I was rewatching an old video on YouTube and the guy was able to walk again after 10 months of practicing yoga and losing 140 lbs. If no one on earth can exactly predict when someone will die or if they’ll be able to walk again, how and why do doctors come up with these predictions?
https://youtu.be/qX9FSZJu448
In: Mathematics
I’m not sure if anyone else brought up this point but that guy put a lot of work into his recovery. Most doctors are basing their predictions like that off patients they had in the past, I’m not sure how common it is for a patient to put as much work as that guy did. changing his diet, losing 140 lbs, getting an exercise routine. He is putting in more work than a lot of healthy people
The make predictions based on data from many other patients in the history of medicine with the same or similar conditions. Why? Because people want to know what to expect, a prognosis of their condition.
The problem lies in believing these guesses to be carved in stone somehow—they’re just ‘statistically probable’ outcomes with LOTS of wiggle room. Docs should convey that instead of trying to seem omniscient.
I’m a surgeon. We don’t usually use terms like “you have X months to live” because that’s not possible to know specifically. These predictions depend on what the scenario is. In trauma, we compare it to other patients and their expected recovery. In cancer, there are many calculators using the patients data that talk about disease free survival, mortality, and morbidity. We use similar calculations based on NSQIP data to predict outcomes after emergency and elective procedures. But, we prefer to say, “there’s only 15% chance of survival in one month in this scenario” and then go into what that survival might look like (nursing home, feeding tubes, drains, etc).
Let’s say you are feeling tired, do not have fever, but you are coughing and have sore throat. You decide to take some time off from school or work, until you feel better.
What would your prediction be for when you will be back? How would you make that prediction?
The answer is the same as the answer to your question: Doctors see many patients with patterns of symptoms for a set of diseases. They also observe all of these patients after treatment. They record the results, publish papers. Doctors also read studies from many other doctors and learn from their experiences.
Just like you understand the symptoms of cold well and generally estimate accurately how long it takes to feel better, the doctors understand diseases they have studied.
Just like how a cold sometimes lasts 3-4 weeks for some unknown reasons and your predictions can be wrong, doctors also can make bad predictions.
There’s no secret, science, or trick behind it. When you do something a bunch of times, you get pretty good at predicting what’ll happen.
A basketball player who throws a lot of balls will get pretty good at knowing where a ball is going to land. A lawyer who handles a lot of criminal cases is going to get pretty good at knowing what sentence a specific judge is going to hand out. A doctor who treats a lot of people with a specific condition is going to get pretty good at knowing when that person’s going to die.
It’s all just a guess, based on previous experience.
It depends on what exactly your issue is, and how likely it is to be something that can “fix itself.”
For example, if you break your back at the C3 Vertibrae, and it severs your spinal column, there is basically no chance you will walk again: your spinal nerves can’t re-attach in the healing process, and won’t, barring some SUPER rare cases where someone got lucky and either the bone was reset just right and their spinal nerves literally knitted themselves together. But this was such a rare occurrence that the person it happened to, was studied for decades, and an autopsy of the person suggested that it wasn’t a complete fracture in the first place.
In other issues like chronic diseases where it is a “you have X months to live” it is usually an estimate based on how long you have before a vital organ fails, and how long that will take before the human body fails due to the toxins that will eventually build up/do damage in the process, and whether medical treatments exist that can replace that biological function, like dialysis for Kidney failure.
Physical therapist here. I get to answer this question with patients quite often in the hospital. Of course it depends on several factors (working with PT, physiatrists, prosthetics and orthotics, etc). Some people can physically take steps with assistance after they are told they will “never walk again” but their walking is not always functional. It also depends on how you were walking before whatever incident. After years of practice, I have a pretty good sense of how someone will walk again after their first week with PT in the ICU.
Doctor here. It all depends on what they’re dying from. A lot of the mortality predictions come from cancer research – from large studies you can say that median survival is 3 years, ie if we took a hundred people in your situation, half would die before 3 years, the other half would live longer. If it’s a dialysis patient, you expect about a week after they stop dialysis. In my experience patients don’t often ask as much as you’d think. Often it’s family members towards the end of life. I also use the “crystal ball” phrase. It’s common to say things like “long weeks to short months”. In the last stages of dying, it can be quite variable from long hours to weeks. Once someone stops eating and starts sleeping most of the day, you’re talking within days. Once they develop a pattern of breathing called Cheyn Stokes, it’s a day or two
Hey! That guy in the video is my old teacher! He ran the sci fi and fantasy club at severna park high school!
He was always super nice
A lot of that figuring is based off both similar cases and a linear projection of the patient’s life. It’s likely that the guy you mentioned would have followed the doctor’s predictions if he hadn’t done a complete 180° in his lifestyle. Some people hear that and give up, some are motivated to prove the doctor wrong.
A doctor told me that if I didn’t have my knee replaced in 8th grade, I likely would be able to walk when I was 20. I’m 32 and, while I have some issues on occasion, i walk, run, lift, ski and hike just fine. But that’s because I learned to listen to my body and did intense physical rehabilitation and still work on keeping my knees both strong and protected. If I kept acting like a kid and never paid any mind to my body, I’d be on my 2nd or 3rd knee by now.
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