I’ve heard that some people who get cancer find religion. As much as I would have liked it if that had happened to me, I never found religion when I got sick with lymphoma two years ago. That’s not to say I didn’t pray. When I had to get a diagnostic gallium scan of my body, lying perfectly still in a tube for three hours, not knowing what future the results would bring for me and my family, I discovered that I knew the Lord’s Prayer. I repeated it over and over again, like a mantra, and it helped keep me from panicking. I prayed and I meditated and I offered a lot of deals to God if he’d get me through the woods. I found some comfort in God, but I didn’t find religion.
Instead, I found poker.
The beautiful thing about poker is that one’s fate is quantifiable. You can always measure your place in the universe by calculating the odds of any given hand. When you have a horrible run of luck, it is easy to measure just how horrible it is. The other day, in a big-pot-limit game, I lost a pile of chips when my full house got beaten by a Wall Street cowboy who drew to a bigger full house. It turns out there were four cards out of 44 remaining in the deck that could’ve helped my opponent. That’s how bad my luck was: 10 to 1. I was better than a 90 percent favorite to win the hand.
Those odds tell me that I did the right thing to make a huge bet, and my opponent made a mistake to call it. The fact that he took my chips is beside the point. Poker, as they say, is played by the year, not the day. The aberrations will even out over time, and the odds will not forsake you.
As it happens, when I was diagnosed, the doctors said my odds of surviving for the next five years were also just over 90 percent. That’s a bit scarier than sitting pretty with a second-nut full house. With the stakes this high, even 10 to 1 is unsettling. Either I will survive or I won’t. I won’t be “91 percent alive” in five years: it’s all or nothing. For me, the word is “destiny,” not “odds.”
But that’s not how oncology works. Science doesn’t accept “destiny” as anything more than a metaphor, and it treats the fate of one patient as part of a pattern that can be observed and controlled in the aggregate. A doctor has to believe in the odds. And a patient has to believe in his doctor. That’s not always easy to do. Oncologists, by design, are almost impossible to read.
They have to be. At the card table it’s called a “poker face,” but for an oncologist, keeping emotion out of the equation is a matter of life and death. At first it drove me crazy. I couldn’t figure out where my doctor was coming from. He told me what I had to do to survive and he told me that I should fare well, but he didn’t show any trace of emotion. Fighting cancer was the most emotional experience of my life, but he was all business. Now I know why.
Poker players use the term “going on tilt” to describe the irrational play that usually follows an improbable loss. A “bad beat”–being victimized by standard deviation–can lead even the coolest shark to start playing wildly. When I lost all my chips on that 10-to-1 shot, I felt the blood rush to my head, so I got up and left the table. But an oncologist can’t leave, and he certainly can’t allow himself to go on tilt. He has to treat each patient by the book, even if that sometimes leads to tragic results.
And after one of those tragedies, he has to get right back to work, without showing any signs of frustration or apprehension–what poker players would call his “tells.” It is crucial that his next patient have absolute confidence in his advice.
Nowadays, I am grateful when I see my doctor putting on his poker face to tell me that the latest gallium-scan results look good. Even though I want him to celebrate with me, I know that that’s not what makes for long-term success. After my one-year checkup, almost giddy with joy, I said to my doctor, “So you mean the cancer’s gone?” He nonchalantly replied, “Well, what did you expect?” What matters most for my doctor is not what he wants to happen, but what he expects will happen over the long term and how he takes advantage of that to get what he wants.
Because most of all, working with the odds requires a lot of faith. Enough faith to know that even if your full house gets beaten by a long shot, it’s right to play the hand the same way next time. And nine times out of 10, things will work out great. As I get better at poker, I am discovering such faith, and it reassures me and offers a sense of control over a sometimes capricious universe. Poker helps me realize how predictable it is to be as lucky as I am.
