X. On the Brink

The care of a patient who awaits the final test of courage, is an exacting responsibility, often shared with a relative. At such a momentous time, when ‘men fear death as children fear to go in the dark’ (Bacon), the spouse's opinion of the patient's capacity to bear the truth is an inviolable guide.

Men and women face the unknown in a state of mind rooted in their character. Psychological defences against mental pain, originally constructed to evade separation from the mother, are called into operation for the last time. When and if the defensive denials break, there appears a touching appreciation of the physician's attendance and companionship in the period of anguished waiting.

At the end, as in the beginning, the attendance of a holding, supporting person, be it relative, friend, nurse or doctor, modulates the pain. Hopefulness is never superfluous, the ‘grave’ physician an oppression. Hopefulness comforts in a mysterious way, even the sceptical. Perhaps it is the hope that those left behind will recover from their loss, and continue their lives with more purpose, as a dying soldier may hope the battle may yet be won.

The renewal of courage, after a friendly consultation, can sometimes be discerned in the comments of those who are otherwise inarticulate. An old bachelor dying of secondary cancer, whose dependence on occasional consultations was conspicuous, commented as he rose to leave, “I don't know what I'd do if I hadn't this old stick to lean on.” I thought he was referring to me.

I witnessed the gradual decline, over nine months, of an old widow with cancer of the stomach. She was nursed by her daughter and son-in-law with whom she lived. An autocrat in character, the daughter of a farmer and slaughterer, the old lady had borne ten children. A handsome tall woman, she presided over her greengrocery shop from the back sitting-room. Another domain was a furniture removal business which she herself had run after her husband's death.

As her health failed, her daug