[ccooffee]

I've been in those situations. Your description here does not match my experiences at all.

I _hate_ the vernacular of "fighting cancer". As a leukemia survivor, it wasn't a fight. You don't punch back. It's more akin to public flogging. My body was absolutely destroyed by the treatments, and as I watched myself turn from a human being to a not-yet-dead skeleton, I had to endure people calling me "brave" and a "fighter". It absolutely felt like public mocking (though the people around me certainly did not intend anything of the sort). I was forced to watch my loved ones struggle with my impending death. Only a couple people were able to actually discuss death with me, with everyone else dancing around the topic like I had nothing more than a bad sunburn.

I never lost hope, but I was expecting to die. The "fight" worldview kept my loved ones emotionally distant and distracted. Maybe that was good for their own mental health, but it certainly didn't help mine.

[basisword]

Sorry for your experience. It was a bad choice of words. By 'fight' I simply meant choose to do everything possible to stay alive (even if that means simply enduring horrendous medical treatment despite the pain that comes with that) rather than deciding it's not worth it and choosing to die.

[ekanes]

I'm sorry you had to go through that. Do you have any ideas on a better framework for society to approach this? As you allude, people intend the best for the patient, and this seems to be what we've come up with. "You are a fighter, you can do this."

It seems like the two possible frameworks are fighting vs enduring? (Others?)

If I had to guess, we might choose to position the patient as a fighter because to fight against harsh odds requires courage, so what we're giving is the compliment that you are courageous. I think that's the intent at least.

[jdietrich]

I think the "fighter" rhetoric is specific to individualistic cultures that place a high premium on personal agency. Westerners in general and (liberal, college-educated) Americans in particular have a really hard time dealing with the idea that something might be largely or wholly out of their control. The opposite extreme would be fatalistic cultures, where one's death or survival is in the hands of god - deo volente, besiyata dishmaya, inshallah.

I think a reasonable middle ground starts with acknowledging that being seriously ill is just a shitty situation, that over a long enough time frame death is inevitable, and that outcomes are often determined mostly by dumb luck. Not being in control can be very distressing, but the struggle to try and retain control often just compounds that distress. Willing someone to "fight" a cellular process within their body probably isn't going to help them in any meaningful way, but there are lots of things that can be done to make them more comfortable. Hope is valuable, but false hope is a kind of cruelty; we all need to be better at accepting the limits of medicine and recognising the threshold of futility.

[ekanes]

Fantastic point - basically it'd be great to know how much it matters that the patient "fights". I do disagree that, "Willing someone to "fight" a cellular process within their body probably isn't going to help them..." in that we have some evidence that the mind can affect the body a fair bit, everything from the effectiveness of placebos to control of autonomic states. Who knows if one could rally better cellular defenses by feeling aggressive and active. One would be much more likely to stave off depression, which is caused by helplessness, especially if one doesn't have a higher power concept in their life that they could accept is in control.

[denton-scratch]

> especially if one doesn't have a higher power concept in their life

I don't think believing in metaphysical beings provides any protection against depression. Espcially if you're facing problems you can't solve (i.e. helpless), and your chosen being doesn't come up with the goods. And "in the middle of cancer treatment" would be a bad time to lose your religion.