Chapter 12. You Might As Well

Glioblastology, the Book

Welcome to a new chapter release of Glioblastology! In Chapter 10, we reflected on independence and isolation; in Chapter 11, we explored the tenderness of parenting while living with brain cancer. Today, in Chapter 12, we flip a well-intended remark from a physician on its head—and reclaim the meaning in our choices.

May is Brain Tumor Awareness Month, and I’d love to offer you a free month of full access. If you’ve been reading along on the free tier, now’s the perfect time to catch up on the book and read with us as we move toward its conclusion in the coming months.

---

Chapter 12. You Might As Well

Sometimes a phrase just pisses you off.

“You might as well.”

The words hung in the air at the end of an otherwise routine follow-up visit with my radiation oncologist way back in 2016 or 2017 in the newly diagnosed setting. This physician is someone whose social awkwardness often veered into the inappropriate. I had expressed interest in augmenting my cancer treatment with something nontraditional—a practice I’d found comfort in, even meaning. I wasn’t looking for permission, just partnership.

"You might as well," he said, after glancing at my weight on the chart—a shrug in his voice flattening months of intentional effort into something negligible.

I’d lost weight from weeks of caloric restriction and a keto diet, not out of desperation, but out of agency and a deep hope. These were my attempts to make meaning, to participate in my care. I wasn’t asking for permission. I wasn’t even really asking to be understood—I was seeking acknowledgment, respect, and a simple nod of recognition. I was seeking acknowledgment. Something that said, "I see the effort, I see what you’re carrying, and why." Not endorsement, not validation, just recognition that this—my disciplined, deliberate engagement with life—was something I was still shaping, not something to be brushed aside with a flippant phrase.

At any rate, I wasn't too interested in bringing him into this. Our interactions were episodic, and I never had the sense that we grounded our relationship in shared goals. Either way, he didn’t ask why my pounds had dropped on the scale from intake to this six or so month follow-up.

But he did have something to say: Why don't you just go home and eat some ice cream.

"You might as well."

The words landed like a slap, offhand, indifferent, and worse, oblivious to the meaning I had poured into the role I felt entitled to when navigating my own care.

That moment stuck. The phrase struck me as both dismissive and, disturbingly, correct. It felt like a betrayal of my agency, even as it gestured toward the freedom that comes with having so little left to lose.

For days, I walked around with those words rattling inside me. You might as well. The tone suggested futility. The implication was that my time was nearly up, so why not? Why not chase a little comfort? This is the guy, by the way, who was sure to emphasize, "What we're doing here isn't curing anything."

"You might as well."

At first, I felt diminished—like the precision of my self-understanding, the dignity of my choices, had been rendered irrelevant.

If there’s no clear path forward, if there’s no rescue from this condition, if there’s no way to optimize my way out of dying, then what am I free to do?

You might as well may be the doctor's attempt at enhancing my quality of life. Like hey, skinny ass, go get a sundae and chill out. But that misses that I was explicitly committed to not "might as well'ing" anything! This was my care to navigate, with partnership. Indeed, my life to navigate! To assume that I'd need permission to eat some ice cream undermines patient autonomy, and more, it cuts off any attempt at inquiry whether some deeper meaning or purpose was at play with my slimmed down physique. It was a projection of how he may assume that he'd handle a difficult diagnosis should the tables be turned, but I'm my own agent, not the projection of his.

While I took pride and accomplishment in my ability to incorporate physical exercise and a disciplined nutritional approach, this doctor was unable to hold at once the grimness of my prognosis and the sacrifice I was making to my lifestyle choices in an effort to be an authentic partner in my care. Whether these alternative or complementary supplements to standards of care were almost second to my real pursuit: clawing back some agency and decision-making capacity not because of but in spite of my very difficult diagnosis.

I approached my care in pursuit of the best possible outcomes. What I wanted was recognition of my hard work, not permission to relinquish my role, but affirmation that I still had one.

What I came to realize is that my resistance to his suggestion that you might as well surrender yourself to the completion of life was to flip it on its head. I'm not yet ready for the completion of life. He had it all backward.

What if we flipped the script?

You might as well what? Eat ice cream? No.

You might as well become the kind of parent who sits on the driveway, quiet for a moment, feeling the breeze before calling the kids in for dinner in the sunshine, even when it hurts, watching the kids play kickball. You might as well write your story, even if it makes you cry. You might as well teach, even if you forget what you meant to say halfway through the sentence. You might as well live like your time matters—because it does.

The spoon goes in the ice cream, even if you’re lactose intolerant. A small act of defiance, maybe. A gesture that says: I’m still here, and I get to choose. The kind of image that sticks—quiet, absurd, stubborn—and maybe one worth returning to. The bass vibrates through your chest, even if your ears are shot from chemo. The good days come. They really do. And when they come, you might as well.

This isn’t a chapter about surrender. It’s about reckoning. It’s about finding your bearings when the compass no longer works. It’s about locating yourself in a narrative that refuses to conclude neatly. It’s about refusing to leave the chair in the middle of the room, even when you’re tired of rearranging furniture in a hospital room that you know you’ll have to leave. It's home for now, like that rental house we stayed in back when I first wrote Chapter 10, the one with the dining room table where I worked through the early drafts of this whole thing. Having a place to call home—no matter how temporary, no matter how cluttered with medical gear or shadowed by uncertainty—is foundational for meaning and wellbeing.

You might as well rage a little. You might as well forgive. You might as well risk hope.

And, yes, you might as well love the shit out of the people who are still with you.

Because they’re still here.

And so are you.

---

Still here? So are we. That’s the point, isn’t it?
Join us to keep reading Glioblastology as it unfolds.
May is Brain Tumor Awareness Month—subscribe now and get your first month free.