Stephen Jay Gould: The Median Isn't the Message

The Diagnosis

In July 1982, Stephen Jay Gould was at the height of his career. The Harvard paleontologist had revolutionized evolutionary biology with his theory of punctuated equilibrium. His monthly column in Natural History magazine made complex science accessible to millions. His books were bestsellers.

Then came the diagnosis: abdominal mesothelioma, a rare and deadly cancer linked to asbestos exposure. Gould had likely been exposed while working at Harvard’s Museum of Comparative Zoology, where specimens were stored in asbestos-lined cabinets.

When Gould asked his doctor about the medical literature, she diplomatically suggested there was nothing worth reading. As soon as he could walk, Gould made his way to Harvard’s Countway medical library.

Eight Months to Live

What Gould found in the library was stark: the median survival time for abdominal mesothelioma was eight months. Half of all patients died within eight months of diagnosis.

For most people, this would be devastating news—a death sentence. But Gould was a scientist, and he understood something crucial about statistics that most people miss.

The Median Isn’t the Message

Gould immediately recognized that the distribution of survival times had to be “right-skewed.” The lower boundary was fixed at zero—no one survives less than zero months. But the upper boundary was open-ended. Some patients lived for years.

In his landmark 1985 essay for Discover magazine, “The Median Isn’t the Message,” Gould explained his reasoning:

“I had obtained the most precious of all possible gifts in the circumstances—substantial time. I didn’t have to stop and immediately follow Isaiah’s injunction to set my house in order—though I suspect that most people, in their final months, gain precious perspective on life.”

He saw no reason why he shouldn’t be in that long tail of survivors. He was young (40 years old). He had access to excellent medical care. His cancer had been caught relatively early. He had strong support systems and the will to fight.

Twenty More Years

Gould was right. He underwent aggressive treatment and entered remission. The essay he wrote—before knowing whether he would survive—became one of the most important pieces ever written about cancer and hope.

He returned to his work with renewed vigor. He continued writing his column. He published more books. He taught students. He lived fully for twenty more years.

On May 20, 2002, Stephen Jay Gould died at age 60—not from mesothelioma, but from an unrelated lung cancer. He had beaten the odds by two decades.

A Gift to Patients Everywhere

“The Median Isn’t the Message” has been reprinted countless times. Oncologists give it to newly diagnosed patients. Support groups discuss it. It has given hope to tens of thousands of people facing cancer diagnoses.

The essay’s power lies in its combination of rigorous scientific thinking and profound humanity. Gould doesn’t promise survival. He doesn’t peddle false hope. Instead, he offers something more valuable: the understanding that statistics describe populations, not individuals.

The Legacy

Gould’s essay remains essential reading for anyone facing a serious diagnosis. Its message:

1. Statistics describe groups, not individuals. Your outcome is not predetermined by a median.

2. Right-skewed distributions mean long tails. Some patients live far longer than the median suggests.

3. Individual variation matters. Your age, health, attitude, and access to treatment all affect your personal odds.

4. Hope is rational. Understanding statistics properly can provide genuine hope, not false comfort.

For Mesothelioma Patients Today

When Gould was diagnosed in 1982, treatment options were limited. Today, patients have access to immunotherapy, targeted treatments, and multimodal approaches that didn’t exist then.

The median survival times have improved. And as Gould would remind us, half of all patients live longer than the median—some much longer.