I believe we have the right to present Christ to our patients

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From Luke’s Journal 2021 | Dying & Palliative Care | Vol.26 No.2

Vinnie* was big, both in presence and size. As an Italian, he had a lot to say and was not afraid to speak his mind.

He grew up in a religious family. He escaped this when he went to university where he found his voice as an avowed atheist. He was a self-made man who ran his own manufacturing firm. He was clever with his hands – an artisan in his spare time. From a worldly sense, he was a very accomplished human being and as a patient, a very interesting sparring partner. We got on well, even though I knew that a visit from Vinnie was going to run well over time. We always booked a double appointment.

We met because he was referred to me. He was dying, of not one but two cancers, one of which caused very troublesome and obvious symptoms. Vinnie was emphatic that he wanted no pain or distress in the end. He would rather be euthanised than to suffer, and for me to assist him in doing so. Over the course of several consultations I respectfully told him that I could not and would not do this. It was against the law. But primarily, my job was to minimise his suffering and allow him to live what life was left, to the full. Vinnie struggled to understand why he did not have the right to end it all before he suffered too much.

Vinnie had plenty to live for. He had a delightful wife, four children and several grandchildren. His life was wrapped around his family and enjoying his craftmanship. 

His symptoms, predictably, were difficult to control, but we managed to negotiate our way through. Every visit, he would start with a loud denouncement of my ability to keep him symptom free. Why can’t I just end it all for him? We’d then work out what had to be done for his symptoms and adjust his treatment.

The consultation would conclude with him more or less satisfied and with a lopsided grin. 

“He would rather be euthanised than to suffer, and for me to assist him in doing so.”

One day, well into his physical decline, he presented not as his usual jovial self, but shaken. He experienced panic attacks and insomnia. He was tearful. He couldn’t understand what was happening. To me, it was clear. His reasoning was catching up with his illness. He was dying. And he was dying as an atheist. He was about to lose absolutely everything; his pleasures, his family, his possessions – everything. All he could see was nothingness, and this was terrifying him. 

So what could I do? After pointing this out, Vinnie reiterated his atheistic stance. He said his fate did not worry him. He was not anxious! He knew I was a Christian and he wanted nothing to do with it. Needing further advice, I had consulted a Christian psychiatrist who specialised in psycho-oncology. Her response to his bravado – Bull***t! So here we were aiming to alleviate distress yet not able to offer anything that would assuage the most terrifying prospect of all. 

The psychiatrist suggested that the only thing that could be done was to encourage Vinnie to work on leaving a legacy for his kids and grandkids. He did do that, and it gave him a lot of pleasure doing so. Eventually his symptoms caught up with him and he was referred to the palliative care unit for advanced symptom control. He died in hospital having spent all but the last week or so of his life at home. All in all a good, but ultimately sad, outcome. What a waste.

Vinnie gave me a lot of food for thought. The book of Ecclesiastes, as Tim Keller explains, is a series of thought experiments where the Teacher considers the fate of a life lived only for the things this world can offer – pleasure, wisdom, and success. The Teacher concludes that the consequence of each of these was Meaningless, a chasing after the wind, and nothing was gained under the sun. (Eccl 2:11b). The realisation of this hit Vinnie hard towards the end of his life.

What does the Christian faith offer?

Further on in the chapter, the writer brings God into the scene. He states: To the one who pleases him, God gives wisdom and happiness (Eccl 2:26). Life is most fulfilling when it is lived for God. Paul writes: Follow God’s example, therefore, as dearly loved children and walk in the way of love, just as Christ loved us and gave himself up for us as a fragrant offering and sacrifice to God. (Eph 5:2) For a doctor, walking in the way of love means walking as Christ would walk with those who had no hope, and offering agape love along with our medical skills. Agape love is loving a person without expectation of something in return. It is something most people rarely experience, and something we as health professionals have the privilege of offering to others every day.

I firmly believe we have the right to present Christ to our patients by offering agape love and building trust. When the time comes, we can then raise the glorious riches of this mystery, which is Christ in you, the hope of glory. (Col 1:27), and know that this will be heard. How they respond is up to them. 

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