Lenihan subordinated his illness to try and put Ireland’s finances in order

THE prognosis — that he would quickly die of his diagnosed heart disease — was not the worst problem Norman Cousins faced.

He was in enormous pain, which, at the time, his doctors were not able to ameliorate. He tried everything, including playing old Marx Brothers movies to himself.

Amazingly, the comedy helped.

“I made the joyous discovery that 10 minutes of genuine belly laughter had an anaesthetic effect and would give me at least two hours of pain-free sleep,” he wrote.

Cousins, a journalist, lived for more than 25 years longer than had been predicted and used that extra time to develop what has been called “the biology of hope,” which concentrated on non-traditional methods of coping with dire diagnoses and the symptoms of lethal diseases.

Orthodox medicine has always been wary of his theories, despite considerable supportive evidence for them. Undoubtedly, the biology of hope has its downsides, not least of which is the pressure on, for example, cancer sufferers, implicit in the notion that a positive, upbeat willingness to fight the disease will lead to survival.

Susan Sontag rightly rubbished the “battling cancer” formula of thought, which constantly finds expression in newspaper headlines, as suggesting that a sufferer who becomes depressed or frightened following diagnosis is in some way lacking courage or fighting spirit and — even more seriously — may be responsible for their own mortality.

This, of course, is damaging nonsense.

Cousins, nonetheless, changed some of the assumptions around terminal illness.

He did it through extensive controlled studies and through even more extensive talking and writing about the topic. The late Brian Lenihan, without much talk and with no writing on the issue of pancreatic cancer, has done the same.

Mr Lenihan never denied that he was going to die.

In private conversations with friends, he made it clear that he understood precisely what lay ahead of him.

When the story of his illness came to public awareness, everyone assumed that he would relinquish his post.

Maybe not immediately, but speedily.

That assumption was rooted in beliefs about how human beings die and should die which tend to influence, if not dictate, how human beings actually die at any given point in history.

Based on examination of paintings using death as a subject, Dr Leonard Condren has pointed to a radical change in the experience of death within one century.

In Victorian times and for many centuries prior to the 19th century, art about death tended to show the dying person, young or old, in a darkened room, surrounded by family.

Typically, the paintings managed to convey a still silence within the scene.

Relatives were never portrayed in conversation.

Any doctor present was portrayed as without active function, instead silently presiding, often in the shadowed background, over an inevitable passing. Any relatives in the paintings tended to sit, one hand over their eyes, the other holding the hand of the dying man or woman.

It is difficult to compare that reality with today’s dying, partly because we have no art using death as its focus these days.

It has ceased to be a favoured or even a possible subject for an artist.

Ironically, we would see as an invasion of privacy the presence at a death bed of an artist with a sketch pad or a photographer with a camera, even though many, if not most people now die without either privacy or stillness, in harshly bright hospital rooms, surrounded by impersonally-bleeping machines, physically connected to IVs and catheters.

Where relatives are present with a medical professional, the conversation often takes the form of the family wanting to know if everything possible has been done for their loved one.

DESPITE the change in the way we die (although the high-tech horror of hospital death is at least counter-pointed by the more civilised possibilities offered by hospice care) some of the Victorian mind-set has sustained into the 21st century, notably the sense that, once a diagnosis of terminal illness has been delivered, it behoves the individual to go home and “put their papers in order.” Although that mind-set was not in media play when it emerged that Brian Lenihan had no plans to relinquish his Government responsibilities, it was certainly manifest in private conversations.

“Wouldn’t you think he’d want to be at home with his family?” people asked, as if continuation in office were somehow the less noble option.

It was a half-thought-out reaction on two fronts. First of all, neither Brian Lenihan nor his medical advisors knew, at the point of diagnosis, how much time was left to him.

So how would it have made sense for him to withdraw from public life and stay at home for one, two, three or four years?

A cancer-sufferer facing death in the medium to long term does not, in real terms, face an idyllic domestic scene characterised by constant family presence, and anyway, such concentration of attention might be more onerous than helpful to any of those concerned.

What too frequently happens when someone facing such a diagnosis leaves work and stays at home, is that the payoff is illness-institutionalisation.

They sacrifice the identity associated with their career for a new identity (if not career) as a patient /cancer sufferer, their calendars dominated by medical appointments, their reading- matter heavy on printouts of blood and cell counts, their circle of colleagues and friends replaced by scarf-wearing acquaintances encountered in the oncologist’s waiting room.

Some fine writers have recorded this process in infinitely sad media diaries.

Those published stories provide value on a literary level, to other sufferers and undoubtedly to the writers themselves.

But Brian Lenihan’s refusal to allow his illness to become more important than his job or permit it to become definitive of who he was, provides an interesting alternative, rendered more significant by the level of pressure he sustained, consequent upon the hellish economic circumstances with which he had to deal. He chose not to go home and put his papers in order.

Instead, he subordinated his illness and its treatment regimen to his efforts to put the nation’s finances in order.

More than 20 years ago, Norman Cousins might have been writing about Mr Lenihan when he said: “Hope, faith, love, and a strong will to live offer no promise of immortality, only proof of our uniqueness as human beings and the opportunity to experience full growth even under the grimmest circumstances. The clock provides only a technical measurement of how long we live. Far more real than the ticking of time is the way we open up the minutes and invest them with meaning. Death is not the ultimate tragedy in life. The ultimate tragedy is to die without discovering the possibilities of full growth.”