On Luck, a Philosophical Interlude

There was a patient I once had; almost exactly my age.  He had never had money.  He had never gone to college or had a good job.  He married once and had a child but hadn't seen him for years.  He did something stupid but not violent that led to a short jail sentence.

During that sentence, his bad habits and bad genes caught up with him and sent him into severe liver failure. He was transferred to the prison ward of my hospital and became my patient.  He had weeks to live.  I contacted his judge, who allowed him to come off the prison ward to die on the regular ward. 

One clear spring day, I wheeled him outside.  He lit one of the cigarettes I had bought him.  He looked at the sky and out over the lovely park in front of us, and he said, "I guess it's been a good life."

Who is lucky?  A lot of people have commented on how unlucky I am.  It's true that I have had many absurdly serious health crises for someone my age.  But I don't think that's the same thing as being unlucky.  In my life as a cancer patient (for instance, Saving the Girl), and in my career as a doctor, I have seen a lot of unlucky people.

The unluckiest have been children.  When I did a pediatric oncology rotation in medical school, there was a teenage girl who had a brain tumor.  The surgery to remove it had left her terribly brain damaged and on a ventilator.  Her wrists were tied to the bed to keep her from tearing  her many tubes out, and she would frantically gesture with her hand as if she wanted a pen.  One day I gave her a pen, and I put a pad underneath it.  She scribbled violently and randomly.  And when I took them away, she continued the frantic gesturing as she did every day, trying to send some message that may not even have had words anymore.  She never made it off that ventilator.

As a doctor to adults, I see all sorts of misfortune.  Patients will open their hearts about their history of childhood abuse, or the spoiled marriages they can never leave because you need two incomes just to keep a roof over your head and the refrigerator full, especially if you are old.

Even if I die tomorrow, I am lucky.  I was born into a family and a place and a time which gave me protection in my crises.  No one important has ever made assumptions about me based on how I look.  I have a happy marriage with a thriving son, and I have wonderful relatives on both sides who are there for me.  I have dozens of close friends ready to help in crisis.  I have a good job.  There are people I have never met who read my updates and offer sympathy and support.

So, no, I am not unlucky.  Thank you to everyone who makes that so.