The Prognosis Is Grim, but I'm Living My Life Statisticians know how to count, but Paul Kalanithi, a 36-year-old doctor with lung cancer, knows what counts ("How Long Have I Got Left?," Sunday Review, Jan. 26). I am also young and healthy and five months out from a diagnosis of terminal lung cancer. At first I could articulate no hope; it was foolish and futile, according to the actuaries. Now, after chemotherapy that was supposed to be only palliative, I make appointments with students and patients, accept book contracts, dream of my children's futures and run on the treadmill while listening to Sinatra belt out "The Best Is Yet to Come." Dr. Kalanithi and I do more than go on. We hope, even if we are afraid to say so. The writer is a professor of anthropology at John Jay College of Criminal Justice. It is understandable that health care providers are reluctant to give a specific prognosis initially in an illness, as survival can be very variable. This is not the case, however, as illnesses move into the final stage. As a nurse practitioner in a large medical center, I often meet patients who are clearly nearing the end of their lives. Most, however, haven't been told this and therefore don't have advance directives, and haven't chosen someone to make medical decisions for them or discussed their wishes with their loved ones. Instead, they spend their last weeks in and out of the hospital, which is likely not where they'd want to be if they knew it was their last weeks. Or they are among the 36 percent of hospice patients who get less than seven days of that care. Prognostic information for end-stage illnesses is usually very clear, and it behooves all providers to share it with those patients and families who ask at that point, "How long have I got left?" MARIAN GRANT Reisterstown, Md., Jan. 26, 2014 Jenny Wildfang