Lost fatherhood: A doctor's dilemma with a dying patient's secret

When a patient has physical, psychological and social pain, management of the patient becomes very challenging. I have many times become a listening ear, confidant, family secret bearer and punching bag.

I recall the story of a man who landed at the hospital in extreme pain. The patient had end stage cancer, but his pain seemed disproportionate to the symptoms and care already provided in his treatment. An array of tests were done to try pin down the cause of pain. No physical reason for the excessive pain was found.

The man had a loving wife who catered to his every need. They shared a familiarity that could only come from years of love and mutual respect. She would happily jump at every opportunity to help him sip his drink, fluff his pillows and try to make him comfortable. During his stay in hospital, she brought his favourite porridge or soup in a flask every morning. His extended family regularly brought fruit baskets for him and all the nurses and caregivers on the floor. Everybody marveled at their love.

After the physical tests came in negative, it was time to have a serious conversation, to discuss what else could be bothering him. During a family session with his wife by his side, he spoke of his life, business opportunities missed, opportunities taken, friends made, enemies forgiven, his undying love for his wife, mother and family. He realised that he did not have long to live, but was thankful for every day, in every way. He seemed content.

Later that evening while doing final rounds for the day, the doctor found him awake. He was still in pain and drowsy due to the high doses of morphine. The doctor explained that other social and psychological problems can make pain worse. “So, thinking through your life, what else bothers you?”

“I am in a lot of pain and have bigger regrets that I cannot voice in front of my wife. She has been a very good wife, I know she adores me, and I don’t want to break her heart now, not when I will not be here to pick up the pieces…….”

He had one regret, after his first degree he landed a government job some 500km away from home. Young, carefree and with a good paying job, this small town was his playground. Soon he met a beautiful nurse at the government hospital he oversaw. Friendship then love blossomed, and overtime, they were blessed with two children.

All was well until his time in this town came to an end and his transfer papers were processed. Fearing that his family would not accept his relationship with a woman from another tribe and religion, he told his girlfriend he would be leaving without her. Through angry fights, bitter words, and threats of withholding his children from him, he left.

Back in the city, he tried to keep up with his young family. He sent some money for their upkeep, but overtime felt less and less inclined to support them. Slowly, he forgot about them. He finally met and fell in love with his current wife. She was a wonderful woman, the correct tribe, and his family adored her. They had been married for 17 years, and had no children. They had tried all manner of treatments to get children of their own, and just before he got ill, had settled for adoption.

The man spoke of his sincere regret at not having kept up with his children. With tears in his eyes he wondered, did they go to college? What were they studying? How were they managing? He wished he could see them just once before he died, surely, somebody needed to carry on the family name! He needed to see them and explain himself somehow. He would figure out what to say when he met them, but he needed to see them.

The doctor watched as all manner of emotions ran through him. The first thought that came to mind was why didn’t he have children with his current wife? How would they even start looking for someone who had not been seen or spoken to in over 17 years? Were the children he longed for even his?

As if reading the doctor’s mind, the patient blurted out; “My wife and mother cannot know until I sort out some things...  doctor, we have to find them, I must make this right... You have promised to help me deal with my pain,” he pleaded.

He had his my children’s mother’s number saved, having gotten it from a friend who still lived in that town, but hadn’t called yet.

What now? She took the number with a promise to call. Within days, the patient now living on hope and a plan to find and reconnect with his children was mostly pain free; much more comfortable than when he first arrived. Most importantly, he needed no adjustment to his pain medication, the morphine dose was even reduced.

A call to the number was made, but the news was not good! The doctor wondered what problems if any, her involvement in her patient’s private life would bring. Was she doing the right thing?

For her, keeping hope alive was really important, in the short time he had left. As George Savile wrote, “Hope is generally a wrong guide though it is good company along the way.