Living in the Light


Branch in the Sunshine by Timothy Eberly on

“Take the fig tree as a parable: as soon as its twigs grow supple and its leaves come out, you know that summer is near.”

One of the things I have to do from time to time in my work as a doctor is to tell someone they are going to die.

Well, in one way, that is no great surprise. Sooner or later, we are all going to die. And we will all die of something. But it always comes as a shock to anyone to know that they now have the disease which will probably kill them.

Telling someone that he is going to die is – for me – a little like going to confession. I don’t really like doing it. Truth hurts. Sometimes I feel like it hurts too much. But afterwards, I feel better because I know it was the right thing. Because every time I do it – every single time – the person says ‘thank you’. And that is odd because people don’t often thank doctors. Even when we do something really good, like making a clever diagnosis, or managing to cure some problem, people don’t often thank us. But every time I tell someone they are going to die and there is nothing ultimately that medical science can do about it – every time they thank me.

Why is that? Well, I don’t rightly know... but I have to think that it has something to do with the fact that we are telling them something they already know. Most often people have been sick for some time and they know perfectly well what is happening to them. And the last gift their doctor has to give them is honesty.

When I was training in geriatrics, one of the senior consultants suggested I should come with him on what is called a “domiciliary visit” – that’s when a hospital doctor comes out to see a patient in his or her home. This patient was an old lady of 92. Three months before, she had been fit enough to dig the garden she had tended for the last 50 years. But gradually she had noticed herself feeling very tired, losing a lot of weight, her clothes suddenly becoming too large for her and lumps appearing all over her skin. She wanted to know what could possibly be causing this. As we listened to her story, around her clustered protectively her two daughters and her son-in-law.

My boss then did a very careful and thorough examination, which took about half an hour. Then the lady went away for a few moments to the toilet to tidy herself up. Instantly, the two daughters and the son-in-law broke into passionate argument imploring my boss that, if it was bad news, he should not tell her, because she would not be able to cope with it. They knew her well enough to know that she could not possibly live with any bad news - they were her two daughters and son-in-law.

My boss looked at them very sadly and said that he would only tell her what the patient herself wanted to know.

When she came back in the room, he sat her down and said very simply: “Mrs <Jones>, I have come here to find out what is wrong with you. I think I know what it is. Do you want to know what I think?”
There was a pause and then she replied: “Yes, doctor,” she said firmly.

And I will always remember what he said – if you wonder why, it’s because I’ve often recalled his words and wondered if I would ever have the courage to say the same. This is what he said:
“Mrs Jones, I think you have a very widespread cancer all over your body. If you wish I can take you into hospital and cause you a lot of pain and spend a good deal of the country’s money doing a lot of tests to find out if I am right or not. But I honestly think that I am right. So, if you are prepared to trust my judgement, then here is my telephone number. If you get any pain or any other problem that you think I might be able to help you with, please call it at once. Is there anything else you would like to ask me?”

The two daughters and the son-in-law all collapsed in an untidy heap. Mrs Jones ignored them. She smiled beautifully and said: “No doctor. Thank you very much. You have helped me.”

After that there was nothing more to be said and we left. I never saw her again, but I happen to know that my boss called her every week for months after that until she did need help with her pain.

There are signs in our lives which, if we are willing to pay attention to them, tell us all we need to know about what is really happening with us – whether or not we are really living well – living the lives God created us for. But so much of our time is spent on other things – the daily grind – the pinprick problems of everyday life – that we forget those signs. Or worse, we try to pretend that they are not there. But the truth is that we cannot pretend forever. Sooner or later, reality bites. And then we have no choice but to be honest and alone before God, offering him the fruit of our lives.

Let us “Take the fig tree as a parable” of the shortness of our own time on Earth and our need to use it well.

Paul O'Reilly SJ