Dr Orlanda Goh has written a stimulating commentary describing her struggle to understand her patients' response in the face of death ("Accepting indifference in the face of death"; last Sunday).

What I find most interesting is the comment that the patients know more than we think.

In my own practice over some 40 years, I have found this to be true. Not only do they know more than we think, but they also probably understand more than we realise, in some instances, about death, the meaning of living and the concerns for those who are alive.

In that respect, I find it most humbling to learn from many of them about what it means to face death, the prospect of accepting that there is no cure and the willingness to accept the inevitable with calmness and serenity.

Many are not so much afraid of facing death per se; they are more concerned about the process of dying and the unnecessary pain and suffering involved when the treatment is worse than the disease.

Also, it is sad but true that not all can afford to battle a terminal disease like cancer in spite of government programmes such as Medisave, MediShield Life and Medifund.

Not all expensive medications are covered by these provisions. I have had patients giving up treatment because they could not afford the astronomical price of medications and they did not want to burden their families with the cost.

Some have irked their oncologists by choosing to opt out of treatment, with the prospect of certain death resulting, and for quite a few of them, they have died with a certain sense of dignity and courage.

It is sobering to reflect on the inevitability of death for all, no matter what our station in life and no matter what our age.

What is perhaps meaningful is to endeavour to live well and to live with a clear conscience and with no regrets, when we finally come face to face with the door of death.

Quek Koh Choon (Dr)