This post completes a post from the future, so it won't make much sense plus it contains spoilers.
We readers are meant to think that both patients have taken similar news differently--perhaps one being more dire--or not. We can't know. However, due to the point-of-view, things cannot have turned out so dire so quickly. In part because it doesn't feel like the patient is that near death due to behavior--if that's how we're to read the ending. It seems like we need a little more: a new angle, a different or more visible narrator, and/or more development in the past, present or future. It feels like it's almost there but not quite. Still, Shipler knows how to move his characters through emotional events and how to get us talking about his story.
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