A READER – a qualified scientist I’ll call Ron – asks for my view on a dilemma that pitted his personal and professional integrity, and belief in absolute truths, against his love for a dying friend.
Ron’s friend, also a scientist, was dying of cancer. “He said that he would never use magic bullets,” Ron says, “but after two years of great pain he turned to … a [medical] device I knew … was a blatant scam.”
Should Ron have been honest and told his friend what he thought about his medical choices, or supported his friend in the choices he made, whatever Ron thought of them? Ron chose to keep his mouth shut. His friend died some months later. Now, he wonders, did he do the right thing?
I think so. What really mattered in this situation was that Ron kept faith with the requirements of being a friend, not with his beliefs about the importance of medical interventions having a base in evidence. His friend was terminally ill and the Western medical kit bag was clearly empty so whatever he chose to do or not do was not likely to substantially alter the final result.
People at the end stage of a terminal illness have two options. One is to put their affairs in order and live their life to the fullest, in full knowledge that death is imminent. The other is to fight, not necessarily in the belief they can win, but to assert control by resisting the unwanted end.
In Helen Garner’s novel The Spare Room, the dying Nicola injects massive doses of vitamin C, then tosses off the pain and noxious side effects as evidence the intervention is “savaging the tumours and driving them out”. Nicola’s friend, Helen, rails at Nicola’s naivety. “Their treatments are bullshit, Nicola. They’re ripping you off. They can’t cure cancer.”
But the truth is that what frightens and enrages Helen is not Nicola’s non-evidence-based approach to medicine. It’s her friend’s refusal to accept her own death. “You’re using that bloody clinic to distract yourself,” Helen tells Nicola.\ “Don’t say it, Hel,” says Nicola. She raises one palm. “Don’t tell me.” But Helen won’t be stopped. “You’ve got to get ready.”
It is easier for those of us who love and care for the terminally ill to witness their smooth transition through the Kubler-Ross stages of dying: denial, anger, bargaining, depression and acceptance. We sleep better knowing that as their time approached, our friend or family member was “ready” and “at peace”.
The truth is that not everyone does dying the same way. Some will never come to acceptance. They will “go on fighting right to their last breath”, explains the nurse who comes to look after Nicola. “And it is one way of doing it.”
For Helen, it was recognising that it was not the idiotic fruitlessness of Nicola’s vitamin C detox that was distressing and enraging her. It was Nicola’s inability to “work towards a glorious moment of enlightenment” and to admit she was dying and, by so doing, allow Helen and others who loved her to accept and be open about it, too.
However painful we find it, supporting our friends to die as they see fit can be our final gift to them. Biting his tongue, as Ron did about the sham nature of his friend’s last-ditch medical efforts, didn’t compromise Ron’s integrity. It gave his friend permission to die fighting and was the act of a true friend.
Support for a dying friend can be our final gift The Sydney Morning Herald