Life in Jeopardy

Alex, I’ll take standing on my soap box for $200.

HOPEspotters, yesterday, long time “Jeopardy” host, Alex Trebek announced that he has been diagnosed with Stage IV Pancreatic Cancer. This is a devastating disease. Mr. Trebek released a video sharing his news and provided his positive outlook on his situation.  He states the announcement is in “keeping with (his) long time policy of being open and transparent with the “Jeopardy” fan base.

“Just like 50,000 other people in the United States each year, this week I was diagnosed with Stage IV pancreatic cancer. Now normally the prognosis for this is not very encouraging. But… I’m going to fight this. And I am going to keep working. And with the love and support of my family and friends, AND with the help of your prayers, also, I plan to BEAT the low survival rate statistics for this disease. Truth told, I have to. Because under the terms of my contract, I have to host “Jeopardy” for three more years. So HELP ME. Keep the faith and we’ll win. We will get it done. Thank you.”

Friends, I am not about to kick someone when they are down. Let me be absolutely clear that I am terribly sorry for Mr. Trebek and his family.  I absolutely wish him the very best. And until I walk a mile in his pancreatic cancer filled shoes, I am NOT going to judge his reaction. I have NO idea how I might respond in a similar circumstance.

I am, however, going to use this public example as a critical teaching moment because I feel like I have to. There is SO much to unpack in Mr. Trebek’s situation and statement that it would be.. negligent.. for those of us who see these cases to remain silent.

Media around the country today was flooded with well wishes for the long time, beloved game show host. The constant commentary frequently included, “he’s a fighter” and “if anyone can beat it” and “he’s got the right attitude”.

While these are wonderful sentiments, and well meaning I am sure, I challenge the speaker to sit and say these words to someone with Stage IV pancreatic cancer. In their bedroom. Because they can’t get up and get dressed. Because they are too sick. And they just barfed their toast. And they are terrified. And really, really, sick.

Cancer really challenges the adage that attitude is everything. And suggesting it to the patient can be totally out of place.

Further, can we finally debunk the notion of the “cancer fighter”? Everyone who has cancer, had cancer, fears cancer, survived cancer, fights. It is all a fight. A terrifying, soul searching, highly inconvenient fight that often offers strange and scary forward paths. “We didn’t get it all”. “There is a clinical trial that is being offered..” “We can’t do treatment this week because your levels are too low..”

It can be like a blind folded boxing match with multiple, fierce opponents.

Everyone fights, Mr. Trebek. In 20 years of sitting at the bedside of people with your diagnosis, I’ve yet to meet the person who has said, “Eh… no biggy.. I’m just going to roll over..” Even, and perhaps most especially, the patients who have told me, “I am done with treatment” are fighters because they have decided to fight for different things: peace, comfort, dignity.

Fighting for a legacy is still fighting. Without question.

So please, oh please, let’s reframe the “fighter” paradigm and let’s be awfully careful to not assign those who make different choices as ones who’ve “given up”. They’re already afraid enough of that suggestion. It can be crippling.

Mr. Trebek also states he plans to “beat the low survival rate statistics for this disease”. Clearly, I don’t know when the famous game show host was diagnosed or what the situation was that predicated his diagnosis. I can imagine he is in shock, so again, I don’t judge him for his words. But Mr. Trebek, the survival rate for Stage IV is 3%. Yes, I believe in miracles but I also believe in science and the benefit of expert opinions. In my work, the hardest thing is balancing real hope against false hope which is done by restating the question, “what are we hoping for?”

Additionally, Mr. Trebek’s brazen suggestions that he has got the upper hand on his illness makes me worry that there are thousands of very sick cancer patients calling their oncologists today screaming, “Give me what Trebek is having!” If only. If only…

Finally, Mr. Trebek’s statement concludes with “keep the faith and we’ll win”.  I’m sorry. That breaks my heart. For all the millions of people that admire the long time Jeopardy host, I fear there may be some who will deeply believe their faith and their prayers will save him. I believe in prayer and I believe in hope but I recoil when we offer false guarantees. I believe in God. And I don’t question that. I’ve been at the bedside with - I hate to say- HUNDREDS of patients who wanted to believe their faith would guarantee them a win.

When the win isn’t delivered, the loss is exponentially devastating.

Let’s all be mad as hell at pancreatic cancer. It is an asshole. Let’s all pray for people with love and people with cancer and double pray for people we love who have cancer. And certainly, let’s all pray for Mr. Alex Trebek. For what I know of his life and career, he’s very well liked and considered very smart. Unfortunately, neither of these things kept him immune from the deadliest cancer. At age 79, he’s going to face a very difficult situation.

Here’s the upside: “Jeopardy” reaches millions of Americans every night and it helps make them smarter. Let’s hope that Mr. Trebek’s VERY unfortunate situation can be an opportunity- going forward- to educate the American population about hard choices and palliative care.

What if he said instead, “My friends. I have received a devastating diagnosis that is Stage IV pancreatic cancer. I didn’t see this coming and it is very frightening. While there are so many things I don’t know, here are the things I do: I don’t want to spend my time in the hospital. I want to be optimally comfortable. I want to spend my time with my family, reviewing my wonderful life and finishing my business. Therefore, I am resigning my position, that I have deeply loved. Thank you for all you support over the years. Please pray for me and all the people facing cancer. We need grace.

Because in the face of Stage IV pancreatic cancer, I will take grace for $1000. With a daily double for palliative care.