Physician and patient

by Worthington Hooker

LETTER I.

ON THE DIFFICULTIES OF THE UNDERTAKING.

My dear Friend,

You were pleased to desire me to send you the result of my observation and experience on the deeply interesting subject of endeavoring to promote the spiritual welfare of the sick committed to your care. I cheerfully accede to your wish, although I can scarcely hope to offer any suggestions which have not already occurred to your own reflective mind.

If the soul of man be immortal, and if the state of the soul, at the moment of its separation from the body, determine its happiness or misery through endless ages, with what deep solicitude should every Christian approach the bed of a fellow creature, who, to all appearance, is about to undergo the momentous change, yet unprepared “to meet his God!” If we saw a human being proceeding blindfold towards a tremendous precipice, even already at its brink, how eagerly should we try to snatch him from the threatening destruction! And can we, my friend, remain insensible to the spiritual danger of the dying man, who seems about to “take a leap in the dark” into the gulf of inconceivable—irretrievable ruin? How often, alas! are we called to witness the appalling scene, unalleviated by the presence of a Christian minister, or any pious relative, who might direct the helpless sufferer to Him, “who is able to save to the uttermost!”

I am aware, indeed, that those alone who, like ourselves, have felt the weight of medical responsibility, can fully estimate the difficulties to be encountered in attempting to advance the highest interest of a patient, while conscientiously discharging our primary duty, in the exertion of our utmost efforts for the restoration or relief of his bodily frame. Even to those, who, by habits of early rising, punctuality, systematic arrangement, and calm despatch, have been able to allot a sufficient portion of time to each appointment of the day,—how often does it happen that some unexpected emergency, some sudden complication of disease, the alarming sickness of another member of the family, some anxious inquiries of the patient or his friends, or other unforeseen circumstances, have more than consumed the allotted time, and in justice to the indispensable claims of other cases, rendered an immediate departure necessary: thus affording no opportunity of even alluding to “things unseen and eternal.”

Another difficulty is often found to arise, from the almost exclusive occupation of the physician’s mind by the diseased condition of the sufferer, the relief of which is, of course, our primary and incumbent duty. In order to give to each symptom, as well as to the whole assemblage of symptoms, a close and discriminating attention, and to adapt, with equal care, a corresponding treatment in medicine, diet and general management; to do this within a limited space of time, requires a concentration of all the energies of the mind in a degree scarcely compatible with attention to any other subject. Under such circumstances, it is difficult in the extreme, to dispossess the mind of the engrossing anxiety just described, so as to leave it sufficiently free for availing itself of any suitable moment for introducing, with needful delicacy and tenderness, the all-important subject of eternity. How frequently, too, have we found that by the time we have completed our medical inquiries and directions, the patient has become too much exhausted to render any further exertion safe or practicable!

In addition to the obstacles already specified, you have probably, my dear friend, sometimes encountered opposition from the mistaken kindness of the patient’s relatives, who have deemed it next to madness to endanger the comfortable serenity of one “whose goodness of heart,” they persuade themselves, “must secure him a happy hereafter.” Generally, however, the confidence reposed in the kindness and discretion of the medical attendant, will soon allay such a feeling of alarm, and afford the assurance that nothing will be attempted of a doubtful or hazardous character.

But the most formidable hindrance, I apprehend, exists within ourselves. I refer to the prevailing impression among us, that the religious welfare of a patient is foreign to our province; that to aim, in any direct manner, at promoting it, is superfluous, if not also obtrusive; and that the attempt might be regarded, moreover, as an unbecoming interference with the sacred office. The sedative influence of this opinion is often rendered still more paralysing by a consciousness of not possessing the facility and tact supposed to be essential to the success of the effort. Hence, opportunities for speaking “a word in season,” are scarcely looked for or desired. The mind, at length, rests satisfied with an abandonment of the matter, as hopeless and impracticable, not duly considering whose cause it is, nor recollecting the divine promise that “strength shall be made perfect in weakness.”

