With blood samples drawn several times daily, a catheter in his bladder, a catheter in his arm vein, unable to eat, and isolated from knowledge of day or night in his intensive care cubicle, Mr. Beck had been undergoing exquisite torture for more than a month. Relatives called at rare intervals.
Now it was plain, the new resident said, that Mr. Beck would not recover but would die of his unusual lung disease in days or weeks. It had become harder for the young doctor to enter Mr. Beck's cubicle. So little could be done. Conversation was so one-sided, so frustrating for both as he tried to decipher words formed by Mr. Beck's trembling lips.
Further "therapy" usually meant adding to his already considerable discomfort. A suction tube could be put into his tracheostomy more often in a vain attempt to keep up with the pneumonia that was dealing the final blows to his lungs. Again, more torment for Mr. Beck from the spasms this induced.
Because of our practice of sharing night and weekend call, all of the other residents present at the meeting had come to know Mr. Beck. We all knew his torment and his prognosis. We also knew how the new resident was feeling.
There were no helpful suggestions for the patient's or the resident's plight. There were no measures being carried out in Mr. Beck's care that are considered "extraordinary medical care," no dramatic respirator with its controversial plug. Yet it is also true that the ordinary care being provided to Mr. Beck is extraordinary when compared with what was available a few years ago.
He was alive this far only because of the ability to monitor and correct subtle imbalances in his blood acidity and levels of various dissolved salts and gases. This "ordinary" care was also extraordinary in its ability to prolong his dying. At the moment, no one present was particularly proud of this medical prowess.
The meeting was a teaching conference on the topic of death and dying. As the guest speaker, a Christian minister, began to address himself to Mr. Beck's suffering, I began to be turned off by what he was saying. It was, disappointingly, the usual: Don't avoid the patient. Allow him to express his feelings, to vent his anger. Death is a part of life. The steps of dying as described by Kubler-Ross. How trite!
I began to yearn for him to address himself to the crucial issue--death as the gateway into the hereafter. Please, you are a Christian minister. Your expertise is not psychology.
Mr. Beck is dying. The issue is what is to become of him after he dies and this is what you can effectively speak to. This is, after all, your calling. You could add a dimension to this conference that is almost uniformly neglected in such conference. Saved and unsaved residents here could benefit by a consideration of Christ's offer of eternal life in Him.
Very shortly after my thoughts took this trend, I was convicted in my heart of hypocrisy. I, least of all, had the right to criticize anyone on this point, for Mr. Beck had been my patient before his care was assumed by the new resident when I rotated to the hospital's obstetrical service. I had known him when he cold talk. And talk he did. He had been an obstreperous patient, difficult to deal with.
Mr. Beck had known he was dying before I had. It wasn't plain to me until the last day he had been my patient, just before the new resident assumed his care. By that time he had withered in body and spirit.
I had continued to visit him daily after it was no longer my responsibility to care for him, but my visits had become more and more sporadic as I felt the same helplessness that the new resident had expressed. I could get out of seeing Mr. Beck in the situation I had had a hand in creating. The new resident could not.
Throughout all the weeks I had seen Mr. Beck, I had not witnessed to him about Christ, although I strongly suspected he was not a Christian. I knew that the long-term outlook for Mr. Beck was grim, but death was not pressing at the moment, so I let it slide. I had talked to patients before about Christ's answer to their problems, especially to alcoholics, but never yet to someone with a terminal illness. I had yielded to subtle pressures.
One pressure was the precept of "not taking advantage of my position and the patient's physical and mental weakness to push my religion." People are especially vulnerable when they are ill. Physicians are in a unique position to take advantage of this weakness in many ways, if they choose.
I had disagreed with this precept mentally, but not often enough in action. When questions of our eternal existence and judgment for our life's actions are forced into our awareness by the threat of death, we are indeed weak. But man's weakness is no reason to withhold the Gospel. It is rather the reason to present it. There may not be another opportunity.
Another precept was "Never take away hope!" My supervising physician had once told me this in regard to terminal patients. A frank discussion of the hereafter with Mr. Beck would have strongly implied to him that I thought there was no hope for him medically.
