Consider a Different “Con” in Medical Decision Making

man with heart image

My neighbor Stan, age 57, was told last summer that he needed open heart surgery, in the midst of the COVID pandemic. He was scared out of his wits and could not make the decision to have the surgery. He lived by himself and had no one to help him out or provide support.

As I was walking my dog one morning, I saw Stan in his driveway. Stan knows what sort of work I do, and he approached me, asking me if I had a minute to chat with him. He described his dilemma, including his inability to make up his mind. In my attempt to be as good a neighbor-advocate as I could be for him, (we didn’t have a formal advocacy relationship. This was just a conversation…) I asked him, “Stan, have you figured out the pros and cons?”

“Oh, sure, of course,” he replied. “But I just can’t figure out which way to go. I don’t have good options.”

So I asked him what pros and cons he had thought of. The pros were all about the repair of his heart and a healthier future.

The cons were the problems that could crop up if he had the surgery. “I could get sick from COVID, or they could botch the surgery, or I could die on the table…” he listed. Fair enough.

But what he didn’t include was the real con Stan needed to face. “OK – let’s try something different,” I suggested. “Let’s look at a different con – the CONsequences of what will happen if you decide against the surgery. That’s a very different sort of con!”

Stan paused. He got quiet. “I’m trying not to go there,” Stan lamented. “I do know the consequences. I can die. My father died from heart disease back in the 1980s. He was only 58.”

That explained so much. My heart broke for him.

Where Stan needed to take his thought process was across all those possibilities. He was having trouble getting past the one. And it was so easy to see why.

The Consequences of No Decision

So, I tried another approach. “Stan, do you realize that making no decision is the same thing as making one? Making no decision at all is the same as deciding against having the surgery. And you know the consequences of no surgery because that’s what happened to your father. Is that the choice you want to make?”

He looked stunned. “I hadn’t thought about it that way,” he replied. “But I see what you’re saying. I’m choosing to die because I’m not choosing the only option I have to live longer.”

Stan got it. I could see it in his face. He thanked me and headed back into his house.

A week later I heard from another neighbor that Stan was being admitted for his surgery. He came home a week after that. That was 5 months ago, and I’ve seen him in his yard many times since then. He’s even gone back to playing tennis again! He has thanked me for forcing him into the right decision for him by making him see the CONsequences of making no decision.

When we are sick, or injured, or debilitated in any way, it’s very difficult to make difficult medical decisions. We don’t have the clarity of thought needed, and often we don’t even understand all our options. We might not even know the right questions to ask. Worse, we might postpone the decision completely, not really processing that by making no decision we are, in fact, actually making one – the decision to default to the problematic situation we already face.

An independent, professional patient advocate brings that clarity and those options to the table. You are the decision-maker. You are the driver. But finding that support from a professional who can help you figure out the right decision for you will always be your best approach.

And here’s a bonus: having made your decision with all that support will further give you the confidence you need to thrive from the choice you make.

Why would you consider doing it any other way?


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