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Cancer Care Chronicles
May 30, 2019

Genetic Testing After a Terminal Diagnosis—Providing Purpose

Author Affiliations
  • 1University of Maryland School of Medicine, Baltimore
JAMA Oncol. 2019;5(7):936-937. doi:10.1001/jamaoncol.2019.0846

The woman sitting across from me at the round consultation table looks tired. Not exactly ill, and not well either, but profoundly tired in a way exclusive to those with a terminal illness. A colorful purple scarf protects the top of her head, although her baldness is still evident around the silky edges. She gazes at me with hooded eyes, contemplating the reflexive question I just asked her, “How are you doing?” What is she even supposed to say? That she is miserable and nauseous and only leaves her house for doctors’ appointments; that she is not sure if she should be striving to make it to Christmas to see her grandchildren or if she should be hoping for the opposite, for an end to this exquisitely awful form of suffering; or that she is doing fine because that is the American way to respond to such a question.