In my last blog I made reference to the true account of a middle-aged patient, who was being treated for ovarian cancer, on the hospital oncology ward in which I was working at that time. I shall therefore assume that you have read last week’s posting and that we are ready to continue.

As her disease appeared to be progressing – in spite of ‘state of the art’ treatment at that time – everything about her appeared to be taking a downward drift. You will also recall my reference in last week’s blog, to the part that religion and my patient’s apparent faith in God appeared to be playing in her own management of the predicament in which she daily found herself; and thus, of necessity, was required to face up to. Add on to this the further and considerable burden of her determination to remain outwardly cheerful in the presence and for the benefit of her family and seemingly endless stream of visitors; and perhaps you will be able to grasp snatches, at least, of the overall predicament that this lady was daily being required to manage.

Now it so happened that one of this lady’s sons was a Church of Scotland minister, having some years earlier made a career change from his earlier occupation in property management and surveying, to the Christian ministry. Following ordination and induction into a parish pastorate, as an assistant minister, he thereafter accepted a ‘call’ to another pastorate as minister in charge. Being, as it was, only twenty miles from his parents’ home, he was frequently to be seen – together with other family members – by his mother’s bedside in the ward.

All this, not surprisingly, was a source of great pride, especially to Alan’s mother and she appeared to draw no small measure of comfort from her son’s regular and frequent visits: that is, until the occasion on which, just before taking his leave, he seemingly, first offered and then, without waiting for her response, immediately ‘launched’ into a bedside prayer. Now doubtless this was intended to bring comfort and reassurance into Alan’s mother’s life. However, as things transpired it seemed to be having quite the converse of such effects. Question after question ‘darted’ uncontrollably across this (it would be no exaggeration by now to say) terrified lady’s mind: what was really happening to her, as she lay in bed on the ward day by day? What did her son know that she didn’t? Why had the doctors on their morning ‘round’, seemed to spend so little time with her? In addition to that, she had happened to notice two members of ward staff chatting together and, so she thought;.. no! there was by now no doubt in her mind; they were talking about her. I will leave my account of this incident here, save to say that although matters appeared to have been cleared up, at least somewhat, it created something of a ‘glitch’ (hopefully of only a temporary nature) in ‘our’ patient’s’ on-going relationship with her son.

To many people reading this short series of blogs on the subject of human stress, the contents of its individual or group occurrences and contributions may appear to be so basic and fundamental in and to daily living, as to not really warrant the attention that I have afforded and am affording to them here; especially in this final blog. However, such a view would, in my opinion, be perfectly valid but quite mistaken. Indeed, it is precisely because of the fact that the contents of these blogs are so basic and elementary to and for daily living, that they fully and richly deserve the attention given to them here.

Human stress comes in many guises (and disguises) and is no more (or less) a function of their personal relevance(s). In simple terms, idiosyncratic and/or interpretations or “perceptions”, continue to influence and shape thought and behaviour, from the beginning of life as we now know and live it’, right through to the end of that life. Even our thoughts, feelings, aspirations etc., about an afterlife (or conclusion reached that “there is no ghost in the machine” as some would have it) are utterly dependant upon personal aspirations/ interpretation(s), i.e. of itself/themselves; namely that we are not the victims of delusion in the process/es of our daily cognitions or patterns of such thought. In Emerson’s timely ‘phrase; ‘thought is ancestor to the deed’: or, in the much later thinking of the kind that underpins a modern clinical tool, namely, Cognitive Behaviour Therapy (CBT): how we think and behave, are vital precursors and thereafter, inextricably linked to the kind of person we become/are; both in thought and deed.

Were we to pursue this pattern and process of thought further, we would swiftly discover that there are certain behavioural acts and patterns; times and seasons; verbal statements and accounts; outcomes of seemingly neutral and unrelated events, that depend utterly for their impact and effect(s) in daily living, upon how we perceive all and everything about us; over time, in recent days and at this present moment. Indeed, we have witnessed and do witness daily in real life situations, experiences and events, how sometimes (and without prior warning), experience can and often does produce very different outcomes to those intended. Such a state of affairs poses an urgent need for thoughtful preparation and awareness of the impact that human stress plays in the management of physical illness and disease. Sensitive and insightful care and management, is also of paramount importance for and to those who work at the ‘sharp end’ of contact with patients and their families.

Fortunately and thankfully, much more by way of a curative, as well as of a palliative nature and outcome in the face of malignant illness is now being reported with greater regularity, thanks to state of the art research and its ensuing translation into treatment. In the broadest of senses, the history of man is littered with accounts of men and women who have not only endured uncertainty of a perilous nature, persecution and even death, for what they perceived to be a worthy and noble cause. We can therefore conclude that it is not so much the stressful experience event that determines mood and subsequent behaviour; but rather how it is perceived, interpreted and managed.