A skeptic's experience of a "cancer scare"

Less than three weeks ago I was sitting opposite my GP when I heard the words any sensible person would dread. Well not really all of the words; it was every other phrase or so. "Shadow on the lung", "urgent referral", "need to exclude cancer", "this is not a diagnosis"…

Well, there you go. Looked pretty bad from where I was sitting. After all, I was carrying the two biggest risk factors for cancer: smoker; old.

One always wonders how one will react to such a conversation, and it's impossible to predict, however well one knows oneself. In particular, how I might react as a trained scientist and atheist. My variety of atheism is probably the variety you simply can't undo. It's based far too much on a deep love of and joy in being rational. And a powerful resistance to simply "believe what I'm told", a modality of thinking not easily undone.

As I walked slowly back home from the surgery, what was my state of mind? I can tell you this: I was completely calm and completely terrified all at the same time.

I know that it's hard to believe that two such seemingly mutually exclusive emotions can live together, but there you are. Playing a sort of background noise to all this was a welter of practical questions such as, Who should I tell (or not tell)? How will I manage my working life (I had immediate work commitments away from home)? How long shall I have to wait (was it going to be the full two weeks)? How will I cope with the uncertainty?

I can also say this: at no time - not for an instant - did I feel the slightest urge to pray, or to wish I had the "comfort" of belief. In fact, my unalloyed atheism was itself a great constant and comfort during the waiting and the wondering.

Did I have hopes? Well obviously in the sort of everyday sense I "hoped" that I didn't have cancer. But I am a realist. I discovered that unfounded, irrational hope was not for me. I couldn't "unknow" the odds. Better to deal with the likelihood...

In the days of waiting I discovered how immensely helpful to me was my training as a scientist, my understanding of statistics, my previous months and months of learning about the great harms done by false hopes peddled by the alternative medicine industry, my much deeper understanding of all this which came from reading the likes of Simon Singh, Edzard Ernst, David Colquhoun, Ben Goldacre, Margaret McCartney, Rose Shapiro, Steven Novella, Rob Buckman, John Diamond, Christopher Hitchens, James Randi and many others.

Therefore I was wearing powerful protective armour when I did my inevitable googling.

For the scared patient, the internet is not a minefield of dangerous batshit. "Minefield" is too weak (and clichéd) a metaphor. The internet is a turbulent ocean of dangerous batshit with a few tiny, scattered islets of fact and rationality. But I had good pilots with me, and the islets are there for those who know where they are, or for those who are guided to them by a the good and brave people such as those I have mentioned.

One of the most truly helpful things I had learnt was that there is no good evidence that "maintaining a positive attitude" has any effect on one's outcome, should one indeed have cancer. This was helpful because when my mind wanted to think through the worst, I simply let it. I did not try to distract myself. Nor put on a "brave face" to myself, even if I did to the few people that knew of my worries. The rational, thinking mind needs to think, not suppress that thinking, however unpleasant or frightening those thoughts may be.

And a few, angry, words about "being brave" and "battling" against cancer. The patient doesn't (can't) battle against cancer. That's what the clinicians and the researchers do. Bless them. (Shame there's not an atheist equivalent of "bless"!) The patient is the one most intimately concerned with a very serious problem, and the rational thing to do in that situation is to seek the help, support and advice of those most realistically able to deal with the problem - all those involved in modern, science-based, evidence-based medicine, and in the best clinical care. And if the patient dies, it’s not the patient’s fault and they haven’t “lost” through some moral weakness. They were gravely ill and they died. There’s a difference!

Well I had my appointment. The news looks good. There will be follow-ups, but that’s good precautionary clinical practice.

What have I learnt?

·       It is perfectly normal to be a rationalist atheist and skeptic - and thoroughly terrified all at the same time

·       It won’t harm you to be frightened

·       It helps to think, even when the thoughts are scary. Having a reasoning mind is at least as great a comfort as having “belief”, and will lead you to good, sound information

·       I’m even more angry now with the quacks who prey on the vulnerable

·       More than ever before, I value and honour those who battle (correct word this time) against superstition, unreason and quackery