Death Is Like Gravity, It’s Always There

Being a GP meant I spent a lot of time with people who were afraid of death. When people come in ill to see their doctor, death is like gravity, it’s always there, it has an effect on everything that happens, but no-one ever talks about it. 

People’s core reaction to death and illness has different effects, but it means that the vast majority of people are incredibly honest when they go to see their doctor – thinking, if I’m not truthful it might effect what the outcome is going to be. This makes being a doctor a real pleasure as the whole thing goes with the grain of truth. Not always true, but for the most part.

When they come in to say ‘what’s wrong with me’ really they’re asking two questions but most often only one question gets answered. They get the diagnosis, but what they’re also asking is “what’s wrong with me as a moral person – why has this terrible thing happened to me”? 

We all have this kind of folklore construction, a moral retelling of illness about why it happens…because my mum was an alcoholic, because I smoked when I was 17, because I didn’t look after myself.  They’re very complicated and it’s not that those reasons are untrue, they’re very true, it’s how we make sense of the our perceived moral misfortune to have got disease ‘x’ when other people have escaped with their health.

I often found it more interesting and rewarding to explore that moral question than to explain how to treat back-pain, how to stop smoking.

They’re asking the question ‘why me?’. I used to spend my time defending chance. Getting cancer or depression or multiple sclerosis doesn’t mean that you’re a bad person, it doesn’t have to be because your parent was an alcoholic, or that you didn’t love your child enough.  You were dealing with the consequences of that and, alongside it, this stuff called illness just happens. They didn’t teach me that in my training, it took me an extraordinary long time to get there.

It’s what made the job interesting, for me anyway. It’s a setting in which it’s possible to have very important conversations, quickly. Social norms and societal barriers slip away somewhat in that room and you get to the intense parts of people’s lives very quickly. It was a real privilege.