I would not have been taking away hope had I presented the Gospel to Mr. Beck. I would have been replacing a vain hope in this life and its strengths and pleasures (obviously a slight hope in this case) with the hope of eternal life. That is hardly taking away hope.
Perhaps the strongest and most dependable pressure I had yielded to was "What will the others think?" The others were the nurses, orderlies, nurses' aides, technicians and doctors. There is little privacy in intensive care units. To present the Gospel to Mr. Beck would have to be public profession of a type I haven't often practiced.
To make it worse, Mr. Beck was slightly hard of hearing. I would have had to raise my voice. So I let it slide. And I had been critical in my heart of a Christian minister because in my opinion he wasn't living up to the name Christian. Then I realized that I, too, bear that name, and my responsibility was greater because my opportunity had been greater.
The minister was at the moment offering his services to the new resident to visit Mr. Beck. If that resident wanted him to, he would be glad to do so. I could sense that the new resident would assent to this.
Fearing that the minister might play psychologist and ease Mr. Beck out of this life with a listening ear and sympathetic touch rather than telling him the good news of Christ's atonement, I offered my services instead. I don't know that the minister would have played the role of death therapist rather than doorman to the way of life; however, the possibility that he might subject to the same pressures I had yielded to seemed real.
The reason for my being the one to "spend time with" Mr. Beck was the thin one that I had known him longer and had known him when he could converse well; therefore, I should have better rapport with him.
Within the hour, I was at Mr. Beck's bedside. If Abraham could arise up early in the morning to fulfill his unpleasant task of sacrificing Isaac, surely I could afford to put it off no longer. That I regarded sharing the Gospel of Christ with a dying man as such a chore rather than a privilege shows how much of a hold the gods of this world had on me yet. Relief! Mr. Beck was asleep, a rare privilege for him.
Two hours later I again entered the intensive care unit, this time after some prayer. As I came in the door a nurse told me, "Mr. Beck has been asking to see a doctor, any doctor."
To his cubicle I went, being careful to close the double glass doors behind me. Some privacy at least, though I was keenly aware of the partition behind his bed. It did not reach to the ceiling and the passageway on the other side frequently had visitors or hospital staff members standing around, easily within earshot of my voice.
"Hello, Mr. Beck." He immediately began to struggle to mouth words. He was too shaky to write. It was very clear what he was mouthing, but to be certain, I let him say it twice before I said it aloud to let him know I understood. He said, "Let me go."
"Mr. Beck, we're trying to. But it's hard for us."
Weakly, he nodded assent, then weakly shook a couple of the tubes leading from his body, in frustration at being held prisoner in life by them. I ask him if he knows what will happen to him once he dies. He indicated, "No." I asked him if he believed in God. Yes. Was he a Christian? No. Would he like to hear? Yes.
As simply as I could, I told him: Our sinfulness. God's righteousness. Christ, the way of salvation, by whom we become righteous because He paid the penalty we richly deserve. If we accept Him as God's Son, as the one who has paid our penalty, then we are received into God's presence at death. No one earns it. It is a gift.
As ineloquent as I have ever been, but all the elements were there. Would he like to pray with me? Yes. Aloud I prayed, laying out before God Mr. Beck's situation and suffering and our helplessness to help him. Briefly, it crossed my mind that some nurse or visitor might be looking or listening. The answer was swift: I must serve God, not man. If someone was listening, fine. Perhaps they needed to.
I asked Mr. Beck if he would like to receive Christ into his heart as his Savior. Yes. He closed his eyes in prayer. When he opened them a minute later, he was weeping. At least I think so, for so was I. Later, I left him and asked the nurses to please give him a half hour's respite from their routine of care. They understandingly assented. Obviously, Mr. Beck had been a trial to them as well as to us.
I visited Mr. Beck several times before his death eight days later. His suffering continued unabated. Satan extracts his pound of flesh. Mr. Beck certainly had been a help to me, and I tried to explain to him why and thank him. Will we meet again in heaven? Was it genuine? I hope so.
This article was originally published in The Presbyterian Journal in February 1976. The "Mr. Beck" of this story is not the patient's real name.
