March 24, 2018
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A doctor’s plane crash brings thoughts of fate and beating the odds

Erik Steele
By Erik Steele, Special to the BDN

Last week, that capricious bastard Fate plucked one of Maine’s finest physicians from the sky and flung him to the sea in his small plane.

Dr. Louis Hanson died while help raced to his side, as though all the good he had done in his life counted little when it mattered. It felt to me that God was asleep at His switch, but perhaps He just needed another family doc in heaven.

But was it just Fate? What else would suddenly strike down such a man literally and figuratively out of the blue? Math, that’s what, the boring, grinding, inexorable math of probability: probability of illness, probability of injury, and probability of premature death. Our lives are a cold calculus of odds being bent one way or another, waiting to see if our number is up.

Sudden death, or life-threatening illness before we are old, are what result when chance meets our personal probability of developing these problems, or of surviving them. The more prepared and a little lucky we are, the better our chances of avoiding trouble, or surviving it if we cannot avoid it.
The less prepared or lucky we are, the more likely we are to become that tragedy everyone shakes their head about and hopes never happens to them.

Two different 60-year-olds who come up against identical serious illnesses or injuries illustrate the math-meets-fate issue. If Person A exercises regularly, does not smoke, and has pretty good muscle mass, he is substantially more likely to survive than Person B, who has emphysema, heart disease, and the muscle mass of a jelly doughnut. If bad luck — a car driven by a drunk, for example — meets both, Person A has bent the probability curve of survival in his favor by a lifetime of preparation and good health. Person B has bent it in the opposite direction, so his chances of survival are substantially less.

Much of this battle for favorable odds against disaster goes on silently within us. Every day, countless cells in our bodies copy their DNA in order to reproduce, each time with a small probability of an error in the copying. If our cellular repair mechanisms fix the mistake, normal cellular reproduction goes on, and so do we. If the mistake does not get fixed, and then gets copied as multitudes of abnormal cells, we get cancer or some other disease of cells gone bad. The more our lifestyle or genetic makeup contributes to DNA damage, the more abnormal DNA we produce, the more chances we have to make cancer cells, and the more risk we run of developing cancer.

We affect these odds every day, bending our probability one day in favor of longer life, and another day in favor of a shorter life. On good days, we exercise, eat right, don’t talk on the cellphone while driving, etc. If we add these kinds of favorable odds-benders to others — such as having health insurance, regular health care, good genes and a college education — the odds stack substantially in our favor when compared to those with fewer of these advantages.

On other days, we bend the odds in the opposite direction; we smoke cigarettes, text while driving, skip our medicines, eat the wrong things, etc. We might indulge our passions for riskier pastimes, such as flying planes or skiing down mountains.

We often play this odds game with the lives of others, including those we love. Gather the family for a boating excursion, run the safety checklist, get everyone in life vests, train them for emergencies, stay sober while captaining the ship, and the chances they will all survive a surprise disaster on the water are higher than if any one of those things does not get done.

So the question is not whether Fate can reach out and push your plane from the sky, your car from the road, or your cells from the right pathway of DNA copying. Of course it can, no matter what life you have led.

The question is, which way will your odds have been bent when that happens? Knowing that, which way will you bend your odds tomorrow?

Erik Steele, a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.

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