Numbers Mean Squat

I will never forget the moment I woke up after my hemicolectomy in the recovery room. Josh was being consoled by Tim, the nurse, and my surgeon, Dr. D.C. He was being told that he had to take care of himself in order to take care of me. Tim asked him if he’d eaten dinner and, before Josh could answer, brought him a slice of pizza from his own dinner. Even in my anesthetized state, I knew something had to be really wrong if everybody was fussing over Josh and not me, the person who had just come out of surgery.

So when Dr. D.C.’s youthful face appeared before me, I croaked out, “Is it dire?” Based on the mood in the room, I fully expected the answer to be yes.

Instead, Dr. D.C. said, “No, it’s not dire. It’s very serious but it’s not dire.” He went on to explain to me that he had successfully removed the tumor, but that he had found one “pea-sized drop metastasis” to the peritoneum in the area above the bladder, literally a drop off the main tumor. I thought to myself, okay that doesn’t sound that bad — a pea-sized drop met that was also removed — so why was Josh so upset?

I lay there in my drugged state, letting their conversations wash over me as I worked myself to greater wakefulness. Dr. D.C. said that I wouldn’t remember anything that was being said that evening. Josh told him he wouldn’t be so sure about that. I smiled to myself. Years of being with me had taught Josh that my mind is like a steel trap and that, drugged or not, I don’t forget anything (especially when it’s something I can use against him).

I, in fact, remember a lot from that evening. In addition to the physical discomfort of just having come out of surgery, I remember thinking that the surgery must have taken way longer than the estimated 2.5 hours since it was dusk outside. I remember my brother and cousin coming to visit me in my hospital room. Most of all though, I remember everyone throwing numbers about. 1 drop met. Stage IV. 6%, 8%, 10%, 15%. 30-year-old numbers.

Because I had one metastatic spread of the main tumor to another part of my body, regardless of the number or size of that spread, I was thrown into the category of Stage IV. Stage IV colon cancer is associated with very low survival rates, ranging anywhere from 6 to 15%. Dr. D.C. repeatedly told Josh that evening that the statistics on survival rates are themselves based on 30-year-old studies and therefore should not be relied upon.

Once I grasped that everyone was preoccupied with the numbers, I understood why Josh was so upset. Josh loves numbers. He can do complicated arithmetic calculations in his head. When we first started dating, he’d asked me at various points during our courtship, “What do you think is the percentage likelihood of us getting married?” He’s memorized every Super Bowl score since the beginning of the Super Bowl. He can remember that Federer was down 5-3 in the second set of the third round of Wimbledon in 2009. For him, as for many people, numbers impose order in an otherwise chaotic world of randomness. And to be told that his wife has Stage IV colon cancer and therefore possibly a single-digit likelihood of living five years was understandably and especially devastating.

Josh sobbed that night and early the next morning, as he googled again and again survival rates for Stage IV colon cancer from the recliner that was doubling as his bed. The light from the iPad cast an eerie glow on his face in the darkness of my hospital room. He didn’t want to discuss the statistics for fear that they would upset me, but Josh can never hide anything from me — that’s one of the reasons I love him so much.

And then he was incredulous when the numbers didn’t actually upset me. “So what?” I said. “Don’t you get it?” he demanded, wanting me to understand the seriousness of the situation.

As much as Josh loves me, he cannot comprehend a fundamental truth about me simply because he hasn’t lived my life. He doesn’t understand that my very existence on this planet is evidence of how little numbers matter to me. Numbers mean squat. I asked him that night to go back to 1976 into the desolation and hopelessness of Communist Vietnam and set the odds of a blind girl making it out of that unimaginable poverty, of her escaping the stigma of having a physical deformity that would make her undesirable to any man and unworthy of being any child’s mother, and of her withstanding the shame of knowing that she would forever be the burden of a proud family that would have to care for her like an invalid for all her life. I demanded that Josh set the odds of that little girl surviving at sea when so many grown men perished, of her gaining some sight despite years of optic nerve damage, of her achieving academic success despite the low family expectations stemming from immigrant ignorance, of her graduating from Harvard Law School, of her establishing a legal career at one of the most prominent international law firms in the world, and finally, of her marrying a handsome, brilliant man from the American South and then having two beautiful daughters with him. Of course, Josh couldn’t set the odds.

Josh has spent many hours reading medical studies, trying to increase the likelihood of my survival. A single metastatic spread as opposed to multiple metastatic spreads yields some additional percentage points, as does my age and fitness, as does the fact that I have access to the best medical care in the world, as does the fact that I have a wonderful support system. According to Josh, this raises my odds of living five years to somewhere in the vicinity of 60%, which is to him a hell of a lot better than 6%.