Such, my valued friend, are among the difficulties in our way; great, indeed, we must allow them to be, yet, happily, they are not insurmountable.

Assuming, for the moment, that the duties and qualifications of the medical practitioner do not impose upon him a higher degree of responsibility, relative to the spiritual good of his patient, than attaches to every other well-informed Christian, in reference to his neighbor, I may safely assert that the profession of medicine does in no wise release its member from a duty common to all Christians—that of embracing every opportunity to testify their gratitude to the adorable Saviour, and their anxious desire to extend the blessings of redeeming mercy to those who “are ready to perish.” But the assumption itself is incorrect; for it would not be difficult to prove that the favorable opportunities and peculiar facilities possessed by the physician do proportionably augment his responsibility, and the consequent amount of obligation. Nor can this fearful responsibility be evaded, by a general impression of our unfitness for the task, unless we can conscientiously affirm that we have tried to the utmost—that we have done all that we were able to do.

As regards the alleged interference with the ministerial office, I may truly say that, to the extent of my own observation, the apprehension is entirely groundless. So far removed, indeed, are the judicious, well-timed suggestions of the physician, in relation to the immortal interests of his patient, from anything like interference with the sacred function, that, in the instances in which they are most needed, they may be strictly regarded as precursory and introductory to the more direct instructions of the minister; as opening a way for him which would otherwise be closed, as removing ill-founded objections to his assistance, and enkindling a desire for his spiritual counsel. In many other instances, the Christian physician proves a powerful auxiliary to the faithful minister of Christ, especially by facilitating his visits, pointing out at what time, under what circumstances, and to what extent, the patient may be likely to attend, with safety and advantage, to “the things which make for his eternal peace.” I have good reason, indeed, to believe that the enlightened ambassadors of the Saviour, so far from entertaining a feeling of jealousy, do really hail with cordial satisfaction such auxiliaries, in their trying visits to the bed of sickness and death; persuaded that none can feel a deeper interest than a Christian physician, in the well-being of the whole man, bodily and spiritually, in reference to eternity as well as to time. And how can jealousy be felt? Is not the glory of his Divine Master in the salvation of immortal souls, the supreme object of every pious minister’s pursuit? If so, even the feeblest attempt to subserve the same cause must gain his hearty concurrence. Happily, the un-scriptural, un-Protestant notion of religious instruction devolving exclusively on the clergy has become obsolete. As well might the Bible itself be read and studied by them alone. The very constitution, indeed, of our most efficient religious institutions speaks a contrary language; especially that of the visiting and district societies, in which the principle of lay co-operation is clearly recognized, and the obligation thence arising is fully avowed. In truth, it requires but little sagacity to predict that, in the noble enterprise now in progress for evangelizing the world, the zealous exertions of Christians generally will be more and more called forth. Such an active and pervading influence seems evidently implied in the prophecy of Jeremiah, as cited by the apostle of the Gentiles, alluding to the period when “they shall not teach every man his neighbor, and every man his brother, saying, ‘know the Lord;’ for all shall know me, from the least unto the greatest.” We have yet, indeed, to realize the happy day when, even comparatively, every man shall seek the spiritual good of his neighbor; but we are surely authorized to expect it, as well as bound to hasten it, by earnest prayer and vigorous endeavor. We are even encouraged to anticipate the more distant and glorious period, when the omnipotent Saviour shall have given complete efficiency to the universal labor of love, and when “He shall be all in all.”

Not to weary your patience further, I will here close my letter; hoping, in a second communication, to present a few encouragements which may serve to cheer you under the difficulties we have been considering. I shall endeavor also to add some practical suggestions, in reference to the most eligible methods of introducing the subject of religion to persons dangerously ill. Of the power of executing the latter part of my task, especially, I cannot but entertain much self-distrust.

I remain, my valued friend,

Your’s, with sincere regard,

T. H. Burder.

Tilford House, Jan. 1st, 1836.