To Exquisite Specificity

Cancer treatment in the 1970’s was brutal. The War on Cancer had just begun and doctors were in a race to defeat it, to overcome it, to eliminate it. They knew enough to be dangerous.

Normal Cells

I want to believe doctors are driven by science, not metaphor, that they would never let that more human side of them overtake the more rational side. I want to believe they weigh all their decisions on the scales of what they know to be effective, that they never make assumptions because they have a story in mind about what’s possible.

I listen to the doctor tell the story of a woman with a 30% chance of survival. The key, he says, is getting her to trust him. He’s honest and confident and so she agrees to a painful, toxic course of treatment. She’s still alive today, he says.

But if she had a 70% chance of dying, even with this chemo, was the key her trust in the doctor? Wasn’t it whatever freak of nature that happened that tipped those odds to her favor? Without the treatment, she would have died, but with it, her chances were only slightly better. Weird, not-yet-defined chemistry saved her. Not trust. Not confidence.

Cancer cells. Note how they are more crab-like. Hence the name.

We know so much more know, the doctor says, we have drugs with exquisite specificity. Unlike the old drugs, that killed all the cells indiscriminately, these drugs seek out, attach themselves to, and kill just the cancer cells.

Why are we continually surprised by the need to be specific and by our ability to figure out how to be specific? Generalizations have never cured anything: not disease or hunger or poverty or ignorance. Every problem needs a solution with exquisite specificity.