Should the Prognosis Affect Me?
First published 3 March 2010
This post is now incorporated with 22 other similar ‘reflections’ in my book, Facing Cancer with Faith.
I was arguing in the last two posts that statistics should not make us despondent or complacent, because our God is above the statistics and has, in any case, assured His people a future victory over every adversity through Jesus Christ.
However, that raises a couple of practical questions which need to be addressed so that we have at least an outline sketch of the full picture.
One of those questions is, if faith in our great God guards against complacency if (from human experience) the odds are good on one hand, and despondency if the odds are bad on the other, does this mean that statistics and odds should not affect us at all? In my case, am I saying that my actions should be completely unaffected by the doctor’s prognosis?
Well of course I’m not saying that. That would obviously be untrue. If that were true, then I would be back at work now.
So I wasn’t in any way suggesting that medical experience, such as treatment success rates, should not be a factor in my decision making and planning. Neither was I saying we shouldn’t weigh the odds relating to various potential outcomes in our decision making and planning in general.
We all have responsibilities in the way we live our lives under God. And even when you’re ill you have to provide for those as best you can. And since different things take different amounts of time and energy, with different levels of urgency and importance, we have to make plans. And since we don’t know everything we have to base plans on “risk assessments”. And risk assessments involve odds, judgments about probabilities of various outcomes, often based on statistics from past experience.
Really we cannot help planning and risk assessments. They are part of what make us human. “Risk assessments” (can’t you tell I’m an accountant?!) simply highlight what the potential risks are in the things that we don’t know about a course of action. If those risks are considered too high, we seek more information until we are comfortable with the risk, or we dismiss the course of action as too risky. “Risk assessments” also help us to develop contingency plans, things we can do if things go wrong to put things back on track. On that basis we make plans.
So my previous essays were not in any way detracting from that. In fact I wasn’t really saying anything about planning. I was really just guarding against the emotional responses that omit from the risk assessment the most important factors in looking at the future – God and His grace.
I’ll come back to my own practical example at the end. But first let’s take a look at what the Bible says about these things. The Bible is full of planning, and we are never criticized for planning per se. “Plans fail for lack of counsel, but with many advisors they succeed.” That was the advice in the book of Proverbs (Proverbs 15:22).
Paul made plans: “… I planned many times to come to you (but have been prevented from doing so until now)…” (Romans 1:13) “When I planned this, did I do it lightly? Or do I make my plans in a worldly manner…” (2 Corinthians 1:17)
So planning is not wrong, but the Bible also encourages us to make risk assessments as well. That’s, I take it, why the proverb says that it’s best to have “many advisors”. Jesus also appeals to our natural inclination to assess risk when we make decisions or make plans when he advises us to count the cost of being a disciple before committing ourselves to him:
“Suppose one of you wants to build a tower. Will he not first sit down and estimate the cost to see if he has enough money to complete it? For if he lays the foundation and is not able to finish it, everyone who sees it will ridicule him, saying, ‘This fellow began to build and was not able to finish.’
“Or suppose a king is about to go to war against another king. Will he not first sit down and consider whether he is able with ten thousand men to oppose the one coming against him with twenty thousand? If he is not able, he will send a delegation while the other is still a long way off and will ask for terms of peace.” (Luke 14:28-32)
There are also right and wrong attitudes towards planning. James says this in his letter:
“Now listen, you who say, ‘Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money.’ Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes.” (James 4:13-14)
If we left the quote out of context, finishing it at that point, we might think that James is just criticizing over-confidence. Perhaps he would prefer it if we just said, “Well hopefully if everything goes well, and nothing goes wrong – because of course I don’t know the future – then I intend, if possible, to do this or that.” That sounds a little more in keeping with the humility of being a “mist that appears… and then vanishes.” But he doesn’t say that. He says this:
“Instead, you ought to say, ‘If it is the Lord’s will, we will live and do this or that.’ As it is, you boast and brag. All such boasting is evil.” (James 4:15-16)
The challenge to the tiny sphere of knowledge about our decision making and planning is not just from the bigger machine of the universe, and the whole course of time, which contains many more variables than we can compute. It is from the One who controls that whole machine – universe and time. Why else would James say that we must humbly acknowledge “the Lord’s will” when we make plans with our own will?
The Psalmist makes effectively the same point, arguing from God’s creating power:
“By the word of the LORD were the heavens made, their starry host by the breath of his mouth.
“He gathers the waters of the sea into jars; he puts the deep into storehouses.
“Let the earth fear the LORD; let all the people of the world revere him.
“For he spoke, and it came to be; he commanded, and it stood firm.
“The LORD foils the plans of the nations; he thwarts the purposes of the peoples.
“But the plans of the LORD stand firm forever, the purposes of his heart through all generations.” (Psalm 33:6-11)
“Many are the plans in a man’s heart, but it is the LORD’s purpose that prevails,” it says in Proverbs 19:21.
So for me, knowing the medical experience of success in treating my kind of cancer is useful information. It helps me to plan the things I should be prioritizing in the short term and long term. Different success rates lead to different predictions, and therefore result in different priorities and contingency plans. But when I make those plans and decide on those priorities I do it with humility, recognising that I don’t have all the information, and that God is the one whose purpose is really going to prevail. So I say, “If it is the Lord’s will, I will do this and that or go here or there…”
Therefore, whilst it is right to plan, and to assess the risks (including recognizing the odds/chances of success), we must do so with humility, acknowledging that the Lord’s purpose will prevail over ours and we accept that. And the reasons we accept it without grumbling are the ones we looked at the previous two articles – we know God is powerful, He is good, He is on our side in Jesus Christ, His Son, and His purpose includes rolling everything towards a great future that will include rest, peace and joy for His people for eternity.