I had been the family's doctor for 12 years. They lived in a small, remote village. One September the father—a tall, physically fit schoolmaster—came to my surgery. “It's stupid,” he said, “I just got back from holiday but I feel tired. I was with some colleagues last Monday and I had trouble finding and pronouncing some words during a conversation.” The results of a clinical examination and blood test were normal.
A few weeks later I was called to his home. His family was very worried. He had been having headaches and was sleeping a lot. But when he was sitting in front of me he made only a few complaints.
I rang the lab for the results of a new blood test. The test showed recent cytomegalovirus infection and infectious mononucleosis. “I have an explanation,” I said, coming back from the phone. He seemed relieved; two tears slid down his cheeks.
Then the situation worsened: he lost his balance. I could not wait for him to be seen at his appointment for cerebral computed tomography. I admitted him to hospital. An emergency scan showed a tumour with oedema. He was transferred to a neurosurgery centre where he underwent surgery.
Ten days later, on a Friday morning, he and his wife came to my surgery for the results. I had to confirm a bad one: he had a malignant glioma. After answering his few precise questions, I noticed that he seemed to be in the best shape of any of us in the room.
For nine months he conscientiously followed the timetable of radiotherapy and chemotherapy. He kept track of his appointments in a notebook. He was excluded from a gene therapy trial.
I saw him every month for his treatment. I found that I needed the support of some colleagues in Le Mans: a network of general practitioners and my local Balint group, where the conscious and unconscious relationships between doctors and their patients are explored.
In July, after I returned from spending a few days in England, I visited him. He could no longer speak. He offered just a last, enigmatic smile. He died at the end of the summer holidays. I was with him at his home, as he and his family had wished. It had been difficult: we were the same age.
Some years later the dignity that this man and his family had during his illness, and the way that he had spared those closest to him, are still in my mind. The last words of Jean-Paul Sartre's novel Les Mots are: “Un homme fait de tous les hommes et qui les vaut tous, et que vaut n'importe qui [A whole man composed of all men and as good as all of them and no better than any].” When I think of this patient, I cannot agree with Sartre's view.