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(1970). Meetings of the New York Psychoanalytic Society. Psychoanal Q., 39:167-168.

(1970). Psychoanalytic Quarterly, 39:167-168

Meetings of the New York Psychoanalytic Society

September 10, 1968. THE DYING PATIENT. Lawrence J. Roose, M.D.

Roose presented a detailed account of three months of psychotherapy with an elderly physician who was dying of cancer of the lung. The patient's illness had been discovered by routine radiography and he had been permitted to view his own chest x-ray. He was told that he had 'pulmonary granulomatosis'. After the initial evaluation the patient became increasingly depressed and made a suicidal gesture with morphine, following which he was hospitalized for a week. He first consulted Roose about three weeks later.

He had ceased to practice, was in turmoil, and spoke of his fear of death. Roose told him that he could not help him with the problem of dying; all he could do was to help him to live. Psychotherapy was begun three times a week and the patient was granted permission to telephone the therapist at any time. At his own request, he paid at the end of each visit, saying that he might die and did not wish to leave any debts.

The problem of treatment was seen as how to satisfy the patient's need for someone to care for him and at the same time facilitate restoration of some facsimile of independence. When the patient asserted that he would rather kill himself than choke to death, the therapist focused upon items of everyday life. When he said that he felt the therapist did not like him, Roose interpreted that the patient expected the same condemnation that he heaped upon himself. This was as much of an interpretation as was offered during treatment.

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