I am very glad that Nelson Mandela is out of ICU. I must say, though, I’ve had a heavy heart whenever his name was mentioned (which was less and less frequently) over the last 88 days.
Anyone who saw him before his present illness witnessed a frail man maintaining poise and charm – yet clearly struggling with an ageing body and mind (95 last birthday). He looked fragile and responded to questions, after a considerable pause, with a few muttered words that carried little of his previous forthrightness.
My reaction, on seeing him interviewed, was a desire to protect this precious man, symbol of wisdom and grace; to give him peace — rest from his labours — and surround him with the love and care of his family.
When he was taken to hospital, I thought it would be a sad but fitting end to such a man, as he went quietly to be with his Lord and Saviour.
Then I heard, with great sadness, that he was on life support and I knew what that meant: Unable to talk, with a tube down his throat, (or a hole in his throat), subjected to violent coughing as he was suctioned regularly, tubes in uncomfortable places and the indignity of having no say in what was done to him; at the mercy of doctors and nurses who turned him and washed him and pierced him with needles at will.
When the outcome is a fit, healthy person, such treatment is accepted with gratitude, but I could not help wondering what Nelson Mandela himself wanted. Why was he getting this treatment? Was it for his sake, the sake of his relatives, or the sake of the nation?
I have noticed that, as doctors, we bring our world view into our practice. For someone who fears death, or regards it as a personal failure, avoidance of death becomes the ultimate goal of treatment. Yet that goal is doomed to be thwarted. No-one has avoided death — not even Jesus. So we do the next best thing — we delay it as long as possible.
Modern medicine gives us the huge responsibility, as Christ’s followers, to examine our world view and to keep in mind, constantly, the patient’s best interests. For a Christian, death is not the end, but the portal to glory. (I have experienced that many times as I have prayed with Christians who were dying – and sensed the presence of God coming to take them home). For us, extra time here is a longer time away from the Lord. It is time given to us to further the Kingdom before our reward.
I am in no way advocating euthanasia, but encouraging an understanding of our responsibility. The gifts God gives us, such as advances in medicine, can be used to further our fallen agenda as much as to further the Kingdom’s. What is it, I must constantly ask myself, that I am trying to achieve by treating my patients — by subjecting them to this ‘therapy’? Will they benefit in the end, or am I buying extra time for myself — refusing to face the inevitable?
This is a complex problem that cannot be regulated nor quantified. It’s something I have agonised over throughout my career. I have seen terminal patients subjected to blind cruelty to keep them alive for just one extra fortnight, because the physician saw death as a personal defeat.
I am encouraging a realisation that, as Christians, we should not uncritically assume that the world’s view of treatment is correct. God’s ways are not ours. They are different and higher. He is compassionately “out the box” and, as His children, we should be thinking compassionately “out the box”.