“I had to admit I was more than a little excited to see my next patient. This was a big day, for both of us.
“Five years earlier, when he was 68, he had come to the emergency room, feeling terrible. His white blood cell count was higher than his age, and he was profoundly anemic — really, to a degree that was almost incompatible with life. He was transferred to our hospital, where we performed a bone marrow biopsy that clinched the diagnosis of acute leukemia.
“ ‘You sat on my bed,’ he said to me, ‘and you gave it to me straight. You laid out my options.’ He stared up toward the fluorescent lights in the clinic room, thinking back to this seminal moment. His wife sat next to him, focusing on his face, her smile frozen as she probably thought about that same moment from her own perspective.
“For people approaching their eighth decade, the decision of whether or not to take chemotherapy for leukemia is anything but straightforward. The treatment can be brutal, confining a person to his or her hospital room for a month, and it can accelerate a death that might have taken months if the leukemia were left to its own devices. People go through with it to try to win the golden ticket — the chance to be cured of leukemia. In someone my patient’s age, that occurs only 5 percent of the time.”