Classical Rhetoric in Medicine: Optatio

I think there be six Richmonds in the field;
Five have I slain to-day instead of him.
A horse! a horse! my kingdom for a horse!

-William Shakespeare, Richard III

Optatio: expressing a wish, typically with earnest (if not fervent) desire.

The situation was disturbing, to say the least. After being bombarded with both chemotherapy and radiation therapy, not only had my patient's cancer survived, it had in all likelihood spread to his lungs. A chest CT revealed the suspicious lesions, some plastered up against the pleural lining like a mud dauber's nest, some floating in the lung parenchyma like bubbles in the airy meadow. This is not what any of us expected, and after explaining the scan results to the patient and his family, reality entered the room and shoved us around a bit. I tried to think of something positive to say.

"You know, these lung nodules are not causing you any trouble right now." I began to stroke my chin. "You don't even know they are there, which means that if we could just convince them to stay the same size you could live with them.

"If I could just talk to them right now and say 'Please stop growing!' you wouldn't need any further treatment. You and the tumors could live in some kind of harmony, if that is the right word. Unfortunately I'm no Dr. Doolittle, and they won't listen to me."

I produced a pamphlet providing information on two powerful chemotherapy agents and sat down next to the patient.

"Maybe, though, they'll listen to this."

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Have you tried augmenting the chemo with hyperthermia? I'm going to try that, somewhat over the objections of my oncologist.