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The Median Isn't the Message
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Member Since:
4 July 2023
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19 July 2023 - 10:44 am
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(Déjà vu - didn't I read this before? Perhaps! This a repost after a technical glitch messed up the first post.)

I was thinking about how we're often reminded by each other here in the forums that "there's no expiration date stamped on your dog's butt" and no matter the path taken or not each dog's (and pet parent's!) outcome and experience along the way is distinctive. All this came to mind as I was reading on the Veterinary Oncology Consultants website and came across this amazing essay called The Median Isn't the Message by an eminent biologist concerning his own diagnosis with a rare, aggressive cancer. It seemed to me to reflect the Tripawds spirit of acknowledging the individual experience amid the statistics that I've grown to appreciate so much here.sp_hearticon2

If you want a bit more background before jumping into the essay yourself, here is the context on the VOC website:


Cancer Statistics


There are different types of statistics used surrounding cancer, but one of the most frequently used is a type of average called the median.

Statistics are important and helpful, but they still don’t allow us to predict how an individual patient will do. Recently a friend and colleague directed us to this beautiful essay by one of the great thinkers of our time, the evolutionary biologist Stephen Jay Gould. It relates to his personal experience with cancer, and different ways of interpreting the survival data that patients and doctors have available to them.
We find it to be very helpful to remember that a specific number does not tell you how an individual patient will do with or without therapy; there are always “outliers”. In addition, there are many treatments that do not change the median survival because the advantage is to fewer than half of the patients. The benefit for those individuals, of course, is great.

Natalie & Juno (aka June)

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Member Since:
25 April 2007
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19 July 2023 - 2:06 pm
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Thank you so so so much for reposting this. Sorry for the gremlins that got your previous one. 

This is such an important essay. A bit head-exploding in places, at least for me. But this is the important takeaway that I got from it:

We still carry the historical baggage of a Platonic heritage that seeks sharp essences and definite
boundaries. (Thus we hope to find an unambiguous "beginning of life" or "definition of death,"
although nature often comes to us as irreducible continua.) This Platonic heritage, with its
emphasis in clear distinctions and separated immutable entities, leads us to view statistical
measures of central tendency wrongly, indeed opposite to the appropriate interpretation in our
actual world of variation, shadings, and continua.

In short, we view means and medians as the
hard "realities," and the variation that permits their calculation as a set of transient and imperfect
measurements of this hidden essence. If the median is the reality and variation around the median
just a device for its calculation, the "I will probably be dead in eight months" may pass as a
reasonable interpretation.

But all evolutionary biologists know that variation itself is nature's only irreducible essence.
Variation is the hard reality, not a set of imperfect measures for a central tendency. Means and
medians are the abstractions. 

It's all part of living in the now, and remembering that even the best, most well-funded and researched studies still aren't predictors of what will happen to our own pets or people if cancer comes into the picture.

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