The patient who loves buying lettuce for his daughter-in-law – and what his case teaches us about shared decision-making in medicine

‘Patients often worry about “dying on the table” but that’s rare – it’s the aftermath that matters.’ Photograph: Chinnapong/Getty Images/iStockphoto

Weeks before major surgery, a patient cancels his appointment with our geriatric oncology service, declaring it unnecessary. An astute nurse convinces him otherwise.

In his mid-80s, the patient has been diagnosed with an early cancer. The surgeon advises that surgery would be the only cure but, noting the lack of urgency, sends him to see me. I can see why. The proposed procedure is long and complicated; in elderly people, even temporary setbacks can result in long-term effects.