Challenges to ones worldview assumptions usually come from exposure to a different culture. My assumptions about the place of talking about ones faith in medical practice received a jolt in the early nineties when I first read Richard Baxter’s 1650 spiritual classic The Saints’ Everlasting Rest.
In a chapter on evangelism, Baxter gives some directives to those in particular situations, and I was surprised, and strangely flattered, to see he had one for doctors:
Physicians that are much about dying men, should, in a special manner, make conscience of this duty: they have a treble advantage. First, they are at hand. Secondly, they are with men in sickness and danger, when the ear is more open, and the heart less stubborn, than in time of health. He that made a scorn of godliness before, will then be of another mind, and hear counsel then, if he will ever hear it. Thirdly, besides, they look upon their physician as a man in whose hand in their life, or at least may do so much to save them; and therefore they will more regardfully hear his advice. O, therefore, you that are of this honourable profession, do not think this a work beside your calling, as if it belonged to none but ministers; except you think it beside your calling to be compassionate, or to be Christians.
Ouch. Suddenly the received wisdom was turned on its head. I had always assumed that the sicker the patient, the more one must avoid “exploiting their vulnerability”. I just hadn’t considered this to be based on two false, secular, prejudices: that to tell someone good news is to exploit them, and that to offer them salvation is to wound them.
As it happened, I had little time to turn this thought over as, the very next day, I was given the uncommon, and unpleasant, job of visiting no less than two patients who had just been sent home from hospital after the failure of their cancer treatments. I considered how I should deal with these visits, knowing that Baxter had to make some difference. Fortunately his exhortation followed a whole chapter of sound advice on wisdom and sensitivity – the Puritans had no place for aggressive Bible bashing (that’s another secular myth).
So I resolved that, in the course of what would inevitably be quite lengthy conversations, I would ask first about any questions or fears they might have about their disease, and then separately whether they had any particular questions or fears about dying. It was hardly Billy Graham stuff.
My first patient, whom I had actually known for a while, in response to my first line of questioning, expressed some fears about pain and so on, and some anxieties about being cut loose by the surgeons. I was able to reassure him about both. To the second question, he just shrugged and said, “Not particularly.” That was hardly Billy Graham stuff either, but at least I’d given him the opportunity. In due course I left, took a deep breath and continued to my second depressing visit of the day.
The second man I’d only seen once as I remember, on behalf of one of my colleagues, the day he experienced symptoms signalling the recurrence of his bowel cancer. I’d had him readmitted to hospital, which was presumably how I came to be visiting him now. He was a tall ex-guardsman, with a military moustache, and he was also a director of a top London restaurant. That wasn’t particularly encouraging after my previous patient’s response, but I’d committed myself, so I started the same kind of conversation. Being the kind of bloke he was, my first question elicited an answer along the lines, “I’m sure we’ll sort out any problems as they arise.” So I half-heartedly asked my second: “Some people have worries about death itself – if you have any questions…?”
He suddenly became animated, stood up and exclaimed, “I knew the day I met you you were going to be good for me! I need someone to help me get ready to die.” No kidding. So there, and on the subsequent regular visits I made to him over the last months, I shared the Gospel as well as I could, as well as sorting out his increasingly challenging symptoms. I visited the other guy regularly too, but those visits were of a different order. The long and the short of it was that, about a week or two before he died, off his own bat he called the local vicar to come round and baptize him. His wife was astonished at how happy he was in the face of death.
I’d like to say it was a wonderful funeral, too, but his conversion came so shortly before his death that very few people knew about it, and so it was just one of those faintly uncomfortable formalities so typical of local authority crematoria. I met his solicitor there, who happened to be a Christian I knew. After the service, he murmured to me, “Funerals are so depressing when you know someone’s died without faith.” I was pleased to be able to share the story with him, and at least one person went home happier than when they came.
I still remember that patient well, and not only because he promised he’d take me to eat at his restaurant if he recovered enough, which never happened. But I also remember him when I hear cases of doctors or nurses being censured, or even struck off, for “proselytising” patients, for in the twenty years since it has become offically outlawed by the General Medical Council. Nevertheless because of Richard Baxter, and my foolish disregard for secular medical ethics, one more person had a good death. And one more person is in heaven.
