13 - Uncertainty in Medicine: Denial and Acceptance
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What is the story behind Ed Stratton’s battle for a life‑saving liver transplant?
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This is the Nocturnus, Uncertainty in Medicine. I'm Emily Silverman. This is the final episode of our series on uncertainty. And as we wrap up, we're turning our focus to a different kind of uncertainty. The kind that doesn't come from a tough diagnosis or a difficult conversation in the exam room, but instead comes from something bigger, the healthcare system itself. Specifically, we're looking at one of the most destabilizing and opaque forces in American medicine, health insurance. It shapes everything, from how clinicians interact with patients in the exam room to whether a treatment is approved. Here, the uncertainty isn't about the diagnosis or the treatment itself. It's about whether the insurance will cover it and whether that coverage will come in time.
Today we bring you a story about a family caught in that kind of uncertainty and how they refused to accept it. Later in the episode, I'll sit down with Alexa Miller, our uncertainty correspondent, to reflect on what we've learned over the course of putting together the series. And finally, we'll close the series with one final voice. A voice that speaks about accepting uncertainty rather than fighting it. But first, meet Ed.
Oh yeah, my name is uh Ed Stratton. I live in uh Bawan, Missouri. Well it started uh back in March of two thousand nineteen when uh out of the blue I just started passing blood. And then from there, you know, I got admitted in the hospital where they diagnosed me with stage four colon cancer.
This is Ed Stratton. He's a sales rep for a medical device company. He loves golf and he lives in a suburb outside of St. Louis. He was a little over 60 at the time of his diagnosis.
I mean if you get if you get treated right away from colon cancer, I mean the success rate is somewhere, you know, close to ninety two, ninety five percent, if it's just stage one. But when it gets to stage four, then the the the success rate goes down dramatically or somewhere around thirteen percent.
Despite those odds, Ed beat the cancer. It took him four years and he underwent a colectomy, four rounds of chemo, a hepatectomy after the cancer spread to his liver, and then by twenty twenty four he had no detectable cancer. The problem was, as these things often go, that wasn't the end of his medical journey. The surgery and radiation therapy had damaged his liver, so even though he had beaten the cancer, at least for the time being, now his liver was failing.
It was a response to the treatment that he received. Yeah, in a good way, right? It worked, but there was just so much damage from treatment. This
is Ed's daughter, Erin. In twenty twenty four, she had just moved back to Saint Louis from Nashville to be closer to her dad. By then, Ed was in and out of the hospital with recurring infections. His doctors told him the infections wouldn't stop. They were a sign that his liver was failing. Eventually, one of the infections would be fatal, so the only path forward was a liver transplant. But before he could get the transplant, he needed approval.
I think there were eleven or twelve doctors that had to unanimously approve this liver transplant. And uh, I mean, it was quite a procedure. It was a two-day experience where I went down and I mean they did all the testing, so an MRI and a PET scan and all kinds of different extra things from me. So that that procedure just to get on that thing probably was a two or three month timeline on that.
It was a group of I think ten or twelve physicians. They had to unanimously decide that he was a candidate and that his case was deserving to be on the list. We really thought that was gonna be the biggest hurdle for the whole thing. So it was it was really exciting once we got past that.
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Chapters
8 chapters
1
What is the story behind Ed Stratton’s battle for a life‑saving liver transplant?
0:00–5:28
2
How did Ed’s daughter Erin and a health‑insurance whistleblower begin fighting the denial?
5:28–10:27
3
Why did Anthem deny the transplant despite prior approvals and what was the appeal process?
10:27–15:42
4
What role did the AI‑powered startup Claimable play in overturning the denial?
15:42–20:42
5
How did the team use legal, medical, and public‑pressure tactics to get the decision reversed?
20:42–25:25
6
What was the outcome for Ed after the appeal and how did the family celebrate?
25:25–30:44
7
What lessons about systemic uncertainty in medicine did Alexa Miller share?
30:44–37:17
8
How can clinicians and patients accept and advocate within medical uncertainty?
37:17–44:25