But, Doc, how long do I have to live?

How much time does my mom have?

Should I think about moving in with my son? I find that questions about prognosis are some of the hardest to answer.

So many things race through my head as I stand there trying to figure out what to say. How am I supposed

to know how much longer they have? How sure am I about my estimate? And what am I supposed

to do with my uncertainty? How can I tell the patient what I think without taking away their hope?

Today we're going to try to answer those questions.

I'm Margo, an Internal Medicine resident at NYU.

I'm Tamar. I trained in Internal Medicine at NYU and am now pursuing research and bioethics.

And I'm Joffer, a hematology oncology fellow at UCLA.

Today we were very lucky to sit down with Dr. Alex Smith, a national leader on prognostication. Dr. Smith trained to bring him

in women's in primary care, followed by fellowship training in palliative care in general

internal medicine and in an M. P. H. from Harvard. He is currently faculty in the Division of Geriatrics at UCSF and

co-hosts a fantastic weekly podcast with his colleagues called Jerry Powell. But his interest

in prognostication began way before this long list of accomplishments.

So my interest in prognostication started in, well, it started with my dad who died while I was in medical school.

And I had a disturbing experience.

He had a glioblastoma multi for me,

which is a brain tumor, and he had stage four, it was incurable, and the first treatment

for it is surgical debulking of the tumor.

And I went with my dad to the follow-up meeting with a

surgeon after the debulking and the surgeon said to my dad I got it all like I got it all and you know I was in med school at the time

...