MAY I, must I acquaint some one, of whom I know, that his sickness is fatal, with his real condition?
Let this question be put not merely with respect to our consumptives, but in general, to all patients who are sick with incurable, quickly terminating diseases. And then you know, what most of our physicians, and with our physicians most families think about it.
Concealment is their watchword.
Let no one judge this practice too harshly. Both with our physicians and with our families, from their standpoint, there operates a higher motive.
Our physicians know by experience, that so little can be done with their patients, the moment they lose courage. Hope brings life, and so long as the glorious outlook upon recovery stimulates courage, the patient does not mind his suffering so greatly and struggles through his restless nights and lengthy days with more moral will-power.
And as regards the families, they mostly deem that love forbids, to tell the sick and slowly dying at once the full, hard truth.
Their beloved sick would be so frightened by it; perhaps burst out in bitter tears; and all the after days be prey to black despair.
Now it takes much effort on their part, to practice self-control, and with sorrow in the heart, yet always to appear at the bedside with a hopeful smile. But love demands that sacrifice, which they are willing to bring.
And now it gives them pleasure, when they observe, how, thanks to their tactful silence, the poor patient continuously builds castles for himself in the air.
First, in winter time be on the lookout whether the swallows are not yet bringing summer back, and presently in sharp days of autumn look forward again to the cheerful fire on the hearth.
Always hope, always ideal illusions! Till finally death surprises them. But then, thanks to concealing love, the terror and the fear of dying has been spared them.
THERE’s something more to this.
Especially of consumptives it has been observed, how little they themselves believe in their approaching death. At least so long as it has not gone too far, a consumptive is naturally cheerful. And though you tell him that his end is at hand, it is not often he believes it.
At least a consumptive who is in the twenties, as a rule, observes what ails him. He has frequently heard the signs of consumption discussed or observed with others. Nothing therefore would be more simple than that, observing these same phenomena with himself, he would at once draw the conclusion and understand whither things were going with him.
And when a consumptive does this, he well knows, that his condition is most serious. What Dr. Koch thought was a cure for consumption, did not prove, alas, to be the real, the of God appointed antidote. And unless one can take a timely departure for the North, and continue to live in the North, such a sick person well knows, that having reached a certain stage, consumption as a rule terminates quickly.
And yet, however strange it may seem, most consumptives do not apply this to themselves; and though it be, that they begin to fear the worst, yet hope keeps them ever confident, that with them, perchance, recovery will follow.
And with this in mind, even a pious physician, and they who desire to conceal the character of the disease ask, whether in the very nature of the disease God does not give an indication, not to tell our weakening patients that death is at hand.
NOW in Christian families the opposite line of behavior is followed. When in our human way we foresee with some certainty, that our sick will die, we tell them so.
We do this with the aged, and also with young men and young women, whom God the Lord calls away early. Yea, even with our little children, if it pleases Him, to take them from us.
God’s children even counted it a fault on the part of their physician, when they thought, that he tried to mislead them; and among God’s people he will be sought after mostly as a physician, who himself is averse to false appearances, and plainly and simply “speaks the truth to his neighbor,” and thus also to his patients.
And what else accounts for this difference, except this: that a child of God does not like to be deceived himself, and to be held ignorant of the fact, if he himself were nigh to death.
As well in our own circles as in those of the others we act therefore after the rule of the high commandment: “Therefore all things whatsoever ye would that men should do unto you, do ye even so to them” (Matt. 7, 12).
Only, for oneself one has another desire.
In those other circles one would wish for himself, not to hear about it, before it came to dying. And therefore they say nothing about it to their patients. In the circles of God’s people, on the other hand, one would think it terrible, not to be told at once; and for this reason one would neither dare nor desire to conceal it from his patients.
CAN you now say, therefore, that those tragic patients, whose dying in the near future seems to be certain, in our circles are so much worse off?
Put the facts before you as they are.
