Reader Dilemma: 'A friend is almost starving and desperately ill - but won't accept help'

'I have to move soon, to look after my parents, but I fear that leaving town would be a passive way of letting my friend die'

"I fear that leaving town would be a passive way of letting my friend die. What can I do?" (Rex)

Dear Virginia

I recently had to call the emergency services for a friend. He was almost starving and desperately ill. A mixture of depression, drinking and perversity has led to this crisis. He won’t accept help, as he wants to keep his independence. But once, when I intervened, he was apparently hours from death. I seem to be the only person who knows where he lives and who he calls for help. I have to move soon, to look after my parents, but I fear that leaving town would be a passive way of letting my friend die. What can I do?

Yours sincerely, Ed

Virginia says:

Have you ever considered the possibility that your friend actually wants to die? I wonder how grateful he is for your constant interference? It seems to me that every time you snatch him from the jaws of death, he recovers, only to get himself in exactly the same situation a couple of months later. Perhaps there’s a bit of him that’s absolutely longing to self-destruct, a bit that will be much relieved when you leave him alone. He’s made it clear he’s depressed, he drinks, and he wants to do his own thing with no help from anyone else. He’s not one of nature’s victims. He knows perfectly well where his drinking will get him eventually and he has made no efforts to stop.

Another possibility is that, the moment you leave the scene, he will be thrown back on his own resources. No longer will he be able to depend on you to come galloping in at the eleventh hour like a knight on a white charger. No, if he wants to live, he’ll have to makes some changes in his own mental attitude. It could be – I’m not saying it will be, but it could be – that your leaving will be the best thing that ever happened to your friend. He’ll be forced to take responsibility for himself.

Or, of course, it could be that I’m wrong on both counts and that your leaving the scene will be the final straw that tips him over into an unwelcome death.

But even if you are right and this last scenario is correct, you cannot be responsible for every lame duck that comes your way. I used to have a great penchant for lame ducks. They used to come squawking and hobbling after me, pecking at my skirts, slowing me down, keeping me awake with their constant quacking and in many ways preventing me from living my own life. Now, I’m not saying that I’ve cast off everyone I know who needs help. I welcome people who are temporarily lame, particularly if I can offer advice or sympathy, and God knows, I’m often lame myself and need the support of my friends. But I’ve managed to shed those about me who are completely unhelpable.

You have tried your best, Ed. You’ve done enough already. And I’m sure that before you leave town you’ll do your best to alert social services and neighbours to the situation so that your friend isn’t left with no sources of help at all. But you are now going off to look after your family. You can’t heal every wound; you can’t care for everyone. You can only do what you can.

I hope your friend lives. But if he doesn’t, you won’t have yourself to blame. You’ll have yourself to congratulate for not allowing it to happen earlier.

Readers say...

You need to live your new life

You describe a sad, depressed alcoholic, whom you haven’t been able to “turn around”. You’re a very caring person, and your fears for him are understandable. But put yourself in his shoes. What has he got? If drinking helps, he’ll probably drink, and, there’s not much you can do beyond the occasional supportive message. You have to live your new life – and leave him to his choices. Nothing’s ideal.

Alison Mace, by email

You can still help him

This sort of dilemma is always tricky. If your friend won’t accept help, there is a limit to what you will be able to do once you’ve moved away. If you could keep in touch with him by regular telephone calls, maybe that would help you to identify times when you need to call for help for him. Whether or not social services “closes the case” after you leave, they would still have a duty to respond to your calls for help for your friend. If the worst happens, as a result of his choices to continue as he is, it’s so important not to feel responsible or guilty if you know you have done what you can.

Sarah Playforth, Seaford

Be prepared to feel guilty

I think my mother still suffers from guilt that she couldn’t do more to stop my uncle (her brother) from slowly dying of drink (he died 14 years ago, in his fifties). He lived alone, didn’t work or see anyone, and gradually let drinking take over his life. Occasionally, there would be a crisis and she was hugely supportive, even though he was never grateful or even cooperative. No one person should carry that burden. When your friend is in trouble again and you’re far away, you will feel guilty. As you will when he eventually dies of drink or neglect. Be ready for that, but try not to allow it to make you suffer and understand that it will not be your fault. You’ve done everything you can.

Susie, by email

He’s not your problem

As your friend is so unwilling to accept help, and has, by the sound of it, driven away all the other people in his life who might help him, responsibility for him has somehow fallen to you. But in truth, that doesn’t make you any more responsible than anyone else. Explain to your friend what is happening, and that you won’t be around to help him. Maybe this will spur him on to get help elsewhere. Then, let his GP and social services know the situation, and get on with looking after your family.

Hilary Price, by email

Next week's dilemma

Having had many oral cancers – I’m quite disfigured and eat and speak with difficulty – I’m now facing an operation that may leave me unable to speak or eat. Should I go ahead with it or bow out as gracefully as possible with a few months of possibly reasonable quality of life? I and my family – my daughter donated one of her kidneys to me four years ago – are happy and fulfilled, but I dread this operation. I so want to be there for my family, to see grandchildren and to help my husband in his old age (as he has helped me over the years). What do you and your readers think?

Yours sincerely, Ghislaine

What would you advise Ghislaine to do? To answer this dilemma, or to share your own problem, write to dilemmas@independent.co.uk. Anyone whose advice is quoted or whose dilemma is published will receive a Finest Bean Mini Bar Gift Pack from Prestat (prestat.co.uk). Include your address to receive a prize