Knowing that you will die, and Cancer

Öleceğini Bilmek ve Kanser

Every researcher, who is interested in this subject matter, knows about the panic experienced by the experimental animals in the cage during decapitation (separation of the head from the body by guillotine).

Nevertheless, everyone knows about the sacrificial animals running away during the feast of the sacrifice…

It is horrifying to know that death is coming.  This is what’s natural.

You can say, “To go to death for the sake of divine values!”.  And I will remind you of the letters written during the Battle of the Dardanelles that reached or could not reach their recipients.  What was written in those letters?  In brief… Longing. Farewell… Sorrow…

Just then, the farewell times of Prophet Muhammad come to mind.  Knowing that he is about to die, tears spill down from the Prophet’s eyes.  He starts to cry.  Comprehending the meaning in the bewildered looks of his companions, the holy spirit says in response, “I am crying for the longing of those who are left behind…”.

Today, cancer patients probably take the lead among those who know that they are going to die.

Fighting is the name of the common thing that I have seen in them throughout the years of relationship that I have had with them.  Those who yield, those who shriek, deniers, those who laugh in pain, those who get angry, those who protest, those who pray, those who run away, those who don’t even want to speak of the subject, I have seen it all; however, a large majority accommodated themselves to even the most grueling chemotherapies and surgeries with a great hope… I repeat, fighting was the common trait of those spirits.

Normally, it is off-limits to speak of death in psychiatry.  Physician had better leave that subject blank.  Yet the patient can speak of it as much as they want to.  Religious remarks, some other types of beliefs, everything must be expressed clearly.  One must listen in silence.  The duty of the physician is to improve and preserve the quality of the time being experienced.  The patient is asked about the most beautiful thing they have done.  Their opinions are received about what they could not do or what they want to do.  Each and every person, including those who protest, laugh and those who are in depression, is reputable to the full extent.  And reputability is the most important thing that is worth preserving.

As is known, before the age of ten, it is rare to have the concept of death or to know that death is an irrevocable journey. But I have seen such pediatric cancer patients who would say, “you wouldn’t be able to take it, papa!” as a response to the overflowing sorrow of their fathers who would say, “I wish I had cancer, not you!”.

As you know, young people believe that they will never die. You would almost always see that youth-driven courage and that disregard in them in the hand-to-hand combats in the battlefields, in the most dangerous adventures.  It is their unique trait to live as if they will never die.  I have had many cancer patients demonstrating all the colors and beauties of the youth.  They successfully kept attending the most difficult schools, approaching all sorts of scientific problems with an unbelievable creativity.  They were as steady as a rock with all that consciousness, belief, common sense. Their hearts were overflowing with love.  You wouldn’t see any selfishness in nearly any of them.  There were as sincere as they come in their love.  They were so magnificent that they could take part in all kinds of love stories.  The years that my young patient Ekrem spent in the bone marrow unit were full of an unbelievable energy. There, he fell in love.  His favorite team cheered him up.  He lived there with all of his being.  And yet he said, “I’m here!” to those passing by his room even when he was breathing his last.   Then there was Serkan, a twenty-three-year-old.  He felt the deep sorrow that I had for the nose he lost due to fungus, he was so emphatic and full of life that he could even say “Don’t be sad, doctor. One day it was going to disappear anyway!”… I would like to emphasize that I’m talking about three days prior to his death.   .

How about those middle-aged people who have children, friends, parents who will be left behind, or even pets that have shared their loneliness for years? If you consider life to be a functionality, you can just find yourself at the breaking point. As a cancer patient, you make ceaseless efforts to conceal the deep sorrow you have from those you will leave behind during the day, and when you are all alone by yourself at night, the darkness bursts into tears.

And the elderlies. You wouldn’t want to be as alone as they are.  Everybody has already discarded you.  I would say, “except for doctors”, but even their desire and willingness to save are diminished by the professional greed they have.  Yet, living is something that the elderlies want and deserve as much as everyone else.  There are many things they can offer to life and human beings.  How precious the experiences and wisdom are… They await death, all alone… How sorrowful…  I have seen “great surgeons” who could say, “that’s enough lifetime for her!” for an elderly patient of mine who had breast cancer.  What a big punishment that was, all alone in pitch black.

Consequently, I want to say, “Death is God’s command, if only there was no parting,” just like the poet said.

I will say my last words as a scientist.  Maybe, death is an unchanging truth.  For thousands of years, every living being has been dying for this or that reason.  Those who are left behind feel sorrow and yearn. And yet, not a single genetic process has allowed any adaptation on this matter.  There has been no genetic opposition against the greatest pain.  Interesting, isn’t it?  Maybe, it is not possible to transfer this incident from generation to generation due to age-related reasons I mentioned above, or maybe the fear of death dominates all of the being and all the cells, and therefore it is not possible to change it.  Or maybe the presence of that sense of horror is among the urges that actually secures the life.

Or, in the end, maybe the change has already occurred and human beings actually wish to die.  Otherwise, why would Dr. Sigmund Freud, the founder of psychoanalysis, speak of Thanatos?  Why would Mevlana the Great deem death to be a reunion with the Creator or to be a wedding?

I will put an end to this topic of death with question after question.

And I will wish each and every reader a long, healthy, happy, honorable life…

Take care…

Prof. Dr. Kemal Arıkan
Psychiatrist