When everything must be held back, for weeks and months together, there is played a kind of tragedy around their sick-bed. Nothing more is natural. Neither the fold in the face, that sets itself into a forced laugh; nor the tone of voice, which keeps conventionally cheerful; nor the content of the words, which contain a lie. A false attitude is dominant, in which every member of the household must take part, and in which they who come in from without, are introduced. It is agreed beforehand, what shall be said, how the condition shall be presented, while the physician takes the leading rôle in the tragedy, himself taking part.
But even when the patient does not see through that game altogether, you understand, that a patient who is but somewhat more discerning, becomes aware of something strange; from that continuous play receives a queer impression; and therefore is by no means yet contented.
Hence the numerous inquiries, and the stare with searching eyes upon the physician and those that stand by; as though he would say: “But, Doctor, you are not deceiving me?”
And when a visitor comes in, he is mostly accompanied by a member of the household, to prevent a possible betrayal of the game; but when for but one moment that poor patient is alone with such a visitor, one hears at once the question put: “I am not going to die, am I?”
But listen, the door opens; one of the family is just come upstairs again; and to the question faintly caught there sounds the answer, not from the visitor, but from mother or sister: “No, indeed, my darling; what are you thinking of! The doctor was ever so satisfied.”
And he who writes this, has sometimes heard this lie iterated and reiterated, when ten hours after, he who asked it, was already in eternity.
IS it not dreadful, when for weeks or months together, in the gravest that can overtake us, from love, be it so, and with the best of intentions a play is acted out with us, where the need was so very great, to prepare our soul, and might it be, to spread a blessing around us?
Can this be good in the sight of God, to involve all our family, and every one that comes in, in such a systematic untruth? Can it be good for our heart, to show ourselves so many days smiling, when in our heart we weep? And above all, is it permissible, that we allow our poor patients in such a way to be surprised by death, and without transition, without comforting light, let them pass into eternity?
Moreover, is this honoring God’s creature in your patient, when you deem that he could not bear the knowledge of death, and would not be able to endure it, if he knew that his dissolution was at hand?
May a father so deal with his baptized child, a mother with her darling, whom she received from God? Death is anyhow sure to come. On the part of your sick, if they must die, there is nothing more to hope for from this world. And of eternity, wherein their only expectation can lie, you tell them nothing, and you prepare them no blessed entrance.
And, therefore, though we do not judge harshly, and though we misinterpret no one’s intentions, yet with a lie at the sick-bed you come upon something cowardly, something untrue, something unmanly, that makes you say: “This cannot be good before God.”
He who is about to die, must in the first place know it himself (2 Tim. 4, 6).
AND now come into our circles, and see how things there are done.
No, boasting is not seemly, and sometimes in our circles also consumptives die away slowly, whose sick-bed was far from inspiring, and with whom no spark of courage, born of the holy faith, glistened.
Alas, also in our circles faith is not the portion of all. There are also such as are hardened of heart.
But this can be testified to the praise of God’s grace, that as a rule this is different. And that our poor patients, whom we do not mislead, and who therefore know that they are to die, after the first shock, which such knowledge always brings with it, they rather are glad that they know it.
And, O, then there is such a change in the feeling of the heart. Now that nothing more is to be expected of earth, the eye directs itself so much more fixedly to heaven. Of the world one becomes weaned, and with God and His dear Son and His holy angels the more intimate. Not infrequently it happens, that our patients soon end the bitter struggle, and now calmly and resignedly await what God appoints them. And meanwhile, confident in their Savior, drink in draught after draught from the cup of His blessed comfortings.
Also, from such a sick-bed, there goes out a refreshing influence upon the whole family. With a sort of sacred emotion one approaches the sick-bed and feels himself more seriously affected. So there comes higher, holier peace upon the heart of all.
And when at length there comes the moment of parting, both he who dies and he who stands by the bedside, are prepared for it. And oftentimes God privileged those who remained behind to jubilate: “A crown is laid up for him.”
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