Tell me the truth, doctor! by Charles Lebaigue MD

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" Tell me the truth, doc!"

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Would you call that a honest demand?

I wouldn't.

In ordinary circumstances, a patient would never ask that

from her doctor (yes, let's assume we talk about a 'she'

patient).

She trusts him -- let's also assume her doctor is a 'he one'--

and she knows that he always talked genuinely with her.

And never would hide anything important concerning her

health condition.

Really never?

It CAN happen that the doctor, quite unsure about a possible

bad evolution in his patient's condition, prefers to keep quiet.

But when the patient's condition has obviously been worsening,

she guesses very often that her doctor is trying to hide her his

opinion about her situation.

And then, sometimes, she finds the courage to ask him, in fact

to beg him:

"Tell me the truth, doc!"

What does she really mean? Most probably this:

"Stop, please, hiding me what you really think about the

possible evolution of my illness!"

And such a demand is a very serious one when the doctor

is actually concerned with the possible nearby death of his

patient!

What can he tell her without risking to loose or -- at least -

seriously damage her trust in his sincerity?

Should he talk her about the statistical probability of her

Survival? I don't think it would be a wise answer.

The Medical Faculty taught him that an average patient at

this stage of the evolution of this special illness will probably

be dead before so many weeks, months or years.

Probably the "average" patient, yes. But is SHE one of these

average patients the stats tell us about?

Okay, MOST patients will behave according to the stats.

Let's say 90%.

But the remaining 10 %? What will THEY do?

Let's assume that 5% will die earlier, maybe much earlier.

But the 5% -- at the other extreme of the probability curve -

will live much longer. Maybe not die at all (at least from

this disease.)

One talks then often of a medical miracle. But it's nothing

more than a totally foreseeable statistical phenomenon: the

exception that "confirms the rule".

Not SO exceptional either: one on the hundred 'members' of the

Stats may expect such a good fortune!

Why not her? This very patient of mine, there in front of me.

I really don't know for sure how this life endangering illness

will develop in HER case. I can just make suppositions -- for

and in myself.

Nothing I can tell her, of course. But I owe her an answer!

A quick college statistical, nevertheless? Maybe. But not

every patient can be satisfied with such an vague answer.

She wants to know HOW SHE will DO in the nearby future.

She doesn't care about ONE'S ILLNESS where the scientists

always talk about.

I could talk her - I did that several times during my career as a

family doctor -- about the really life endangering present stage

of her illness. That she possibly could die, not so far away.

BUT that her WILL to fight for her life, even in this dangerous

moment, can make that SHE won't die, that she will make true

the next medical miracle in my career!

And that I am eager to help her realize that miracle.

That remembers me of a patient of mine, a sixty six old man by

whom a quickly developing colon cancer had been diagnosed.

When he asked me how long the Faculty gave him to survive

his operation, I honestly answered him: "Probably half a year"

and encouraged him to fight with all his power.

He fought successful one and a half year, with the help of some

expensive but very efficient holistic drugs. A month before he

collapsed, he spent a beautiful summer holiday with his family

in the Austrian Alps. He was even able to make some climbing.

When he realized that all at once his strength was fleeing away,

he asked me once more how long I thought he might stay in life.

My answer was; "A couple of days if you stop feed yourself."

He chose to stop even drinking, but asked for opiates to lessen

the pain and died very serenely a week later, short after a nice

farewell ceremony from his family which he asked the parish

priest to organize around his bed.

This is of course the way many of us would prefer to die. Not

everybody however wants to stay as conscious till the utter end.

Not every patient can stand the naked scientific "truth" about

her nearby death. Many less courageous people will receive

from their doctor a different version of the truth they maintain

to claim.

The duty of the 'accompanying' doctor is to evaluate and to

reveal to each patient the amount of "truth" she is able to cope

with. Not more but certainly not less.

Each patient is a unique person who deserves an appropriate

and even unique answer to her solemn request. Only a sound

knowledge of her psychological - and spiritual - needs can

inspire the right words to her 'end of journey' counsellor.

If you let me give you a good advice, dear reader of this mail,

Don't wait till the fore last minute. Choose in time the doctor

whom you will be able to ask -- in full trust that he won't lie

or hurt you -

-Tell me the truth, doc!

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I hope you won't mind if I make now a few 'philosophical' or

linguistic' reflections.

Go to Page 2

BIO:

Charles Lebaigue MD is a retired Belgian professor(Medical Psychology)who successfully practised several holistic therapies

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