Even When a Disease is 'Incurable,' Don't Kill Hope


Television actor Michael Landon, by going public with the news that he has cancer and with the details of his treatment, has shown tremendous courage. Unfortunately, Mr. Landon has already paid a heavy price for his bravery.

Since he disclosed his illness in early April, countless publications, including The Evening Sun, have printed stories containing specific prognoses for the 54-year-old actor. All of those predictions -- culled from doctors with no relation to Mr. Landon -- have been dire. They give him anywhere from several months to several years to live.

The tabloids, in typical fashion, have done worse by giving him only weeks.

The actor himself, who displayed extraordinary grace and even humor during the early weeks following his diagnosis, has more recently indicated through his doctor that he is angered by reports setting a time limit on his life.

Few could be surprised by Mr. Landon's reaction. But we also should not be surprised at the response Mr. Landon's illness has gotten at the hands of the media.

Others facing a life-threatening disease have similarly been treated as if the remainder of their lives could be measured by an hour glass. Hard-nosed journalists, uncaring physicians and oafish relatives share the blame.

As it is, what the Landon saga reveals is the very current struggle between those who believe in the possibility of healing through hope and those who are adamant in their lack of hope when it comes to some illnesses.

Within the medical profession, some doctors have long understood the relationship between a patient's positive outlook and his longevity and possible recovery.

This understanding, however, has not been universal, and some doctors still cling to the notion that a bleak prognosis should be explicitly stated without regard to impact on the patient's attitude.

Others, in and out of the medical profession, have been on the vanguard of pushing the notion that hope and the active involvement of patients in their own survival can make the difference between a longer life and a quick death.

The late editor and essayist Norman Cousins, who himself experienced tuberculosis at a time when it was considered almost always fatal, was an early proponent of the positive effects of attitude. His 1979 book, "Anatomy of an Illness," is about his own recovery through positive thinking and is considered a classic on the subject.

Mr. Cousins described his stay at a tuberculosis sanitarian at the age of 10, where he quickly divided the patients into two categories: those who thought they would conquer the disease and those who were resigned to a long and perhaps fatal illness.

"When newcomers arrived at the hospital, we did our best to recruit them before the bleak brigade went to work," he writes.

The surgeon Bernie S. Siegel, author of the 1986 best seller "Love, Medicine & Miracles," describes his denial and then conversion to the idea of healing through hope after witnessing the near miraculous recoveries of patients who were bent on survival.

The fact that many scoff at the ideas of Mr. Cousins and Dr. Siegel should not be surprising. The clash between the strictly spiritual and the strictly scientific has been historic and bitter.

One rule of thought seeks to explain man's environment in the context of a divine power, the other through principles that can be quantified and proved.

But authors such as Mr. Siegel have attempted to bring the two schools closer, suggesting that in fact prayer, meditation or just having a healthy outlook can actually create chemical changes in the body that fight disease.

While not abandoning his belief in positive thought, Dr. Siegel admits that much more research needs to be done on the effects thoughts have on illness. He also encourages patients to find physicians they trust and feel comfortable with and to follow their doctor's orders.

"I don't know the future for any individual but I do know there is hope," Dr. Siegel writes. "Just as I know there are many people dead today because they lived out their doctor's predictions."

For those with a life-threatening illness these can be comforting thoughts when contemplated within the relative anonymity enjoyed by the average person. But for a celebrity such as Mr. Landon, other influences -- those of a more cynical variety -- are difficult to escape.

The media's role in the Landon affair is extremely unfortunate and signals a need to rethink the coverage of disease in our culture.

Assertions about the public's right to know should never be so callously applied when the result is that it could shatter a person's hope for life. What other purpose is served in publicizing the predictions of doctors about the life expectancy of Michael Landon?

And it is not only Mr. Landon who is ill-served. A number of illnesses -- AIDS in particular -- have become diseases of choice among editors and reporters looking for "good stories" with seemingly tragic overtones.

While these reports should include realistic assessments of life expectancy, a bad prognosis should be tied only to a general description of the illness, not to a particular individual. Moreover, these predictions should be balanced with the warning that no one knows how long someone with an illness will live.

To do otherwise is excessively cruel and particularly unfortunate in light of the fast pace of medical advances and the new thinking being applied to the relationship between positive thinking and survival.

In the end, Mr. Landon may have done us all a favor.

His determination to live in the face of cynicism should not only serve him well, it should give immeasurable comfort and encouragement to anyone facing a similar ordeal.

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