It’s Terminal


In the Hospital Sick Male Patient Sleeps on the Bed. Heart Rate Monitor Equipment is on His Finger.

I was a trainee GP sat in the living room of an elderly couple. They were in their 80s. I was 60 years their junior and equipped with the peculiar overconfidence that is the unique possession of the newly qualified. What I knew, but he didn’t, was that he had an inoperable stomach cancer. My task was to explain the diagnosis and tell him he was dying.

I was, of course, anticipating a difficult conversation. What I hadn’t expected was that, when we got to it, the word death would get physically stuck in my throat. I stammered and stuttered and, somehow, we muddled on through. Death, it turned out, was very much easier to talk about in a Bible study than with a man who was actually dying.

The d-word

Ten years as a doctor and 20 as a pastor has meant lot of d-word conversations – what lessons have I learnt? First, every situation is different. And our support of those facing death must reflect that. We’d do well to learn from Jesus. Arriving in Bethany after the death of Lazarus in John 11, Jesus meets Lazarus’s two sisters in turn. Both have faced exactly the same bereavement. And both speak exactly the same words – ‘Lord, if you had been here, my brother would not have died’. Yet Jesus’s response to each couldn’t be more different. Martha gets a little theology (John 11:23-27). Mary gets emotions and tears (John 11:33-35). Different people really do need different things and Jesus, the master-counsellor, knew that.

So, if you want principles, then here is one: be very suspicious of articles that tell you how to talk to those facing death! Attend to the person who is dying. Let them guide the style and pace of any conversation. A no-nonsense, no punches pulled, conversation that worked really well with one person may be an utter disaster with the next.

Opening the Bible

We should certainly overcome our inhibitions and talk about death, but we should do so at their pace. There is plenty of scripture to turn to. The Psalms will be particularly helpful: the experience of mingled fear and hope in Psalm 61 or 63 or the resounding confidence of Psalm 103 or 121. From the New Testament we might turn to passages that speak of resurrection hope (Romans 8; 1 Corinthians 15; Hebrews 13:20-21) or the many words of hope spoken by Jesus himself (eg John 4:13-14; 11:25; 14:1-6). But always turn to scripture in a way that opens up conversations, rather than shuts them down. Beware doctrinal declarations that function as a kind of intellectual defence against the realities of pain and suffering. Let’s face it: a dispassionate reading of 1 Corinthians 15 is generally a lot less demanding than sharing pain and weeping real tears. But that’s what we are called to.

Six tips

But with all that said, here are six things which (depending on your role and relationship to the dying person) may be worth remembering:

1. Facilitate conversations: are there others among their family and friends they would really like to talk to and can you help them achieve that? Or would they like help in talking to health professionals and getting information? Could you offer to go with them to an appointment?

2. Is there unfinished business? A broken friendship to restore? A family hurt to forgive? A confession to make? Death often raises such issues.

3. Are there messages to leave behind? A parent might write letters or record messages for their children to receive on their 18th birthday. A parent with very young children might record some personal memories or leave mementos to help their children to know them.

4. Have they spoken about financial arrangements? It’s surprising how often everyone assumes someone else will deal with this, and in the end no one does.

5. Has someone helped them think about end-of-life care? Or funeral arrangements? You may not be the right person to do this, but don’t assume those questions have been discussed.

6. And last, but very obviously not least, what questions do they have about the provision of Christ and how do they want to think those things through? Arranging to read the Bible together regularly is often much better than a one-off blitz! It usually takes time (and trust) for questions to emerge.

So, after 30 years, does the d-word still stick in my throat? Yes, it does. And I hope it always will. For if that stops happening, it will mean I have begun to forget the pain of the person in front of me and begun to detach myself from it. And that won’t do, because, to adapt the title of an excellent book, ‘Brothers and sisters, we are not professionals’.

More about Biblical Counselling UK is available at http://www.biblicalcounselling.org.uk or you can contact them at info@biblicalcounselling.org.uk or c/o Christ Church, Christchurch Street, Cambridge CB1 1HT