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Elizabeth Edwards' response to her latest cancer diagnosis offers both useful lessons and cautions for the rest of us.

She decided on her course - to receive treatment while participating in her husband's Presidential campaign. I applaud her stance because she is responding to a difficult situation by considering carefully the contingencies of a complicated life and will now move forward with confidence that this is the right way for her.

But her solution isn't necessarily the appropriate one for others. It would be unfortunate if she became a role model that they measured their decisions against.

Most of us who have received a life-threatening diagnosis find some choices about how to respond quite limited. For example, many of us aren't lucky enough to have such a supportive spouse or can't afford to quit the workforce.

Our situations may be quite different, particularly if we are dependent on employer-provided health insurance. For most working people there is no choice but to stay on the job. And few of us have access to the broad menu of sophisticated medical care that is available to Ms. Edwards.

Her continuing enthusiastic support for her husband's campaign includes a provocative bit of irony. He's campaigning to unite what he describes as two Americas and reduce the gap between the haves and the have-nots.

Many of us strongly support that goal. In my interviews with patients confronting similar devastating diagnoses, I learned both how constrained the world of the have-nots is when one is facing the prospect of complex on-going medical treatment, and how fearful the more fortunate are about falling into that daunting world. That's not a problem Ms. Edwards will have.
After considering the resources available, she has "made the choice to live," as she puts it, through a series of actions that are right for her. All Americans should endorse her decision and hope it leads to a long and happy life.

One beneficial consequence of her decision to speak about her illness is that it may encourage others to think about how they would respond to such a health crisis. But after a serious diagnosis, almost all of us also "make a choice to live," even if our lives will be foreshortened. Hers is not the only way.

In making "a choice to live," some of us will continue to work, others will be too ill to do so, and a few of us will quit our jobs and head off to Tahiti. Some of us will first carefully gather medical information from many sources before we chart our course, some will follow the advice of the first physician we see (regardless of her expertise), and some will devise a course of treatment that draws from different healing traditions.

Many of us will lean heavily on friends and family while we are ill while some guard our privacy and go it alone.
There is no universally appropriate response to a life-altering diagnosis. Each of us must evaluate our own situation as Ms. Edwards has done, and then build on the few certainties we possess to weave together a deeply personal response to our illness with the kinds of support we find helpful, with all the grace we can muster and with all the dignity we deserve.

AFTERSHOCK

Public interest in Center President Jessie Gruman's new book, AfterShock: What to Do When the Doctor Gives You -- or Someone You Love -- a Devastating Diagnosis, surged as the press reported recurring cancer diagnoses for White House spokesman Tony Snow and Elizabeth Edwards, wife of a Democratic Presidential contender. In response, there was an encore appearance on Judy Forman's internet radio show, "HealthTalk Live."

Other book-related appearances included a March 29 talk at the NYU Clinical Cancer Center and a March 26 appearance on New York public radio station WNYC. Dr. Gruman began the month with a CBS News “Up to the Minute” and subsequently was interviewed on the WBAI (Pacifica radio) Health Styles program and on Andrew Schorr's Patient Power that airs on HealthRadio.Net.

KELLOGG HEALTH SCHOLARS

The Kellogg Health Scholars program cosponsored a workshop on behavioral research methods with the National Cancer Institute March 18-20. Kellogg Scholar alumna Ronica Rooks, Kent State University; Kellogg Community Scholar Dawnavan Davis and Kellogg Health Scholar Phoenix Do attended the workshop.

NEW INITIATIVES

As part of our initiative to develop strategies to engage older people in their health and health care, the Center convened three day-long meetings of stakeholders and experts. Participants at the first meeting discussed the potential of public libraries to serve as a focal point for health information for older people and their caregivers. The discussion at the other two meetings revolved around the feasibility of community partnerships to work for changes in local public and private policies to reduce barriers and increase opportunities for older people's engagement in their health and health care.

NEW STAFF

Jim Jaffe has begun a term at the Center as acting vice president of public affairs. Among his duties will be regularly updating the blog and sharing responsibility for producing the daily Health Behavior News Digest.