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between the patients who still had colostomies and those who had their colostomies reversed. The results suggested that the effects of colostomy on overall quality of life were relatively minor. What could explain these very different answers about colostomies? Ubel and co-workers posited that people misremembered what it was like to live with a colostomy. This kind of recall bias can be very powerful; see Laura J. Damschroder, Brian J. Zikmund-Fisher, Peter A. Ubel, “Considering adaptation in preference elicitations,” Health Psychology 27 (2008), pp. 394–399; Dylan M. Smith et al., “Misremembering colostomies? Former patients give lower utility ratings than do current patients,” Health Psychology 25 (2006), pp. 688–695.

111 When imagining unfamiliar circumstances, people focus narrowly on the most obvious difference between those circumstances and their current circumstances and thereby mispredict the emotional impact of the change in circumstances. This is termed a “focusing illusion.” College students living in the Midwest reported levels of happiness similar to levels of those living in Southern California. Yet students in both locations predict that life would be better in California than in the Midwest. Why? People focus narrowly on the better climate in Southern California, and students downplay all the nonweather-related things that make college life enjoyable or unenjoyable. They seem to forget that happiness in college depends more on the kinds of friends you hang out with than on whether you can hang out with them in consistently sunny weather. See David A. Schkade, Daniel Kahneman, “Does living in California make people happy? A focusing illusion in judgments of life satisfaction,” Psychological Science 9 (1998), pp. 340–346; Daniel Kahneman et al., “Would you be happier if you were richer? A focusing illusion,” Science 312 (2006), pp. 1908–1910. In medicine, focusing illusions could contribute to the disability paradox because healthy people overestimate the emotional impact of a chronic illness or disability by focusing narrowly on those domains of their life that are influenced by illness and disability, imagining being much less happy than they would really be.

111 Insightful books on resilience and adaptation: Richard M. Cohen, Blindsided: Lifting a Life Above Illness (HarperCollins, 2004); Strong at the Broken Places: Voices of Illness, a Chorus of Hope (HarperCollins, 2008).

111 Dana Jennings further reflected: “I’ve trudged through Stage 3 prostate cancer and its treatment in good shape. Nearly two years after learning I had cancer, I’m an active fifty-two-year-old, I exercise regularly, my blood tests are where they need to be, and my oncologist wants to see me only twice a year. “But there is one side effect of my treatment that has proved especially stubborn: erectile dysfunction.

“Prostate cancer and its treatment strike men where they live, often causing impotence and incontinence. (My bladder control gradually returned. But I can still be caught off guard by the stray sneaky sneeze.)

“Where does that leave a man who has erectile dysfunction? . . . True manhood is about love and kindness. It’s about responsibility and honor, about working hard and raising your children the best way you know how, with love, respect, and discipline.”

CHAPTER 6: AUTONOMY AND COPING

115 Julie’s feelings about the “best of the best” as a factor in her choice: Paul Slovic, Ellen Peters, Melissa L. Finucane, Donald G. MacGregor, “Affect, risk, and decision making,” Health Psychology 24 (2005), pp. S35—S40. This work focuses on the powerful pull of intuition and emotions that can influence the process of decision making.

115 Patients may, as Julie Brody did, go through their “Rolodex,” contacting people who are “in the know” to identify that one doctor who seems to stand above all the rest. Others may consult published lists centered around their city, like those in New York magazine or Boston magazine. With the advent of Internet rating sites for everything from chefs to housepainters, there has been a proliferation