The above quote is from a book written by a Christian Minister and Professor of Religious Education, John M Hull. A forward to the book was written by Oliver Sacks who described it as a “masterpiece.” The book is about 300 pages long and is not a novel, nor a coherent thesis. John Hull went blind in his 40s. Hull had trouble with cataracts and detached retinae since childhood and was blind in his left eye from age “17 or 18.” He was married with children when he finally lost all of his sight. The book is a transcript of his voice-recorded diary, which he started a year or so after becoming blind. It continued initially daily for a period then intermittently over 3 years. And that is the book. His style of writing is deceptively clean and straightforward, without pretense, or pomposity. There is not a shred of self-pity. Loosely edited he provides a series of fascinating insights into the process of going blind.

However, in the above quote, written in his understated style that stole my breath. In observing that after going blind he could better remember faces from photographs than live circumstances, someone suggested it could be a blessing since he would always remember his wife as young-looking. Hull disagreed.

The epigram reminds us of truth-telling in cancer.

There is an understanding in the palliative care and psycho-oncology literature, as the pendulum start its way back that patients do not have to hear nor bear the “whole” truth. There are several reasons for this re-adjustment: autonomy also devolves the right not to know; for some people, the knowledge is devastating psychologically; denial is an inborn mechanism to protect ourselves from “too much” truth; and for some people, culture or family (not the individual) are the minimum ethical unit.

Hull wrote that ignorance can never be better than knowledge. Yet we just noted that in end-of-life care it is sometimes better not to know, that it is preferable to be ignorant. How can we reconcile these propositions both of which sound true?

From astrophysics to poetry, humans have a need to understand. There is a curiosity to learn and explore. Even in the Dark Ages universities were born. There is a passion to know and to make sense of. Einstein resolved energy and matter. Poets explore the inner universe.

The answer to the question depends on what one wants out of life. If one is self-reflective and seeks to understand ones position in the world, to ponder the improbable interface of consciousness and the universe, to prepare for and to think about mortality, then truth is relevant. Truth is the critical ingredient. Was my life worthwhile? How do I cope with my regrets? Why did I get cancer? Is it a punishment? But I am not a worse person than my neighbor. There were so many more things I wanted to do. How will my wife mange? What message do I want to pass on to my children? Is there anything I want to do in the time I have left? Or prosaically — What is the experience of death like? Is it painful? What in the world happens to my consciousness?

Alternatively, if one is fretting about death (and hence life) then knowing the truth is not only unnecessary but painful. The fore-knowledge of death causes psychological pain. Let there be no questions, but there will be no light — lest hope be extinguished and create despair and giving-up. Better to pretend, and avoid unpleasantness even if the price is a contraction of consciousness. For some people, this awareness or concentration of consciousness is not relevant, either due to fear or a lack of interest. They prefer the here and now rather than broaching the questions of the philosophers.

Is ignorance by choice, a self-lie?

To learn requires knowledge — of Self and Other.

Socrates: The unexamined life is not worth living.

Amanda McBroome: It's the heart afraid of breaking, that never learns to dance … And the soul afraid of dying, That never learns to live.

While the choice is clearly individual, our experience suggests that once one overcomes the initial fear, then contemplation of the knowledge eventually allows one to live and breathe more freely — and to sleep better. Not always but it happens.

I am moved by the idea — and this is what Hull was referring to — that we have a certain obligation to our Creator to contemplate the mysteries of death and therefore life. It honors Him just as much, to study how the chains and pulleys of the physical universe work, as to understand the paradox and absurdity of ephemeral consciousness.

If I were a preacher I would preach knowledge over ignorance; but as a healer I place a salve on wounds and sometimes close the shutters on the light.