On Uncertainty

There's someone in my close circle who is undergoing chemotherapy. This week we are confronted with yet another of the many decisions that need to be made along the way. Actually, seen from the narrowest perspective of the chemicals and the illness and the interaction between them, there shouldn't be much of a deliberation; the situation is pretty clear. But then you factor in other imponderables, such as the physical condition of the person, and then their frame of mind. The physical condition can be mostly measured, sort of; the frame of mind, which is probably far more important, can't really be measured at all, not in any scientific way. And then there are other legitimate considerations: the time of year, the shifts at the hospital, this that and the other. Pretty soon, what started out as a simple equation is anything but.

Then there are the questions of who makes the decision, and by which criteria. At an earlier stage, many months ago, we learned that expert number one in North America would have had a clearcut opinion about the deliberation we were facing at that time, but that his position would have been the opposite of that of the entire relevant medical establishment in Germany; the person telling us is himself a world renowned expert, and he was telling as an explanation for his own uncertainty.

And that assumes it's the physicians who should be making the decision - a position which itself is hardly obvious.

At the heart of the matter lies our uncertainty. We don't know what will happen tomorrow, or next week, or next year. So we do our best with what we have.

This uncertainty is the foundation of the entire human condition, isn't it. It's what medicine is about, but also politics, and history. It's what economics are about, and all ideologies and Weltanschauungen. If it isn't what literature and poetry are about, I can't think what is. And religion, of course. Cynics will say that religion is what gives unknowing people the tools with which to lull themselves into the ability to make decisions by comforting them that they're correct. Respecters of religion will say that it gives people the dignity to live with their decisions, whatever they might be.