Why doctors can’t talk about death

Charles 2 Comments

“Psychoanalysts believe that emotional trauma in human life is because man is not really a god and is something more than just an animal. He is a demi-god and being a demi-god is hard.  He can create and appreciate goodness, enjoy the wonder and awe of each day; teach, learn, and dream, but at the same time, he can see into the future and knows his fate.  His mind can conceive flying through the air, staying awake for days or living to be 10,000, but he is denied by the limitations of his flesh.  This results in life long stress and in order to cope man uses various psychological strategies, including repression and denial, to focus on each day and each moment and not go truly mad.

When someone becomes ill with a life threatening illness such as cancer, their ability to deny the animal part of their existence may collapse.  Suddenly they are less god than ailing beast. This can cause terrible anxiety, confusion and depression, as their personality is threatened by physical deterioration and critical coping mechanisms fail.  At these critical times, the support of a physician who understands the core balance of the human condition can be most valuable.

“However, it seems to me that doctors do not talk about death to their patients, not because they do not care, but because doctors do not know how to deal with the god, they only understand the animal.”



  1. Charles

    This is a very useful analysis.

    It reinforces our awareness of the problems that arise in our lopsided approach to medical care: we have let ourselves believe that ‘life’ is everything, at no matter what cost. Thus we allow the danger that the medics may shun us when we or our relatives and friends get close to death, as we’re breaching their bubble.

    The quality of our conversations about our living and our dying needs to improve . . .

    Not for me, though: I’m immortal.

  2. Charles

    Er, not as immortal as I am, Kathryn, I hope you can accept that…

    I suppose death=failure, for a doctor doing his best to sustain life. But eventually we all fail, so it would be reassuring if we knew that doctors were concentrating more on the moment when they know failure is imminent and they can talk about how they and the nearest can manage it. No, not “manage,” that’s too controlling an idea. How they can support and accompany it.

    Someone I know a little was told she had a life-shortening cancer, and might manage five years, or maybe just two. She was – a little knocked back by the news. The consultant said “Everyone has to die sometime.” So that end-of-life care course wasn’t wasted on him, was it?

    She is 53.

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