Honestly, 60% doesn’t sound that great to me either. In truth, anything short of 100% is insufficient. But as we all know, nothing in life is 100%. The odds of a woman under 40 having colon cancer is 0.08% according to a Mayo Clinic publication — Josh tells me this sort of thing because I personally don’t google anything to do with statistics. That number takes into account women being afflicted with the disease for genetic and non-genetic reasons. My tumor showed no genetic markers, which means that the likelihood of me having colon cancer is even less than 0.08%. My phenomenal internist told me that in his 37 years of practice he has never come across a case where someone as young as I developed colon cancer for non-genetic reasons. Don’t I feel so special? I had at least a 99.92% chance of not developing colon cancer at this point in my life, and I got it. So you see, anything less than 100% provides me little comfort.

So numbers mean squat. They neither provide assurance nor serve as a source of aggravation. Sure, it would have been better if my cancer were Stage I and there had been 0 metastatic spread, but even when the odds are in your favor, you can still lose. For all of Josh’s obsessiveness with statistical odds, he always tells me whenever the underdog wins the football or basketball game and defies the odds, “That’s why we have to play the games.”

So I’m here to play the game and I choose not to live and die by what the odds-makers say. I choose not to put faith in percentages that were assembled by some anonymous researcher looking at a bunch of impersonal data points. Instead, I choose to put faith in me, in my body, mind and spirit, in those parts of me that are already so practiced in the art of defying the odds. Coach Taylor always told his ragtag Dillon High School Panther football team on Friday Night Lights, “Clear eyes full hearts can’t lose!” I have clear eyes and a full heart.

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8 Comments (+add yours?)

  1. Anne Marie
    Aug 30, 2013 @ 11:43:27

    It’s clear why you became a lawyer – you make a very good argument. I am betting on you! 🙂

    Reply

  2. Maxine Jaramillo
    Aug 30, 2013 @ 12:54:11

    You are truly someone very special….of course I knew this when we worked together, but now everyone else knows it too. Love you.

    Reply

  3. aileen
    Aug 30, 2013 @ 14:17:08

    I love reading your blogs. You are so inspirational. Keep playing!

    Reply

  4. Dana
    Aug 31, 2013 @ 14:52:08

    thank you for sharing. You ARE kicking butt one way or another. We ARE you cheerleaders. You ARE amazing!

    Reply

  5. John
    Sep 03, 2013 @ 23:59:47

    Julie, I am so sorry to hear about what happened to you. Your blog is really eloquent and inspirational (this was my favorite entry). You’re incredibly strong and resilient, yet realistic and pragmatic. I am looking forward to reading your future postings (especially the one where you will show everyone once again that “numbers mean squat” and you’re able to announce that all tests indicate you are cancer-free). Peace and God bless.

    Reply

  6. Shan
    Sep 04, 2013 @ 16:11:53

    Wow, I didn’t know about the statistics, but it’s amazing you ended up with such advanced colon cancer (given the numbers). I’m sure you’ll be in the outlier on survival too. This is such a great post, Julie.

    Reply

  7. poorab
    Sep 06, 2013 @ 16:08:19

    We haven’t had a chance to talk, Julie, my fault, not yours of course.
    I stumbled on this post from the facebook link, even though I have an inactive fb account I never use I decided to click on this link. Simply because it was you who wrote it.
    I’m glad I did.
    As usual, your writing is incredibly eloquent. I’ve always admired you for what you have accomplished, envied you for your ability to put it into words, and known that facing what you have faced my outcome would have been much different (and ‘worse’).
    So this may make no sense or all of the sense in the world: When I heard about your diagnosis I was both devastated and yet not afraid for you. I simply said aloud and to myself – ‘if there is someone who can and will beat the odds, it is Julie.’ The odds are just that – odds, and not uniquely quantifiable to the individual person and all that they bring to the table.
    I’ve told countless (pessimistic) patients facing visual problems about my friend who is basically legally blind and went to HLS and has two beautiful kids. Reduced to that simple sentence it seems like a trite throwaway line. Yet, it changes the dynamic every single time. That’s what I always think about when I think of you – that you change the dynamic every single time. This time will be no different, I can already tell.

    Reply

    • julielyyip
      Sep 06, 2013 @ 16:33:09

      Oh Poorab, thank you so much for this. As a long-time friend and an ophthamologist, you know better than anyone what I’ve had to deal with with respect to my limited vision. So your words mean so much and inspire me.

      Reply

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