This week I responded to a call that immediately brought to mind one of my favorite jokes. In fact, before we got back to the firehouse, the other medic was telling it:
A man is standing on his porch watching the rain fall in torrents. The water starts to rise around the foundation of his house and a friend in a huge truck drives by. Knowing that the water is rushing in the streets and that his neighbor will be stranded he says, "Come on, get in and I'll take you to higher ground." The man just smiles and waves him on. "Don't worry about me," he says. "The lord will provide." Later as the water is waist deep and it seems that no one in the neighborhood is left. A small boat approaches the man a lady call to him from it. "Come on, I have room for you. I can get you out of here!" The man just smiles as he replies, "You can go on. As for me, the lord will provide." The rains are relentless and by evening the situation looks grim. The man's house is a loss and he is on the roof, shivering in the storm. Soon he hears a helicopter approaching and a voice booming over a bullhorn. "Get into the basket and we will take you to safety!" The man musters a smile and cups his hands to his mouth and shouts, "I'm fine where I am! The lord will provide!"
That night the man dies, submerged in the flood waters that swept him from the roof of his house. When the man faces god in heaven, he is dismayed and confused. He asks, "Lord, I was so faithful, a witness for you telling everyone whom I met that you would provide. How could you forget me in my time of mortal need?" God replied, "Forget you? I provided neighbors and boats and rescue helicopters, what more did you need?"
The patient who brought this to our minds is a lady who is critically ill. She will probably die from her illness very soon. It has been more than a year since she experienced the first symptoms of her illness. I believe that if she had sought treatment at that time she could have spared herself immense pain and suffering, both physical and emotional. She has insurance and is financially stable. She has a family and transportation. She is relatively young and otherwise healthy. The reason that she did not seek medical intervention earlier is because she has a religious conviction that healing comes from god. I also believe that there is an element of denial in her particular situation. When she called 911 and I arrived on scene, I saw a woman who was very sick and very afraid. For the first time she was facing the fact that she was dying.
How should I respond to patients whose religious beliefs are so confusing to me? While I respect the differences, I become frustrated when a belief comes between my patient's health and my ability to help them.
