paradox

Me: You've got to understand. Your mother is eighty-nine years old. And she's frail: hospitalized seven times in the last two years. She doesn't have a good chance of surviving this pneumonia.

Them: But she's a fighter! She's been through worse than this. Do you know how many times before we've heard this same gloom-and-doom speech from doctors like you? Do everything you can, doc. We're sure: Mom's going to live.


I've discovered a paradox. I can't untangle it. It ties my brain into a Mobius strip and makes me claw the insides of my skull if I think on it too long. Here it is:

Experience tells me that the older a patient is, the more likely she is to die from her illness. Families, however, have the opposite experience. If their mom has come through eighty years of life without dying a single time, that's a convincing pattern of staying alive. If she's spent ninety years not dying, that's even better. And as she goes on amassing years of life on earth, her statistical probability of being alive and not dead at any given moment continues to increase.

Experience also tells me that the more times a patient has been hospitalized in the past, the more likely she is to die. A patient who's in and out of the hospital is by definition made of weak stuff -- which means she's slow to recover and always in danger of complications. But here again, the family's viewpoint is different. Mom's always beaten the rap before, they say. If she's survived three past admissions, she's got a three-and-o record under her belt for beating the spectre of death. If she's come home alive from nine admissions, that makes her nine-and-o -- a hell of a winning record. She didn't die the last nine times, her loved ones muse; so why would this time be any different?

The doctor bases her argument on common-sense medicine. The family bases theirs on pattern recognition and inferring probabilities from past experience. Which side has the greater claim to truth and logic? I've been contemplating this conundrum for years now, and I still can't resolve it. Someday I'm going to dwell on it too long, and be found dead with black smoke issuing from my ears.