Alex Tang
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Medical Students /Paediatric notes
Illness and the Human Psyche
Dr Alex Tang
Mr. Wong was driving when he felt a lump on his neck. Three days later, he sat in shock as his doctor deliver the dreaded “C” word. “You have cancer of the lungs,” his doctor said, “You need surgery!” Mr. Wong’s immediate reaction is that the doctor has made a mistake or received the wrong X-rays. Two days later, he received the same verdict from another doctor. This doctor came highly recommended. His next few days were a blur as arrangements were made for his surgery. He felt a strange sense of loss, as if something is now missing in his life. All he can remember is how he, who grew up poor in the kampong, is now one of the richest man in Malaysia. He is a director and majority shareholder of a few public listed companies. He is the Mr. Wong, whose face appears regularly in the newspaper and covers of financial magazines. “What can all my money do for me now?” he mused.
He rapidly discovered that he is no longer Mr. Wong when he was admitted to the hospital. He has become a diagnosis and a number; the lung cancer in bed 234. His family and friends who came to visit look upon him with pitying eyes. The surgeons and nurses were courteous, efficient and caring. Yet he could feel the distance behind their smiles and felt like a piece of meat for them to carve up. “What am I?” he asked himself in the dark.
The surgery was surprising painless because he was under anaesthesia but upon waking the pain was unbearable. The painkillers given by the doctors helped a bit, but not much. Following the surgery, he has to undergo chemotherapy which made him very sick and lose his hair. After three months of treatment, he did not look like Mr. Wong anymore. He lived in dread of the next course of chemotherapy and radiotherapy. “Why me?” was a long sigh from the dark despair he has sunk into, “Make it go away. I can’t bear it anymore.”
Mr. Wong, like most of us, lived with the wonderful delusion that we are going to live forever. None of us wished to be reminded of our own mortality. To be reminded that our days are numbered and the countdown started when we were delivered from our mothers’ wombs is horrifying. That is why we surround ourselves with symbols and pictures of virile young men and women with body shapes that only a few percentage of mankind can ever hope to attain. These reinforce our delusions of health and wealth, convincing our conscious minds that our health and wealth will last forever.
Yet deep in our psyche (soul, mind, spirit), we know the truth. We live in a fallen world where death and decay reign supreme. In spite of all our medical and technological advances, we barely extend our death rate over the biblical three score and ten. Those who do so often live with severe limitations and poor quality of life. Dylan Thomas underscores our fight against our mortality by writing:
Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Numerous studies have shown that all patients suffer the following on being told they have serious illnesses. First, a keen sense of loss. This loss may be tangible as the loss of a foot after a below knee amputation in a diabetic patient. Or the loss may be intangible as a feeling of betrayal. Betrayal as one’s own body has failed to function as it should. Or a sense of betrayal that one’s health is a right instead of a privilege. It may be a deeper loss as one considers what might have been or inappropriate choices made. Second, a sense of loss of identity. This is especially acute in those who based their identity on their strength, body beauty, or achievements. Suddenly all these were taken away. This loss of identity manifest as a feeling of incompleteness and of disintegration of one’s self-image. This loss is exuberated by feeling of helplessness while under the care of health professionals. Third, a sense of uncertainty. Depending upon the illness, there is always uncertainty. Patients soon realise that medicine is as much an art as it is a science. And there is no guarantee that a particular treatment modality will work. Add that to the increasing healthcare costs, loss of earning capacity, and weakening of one’s body, the human psyche are stressed into depression. Finally, a sense of suffering. Being sick is not anyone’s idea of a holiday and there is real suffering and pain. Obviously, there are more effects on the human psyche by illness than this.
How then should a Christian, who has a redeemed human psyche, in the process of being restored to the image of God approach illnesses? I believe they too will experience the sense of loss, loss of identity, uncertainty, and suffering. However, firstly, regarding the sense of loss, the Christian should recognise that their bodies, like their health are gifts from God. Our bodies and our health are gifts from God, not a right. Only the one who gives have the right to take it away. Secondly, a Christian’s self identity should be based on who God is, rather that what he or she can achieve. Thus that identity cannot be easily shaken as God is unchanging. Thirdly, a sense of uncertainty can be countered by surrendering our life to the Lord. As Jesus in the garden of Gethsemane decides to commit his life into the Father’s hands, Christians too must learn to surrender. Life has always been uncertain but Christians have One who stands behind the scene to protect them. Finally, Christians suffer as much as non-Christians during illnesses. The difference is that Christians can make sense of their suffering in that they know their Lord had suffered with them on the cross, and their suffering, however senseless, do have meaning in God’s great plan. That, in the final analysis, is what really counts.
published in June/July 2008
