A lady was brought to casualty. She was in her 40s, and was in desperate
pain. She had been diagnosed with cancer
a couple of years prior. She and her
family had been referred to an oncologist.
But someone who called himself a doctor had told them that the hospitals
would give her poisons that would make her feel terrible. The “doctor” instead offered them
“supplements” that “will make her feel better and treat the cancer more
effectively.” They chose to use the
supplements, and so the cancer grew, otherwise untreated. She had now developed abdominal pain that
rapidly worsened, and was brought to us.
She was miserable, unable to find a comfortable position. Her abdomen was greatly distended and tender. Ultrasound showed her abdominal cavity was
almost completely filled with her spleen and liver, packed with cancer. She was rail-thin, and her nail beds were almost
white. Surely she had a dangerously low
red blood cell count. We started all the
“doctor things,” ordering meds and blood and labs and such.
The family had many questions. They were kind, educated people. They said she had been doing so well on the
supplements but seemed suddenly to have worsened. I struggled with what to say. They had been fooled by a quack, who had been
taking their money while the cancer grew.
The cancer was a type which tended to respond well to chemotherapy, and
the family had good insurance which would have paid for the chemo, which added
to my frustration. But here she was
dying, well beyond most intervention. We
came up with a plan to evaluate her pain and contingencies for the findings.
When they asked why she was so sick despite the expensive supplements I tried
to gently explain that the cancer had been growing and would soon take her
life, and that the supplements had done nothing. They were quiet. Perhaps they were unsure of
my advice.
Her condition worsened and she became unresponsive. I
realized that she was near death, and that her illness had progressed well
beyond our ability to rescue her. I felt
a push to help the family with realistic expectations. If her heart stopped, we needed to know what
to do. I told them that her condition
was very serious and she could die at any time, that we would continue to treat
her well, but the end would come soon. They were not expecting such news, and the
truth of the consequences of their earlier decision became an unspoken reality
in their faces. I explained that when
her heart stopped, we could try to resuscitate her, but the efforts would
probably be unfruitful and dramatic. The
chest compressions would break ribs and the electrical shocks would make her
convulse. None of those actions would change
her overall condition. On the other
hand, when her heart stopped, we could treat her with dignity and not do those
other dramatic acts. I recommended this
latter course.
We had a time of prayer, and I was very glad to learn that
she was a devoted Christian. There were
tears. The family withdrew to consider. I checked the clock. I was about an hour late in going home, and
other staff were available to take over her care, but I wanted to stay. I needed to stay.
The family returned.
They were confident in their decision to go the way of a quiet end with
dignity. To my surprise, they asked me
not to continue with CT scans and surgical referral, as we had previously
planned. I took a little time to finish the
paperwork, then the family and our excellent resident and I began to push her on
her bed to the ward.
As we neared the ward, her breathing slowed. The ward wasn't ready for us and we paused at
the entrance. Hearing her breathing slow
further, I told the family that she was finishing, and we turned into a side hall. I was so very relieved that we had discussed
the plan for her end when we were in Casualty.
We prayed again, commending her soul to the Lord, thanking Him for an
end to her suffering, and rejoicing, with sorrow, for her promotion to Heaven. Her breathing stopped altogether.
The family thanked us for our efforts and asked God's
blessing on us. Then they departed. We did the necessary things for the body, and
I walked home.
The walk home normally takes four minutes. It seemed much longer this time. My patient had been a young woman with three
kids. Her cancer had been very
treatable. She died “needlessly.” She and her family had been deceived by a
charlatan, with deadly consequences. A
grievous injustice. I felt sick. But God remains Sovereign. “See now that I, I am He, and there are no
other gods beside Me. It is I who put to death and I who give life. I have wounded, and it is I who heal, and
there is no one who can deliver from My hand.”
Deut 32:39. Both were true. The deceiver had profited from malpractice
and she had consequently suffered and died.
And God was sovereign in the whole event. Surely, He was grieved by the sin of the
situation as He is with all sin. I was
grieved, too.
Martha and Meredith and James were already sitting at
supper. I washed and sat. Martha asked what kept me, so I told the
story. Tears came, which was
surprising. I don't remember being that
emotional at the death of a patient since my time in a combat hospital in Afghanistan. Surprising, but welcome. James gave me a long hug.
I believe that God arranges for us people to intersect with
each other for a reason. So why did He
put me in contact with that family, with that lady? I hope that I was able to guide them
medically and spiritually in an important time.
I hope that it was right to choose less medical intervention and more
spiritual support. But those
God-arranged intersections usually have purpose for both parties. What was I to learn? I think I was supposed to be reminded that
ideas matter, and that we must be teaching to prevent the suffering that comes
from deception and greed. I think I was
supposed to feel a little of God's grief at the brokenness of this world, and
cry about it. And ultimately I think I
was supposed to really live in a situation in which medicine was largely futile,
but God's sovereignty was the source of all comfort. Ps 116:15: “Blessed in the sight of the Lord
is the death of His holy ones.”
