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Rev. Dr. Martha R. Jacobs Headshot

Talking about the Horse on the Table

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A young man is dying. It is clear to everyone that he is dying. However, his family wants just one more test done...

To what end does testing make a difference when someone is dying? How far and how much money do we spend to "confirm" that someone is dying? How much do we think it is appropriate to put a patient through in order for a family to receive confirmation that their loved one is dying? How uncomfortable do we allow the patient to be in order for the family to have "proof" of an impending death? Is a simple needle stick and blood withdrawal appropriate? How about a CAT Scan or EEG or EKG or X-ray that requires that the patient be physically moved in some way when their body is shutting down as they are dying?

Why do we need confirmations that someone is dying when their disease trajectory is clear that death is the result of their disease? And, as human beings, we are going to die at some point anyway, so why do we need to run more tests for confirmation that the person IS dying? Can we be honest with ourselves and our loved ones that we will, one day, die? Are we prepared to have those conversations, to at least name "the horse on the dining room table?"

Dorothy Becvar, in her book, "In the Presence of Grief," includes a story written by Richard Kalish about a man going to see a famous guru, an ancient sage, to find out "what a dying person feels when no one will speak with him, nor be open enough to permit him to speak about his dying." The sage's response is, "It is the horse on the dining room table." Many years later, after the man experiences going to a dinner party where everyone saw the horse on the table but no one dared say anything about it or even acknowledge it, this man returns to the guru who says:

It is a horse that visits every house and sits on every dining-room table -- the tables of the rich and of the poor, of the simple and of the wise. This horse just sits there, but its presence makes you wish to leave without speaking of it. If you leave, you will always fear the presence of the horse. When it sits on your table, you will wish to speak of it, but you may not be able to. However, if you speak about the horse, then you will find that others can also speak about the horse -- most others, at least, if you are gentle and kind as you speak. The horse will remain on the dining room table, but you will not be so distraught. You will enjoy your repast, and ... you will enjoy the presence of your guests. You cannot make magic to have the horse disappear, but you can speak of the horse and thereby render it less powerful. [1]

Are you ready to talk about the horse on your dining room table? Are you ready to acknowledge that no matter how many tests may be done, that your loved one may be dying?

What does God expect you to do when a loved one is clearly dying: to encourage them to let go or to plead with them to "not die"?

[1] Becvar, Dorothy. In the Presence of Grief: Helping family members resolve death, dying and bereavement issues, New York: Guilford Press, 2001, 3-6.

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