If, on the other hand, and which is much more frequently the case, the patient says nothing, but the Shakespearian “Oh!” “Ah!” “Go to!” and “In good sooth!” in order to escape from the conversation about himself the sooner, he is depressed by want of sympathy. He feels isolated in the midst of friends. He feels what a convenience it would be, if there were any single person to whom he could speak simply and openly, without pulling the string upon himself of this shower-bath of silly hopes and encouragements; to whom he could express his wishes and directions without that person persisting in saying “I hope that it will please God yet to give you twenty years,” or, “You have a long life of activity before you.” How often we see at the end of biographies or of cases recorded in medical papers, “after a long illness A. died rather suddenly,” or, “unexpectedly both to himself and to others.” “Unexpectedly” to others, perhaps, who did not see, because they did not look; but by no means “unexpectedly to himself,” as I feel entitled to believe, both from the internal evidence in such stories, and from watching similar cases: there was every reason to expect that A. would die, and he knew it; but he found it useless to insist upon his own knowledge to his friends.
In these remarks I am alluding neither to acute cases which terminate rapidly nor to “nervous” cases.
By the first much interest in their own danger is very rarely felt. In writings of fiction, whether novels or biographies, these death-beds are generally depicted as almost seraphic in lucidity of intelligence. Sadly large has been my experience in death-beds, and I can only say that I have seldom or never seen such. Indifference, excepting with regard to bodily suffering, or to some duty the dying man desires to perform, is the far more usual state.
The “nervous case,” on the other hand, delights in figuring to himself and others a fictitious danger.
But the long chronic case, who knows too well himself, and who has been told by his physician that he will never enter active life again, who feels that every month he has to give up something he could do the month before—oh! spare such sufferers your chattering hopes. You do not know how you worry and weary them. Such real sufferers cannot bear to talk of themselves, still less to hope for what they cannot at all expect.
So also as to all the advice showered so profusely upon such sick, to leave off some occupation, to try some other doctor, some other house, climate, pill, powder, or specific; I say nothing of the inconsistency—for these advisers are sure to be the same persons who exhorted the sick man not to believe his own doctor’s prognostics, because “doctors are always mistaken,” but to believe some other doctor, because “this doctor is always right.” Sure also are these advisers to be the persons to bring the sick man fresh occupation, while exhorting him to leave his own.