Now it is said:
The words to unerasable printer's ink committed,
And I have done
What I feared most to do; Put on clinician's mantle,
Knowing that by so doing,
I both preserve and kill;
That where I am in error,
Or not clear,
Someone may die sooner
Because of words I wrote.
I apologize to myself and say
"That for the love of those in pain,
I use the power of the pen
To give some comfort;
Help some to see what choices are."
And know this is not true --I write from vanity,
And hope that I am wise enough
To give more comfort than pain
--More life than death.

I have tried, insofar as it is possible, to keep this part of the book general, and have avoided being too specific. My reason for doing this is that information changes, and often very rapidly. I do not want to tout a particular treatment only to find that the information is wrong. What I have said and documented about breast cancer applies equally well, in principle, to most other forms of cancer and their treatment. It should give a patient some idea about the questions they might ask their physicians, and roughly how much salt should be taken with the answers. There is no way that I know of to provide specific answers based on generalities. Nor can anyone predict what will happen to an individual by looking at the odds.

It is extremely difficult to maintain one's rationality in the face of the most severe emotional stress imaginable; impending death. Hopefully, the reader in these straits has already selected a physician who is basically a rational man. The rational physician has learned to cope with many of the problems of the cancer patient. He is also a human being, and has his "hang-ups."

As in most human transactions there is a lot to be gained from all parties having a high degree of awareness. I know of no easy way to acquire this, and often it is in the process of handling difficult situations that the awareness comes; some times too late to be of much value.

I think that I have probably been too hard on the surgeon and therapists. This was deliberate, because I think that the types of inquiries that this book provokes will eventually help both the physician and the patient. I hope that the love and compassion that I feel for the conscientious physician has not been obscured by our differences. I believe that the physician is basically "good," even though the results of some of the things that he does may be "bad." Mistakes have to be considered in the light of the amount of comfort that the physician gives to the patients; and one must always be aware that he is often forced to make decisions based on entirely inadequate information. He is not someone apart; he is in the same boat that the rest of us are in.

Many of the undesirable things that are done in the world are done by good, well-meaning people. I have only to think of the people whom I have injured, and to conjecture about the potential effects of this book, to know that I am not someone apart. I have taken R. D. Laing's advice and looked at myself in a mirror. What I see there is at least as disturbing to me as what I see elsewhere. I do not wish to criticize people, only acts; and to increase the accuracy of the information available to the public. I regret that I could not provide the definitive information that many of you need in order to make rational decisions. Some of the information is accessible to your physician; but most of the important data just does not exist at the present time.

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