President Jimmy Carter has been diagnosed with metastatic melanoma. Recently, he gave a press conference where he discussed the history of his illness, his plans for treatment, and answered questions from the media. It was superb.
Carter, now 90 years old, demonstrated an impressive understanding of his medical circumstance. As someone who thinks and writes on patient empowerment, here are my favorite moments:
1:52 — Carter explains that his liver abnormality was found via MRI, quickly correcting the word “cancer” to “growth, a tumor,” demonstrating his knowledge of the limitations of that modality. In the next breath, he mentions a positive finding on follow-up PET scan that increases the suspicion that the growth is, in fact, cancer.
2:16 — Carter details the size of his liver tumor and the total volume of tissue removed. Understanding that such numbers are meaningless to most people, Carter clarifies that the volume removed represents one-tenth of his liver.
2:32 — Carter explains metastasis without using the word metastasis.
2:41 — Just for good measure, Carter relays some melanoma epidemiology.
3:48 — Carter correctly pronounces the name of his immunotherapeutic medication and uses the generic name, not the brand name, of the medication.
4:40 — Carter identifies, by name, his team of doctors, their respective roles, and areas of expertise.
5:10 — Carter explains that he routes all external offers of help and consultation through his Emory doctors.
13:40 — When asked how he is feeling, Carter denies some of the most concerning symptoms for someone with brain metastasis — weakness and disability. He continues by discussing the limited pain he experienced with laparoscopic surgery and introduces the concept of pain that is referred from his abdomen to his shoulder.
21:00 — Carter explains that the job of his current medication is to enhance his immune system.
27:58 — In response to a question from Dr. Sanjay Gupta, Carter seems to indicate that doing nothing was never an option for him, that he was given a breadth of alternatives, and that he chose the course of action that was recommended by his doctors.
37:21 — Carter describes himself as a quiescent and cooperative patient with the objective to extend his life as much as possible.
President Carter’s public diagnosis of cancer comes at a time when medicine is more closely examining the notions of informed consent, patient choice, and shared decision-making. The facility he demonstrated in understanding and articulating his cancer journey is a model for patients dealing with disease. Certainly being a former President has advantages that cannot be widely granted to all patients. No doctor is going to cut a Jimmy Carter visit short. But watching him handle that press conference showed me what is possible. I believe it gives doctors something to which we can aspire as we nudge our own patients closer to a complete understanding of their medical circumstance.
Victor R. Laurion is a medical student.