How Tolstoy and Solzhenitsyn define life and death in cancer: patient perceptions in oncology.
REASON FOR THE STUDY: Clinicians use conserving care in their therapeutic decisions. Discussing death as part of the treatment influences patient's perception and their acceptance of death. We compare 2 literary patients' perceptions of cancer and death (Solzhenitsyn's Cancer ward and Tolstoy's The death of Ivan Ilyich), with a contemporary patient perception.


RESULTS
The patient interview revealed naive cancer perceptions: every treatment option should be tried. In Solzhenitsyn's novel, the main character finds a goal in love; Tolstoy conceptualizes death as a solution for patients' moral issues.


CONCLUSIONS
Tolstoy's novel shows death as an honest prospect. Solzhenitsyn's novel shows the opposite: the prospect of love and life helps the protagonist patient psychologically through his disease. The patient interview revealed no discussion of death at all.
Medical Psychology, Leiden University Medical Center (LUMC), Leiden, The Netherlands. b.w.florijn@lumc.nl
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Florijn
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Kaptein
D001293:Attitude to Death; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008093:Literature, Modern / Q000266:history*; D008513:Medicine in Literature; D009369:Neoplasms / Q000523:psychology*; D012426:Russia; D012425:Russia (Pre-1917)