emotions that strip us of our ability to think more clearly than when we are ill, that we need make a plan for how to best take our turn with survivorship—how we want to live and how we will want to die, whether from cancer or, blessedly, simply old age.  Hope is not enough to get us through those impossible decisions when we are desperately wanting to live, and as Dr. Atul Gawande has so well said, “Hope has many roles, but hope is not a plan.”