Recently, two of my patients, whom I had looked after for ten years, died.

They died within two weeks of each other. They didn’t know each other, of course, and neither did their families. All they shared was I, their doctor, and my words, and what I was to them.

And of course, we shared the human condition, the flesh that gives way to dust.

They were old, one 63, the other, 85. They had been increasingly ill for some months, and, though I see and work with decline every day, I had found the course of their fragmentation unsettling and humbling.

Madam Lang had spent her days in a wheelchair for the better part of a decade because of diabetes. She had weak legs.

Two months ago, her fingers turned black.

The first morning, she didn’t believe her eyes when the little finger of her left hand, after a night of smarting, turned purple, then dark red, before settling into a mordant black. The next day it stayed black. Before long, her children, in great consternation, had hauled her into my office. Gangrene, I heard myself pronouncing, a condition diabetes patients fear like death because treatment involved amputation. We could do nothing to rescue the dying flesh.  As she wagged her charcoal-black digit in her maid’s face, as if to defy the heavens, I saw the future but held my tongue.

Will I get better again, Madam Lang asked. I cooed, we’ll see.

In the succeeding days, the gangrene spread to her other fingers. My fingers are on fire, she declared, they’re burning up. I offered soothing words and drugs to dull her pain.

The other, older lady, less feisty than Madam Lang, I had watched turn into a paler, more timorous shadow of her former pale self. Madam Oh had dementia. She didn’t often make sense when she spoke. In fact, if she was no relation of yours, you might double up at her gaffes. If she were your mother, the enlarging holes in her mind would tear your heart in two.

Madam Oh ate less and less, and fell often. One time, about a year ago, she appeared in my office with a huge bruise over her eye and cheek. She had tried to walk to the toilet at night, stumbled, and fell on her face. That was a minor contusion. One month ago, I found myself driving to hospital at three in the morning because she’d had another bad fall, fracturing her skull. Thence followed a flurry of scans, tests and bandages, then the journey home, then a decline so swift and so heartbreaking it cast a shadow over her family’s Chinese New Year celebrations.

Mother’s old, we’re prepared for the worst, Madam Oh’s children said.

When the end came, they weren’t prepared. Neither was I. Our human hearts are just too fragile for death. This is why brave words are only words, wood and detritus in the flood waters of sorrow that, when they come, breach all seawalls, all barriers.

Madam Lang passed away in hospital, the nurses found her cold body in the early dawn, her fingers a clutch of spindly black twigs. Her family did not make it to her side to say goodbye. Madam Oh died at home with her son holding her gnarled hands, at first desperately feeling for a pulse; then later, finding none, for love, for farewell.

I had been travelling. I had been so busy that it was already Ash Wednesday* when I realised that Lent had come again. At first, I felt annoyed at my carelessness. I had made no preparation, and Lent is important to me. But irritation gave way to quietness – God’s mercy, surely – and my thoughts turned to the time of darkness that came for Christ.

Lent lasts forty days because Jesus went into the wilderness for forty days of fasting, meditation and reflection before beginning his ministry. Lent is far away from the singing angels of Bethlehem, and the shout of God over the Jordan, but somehow, mixed inside its darkness, the voice of God is here, too, only softer, like a whisper, and I have to pay attention.

What can I give up this Lent so I could remind myself of Christ’s sacrifice? What would I give up to possess in some measure the emptying, the deprivation, the casting away that Jesus experienced? What gripping distraction would I free myself of, if only for 40 days, so I can cling more strongly to Jesus?

Last year, for Lent, I gave up drinking tea. I was frightened by how hard it was. My throat ached, and my tongue was unhappy there was no hot brown drink to swim in. Perhaps, like many evangelicals, I had become too easy on, and too careless with, myself. What can I give up this year—my compulsive web-surfing? Music? Fancy lunches? Tea again? Besides favourite things, can I give up favourite ideas?

Can I give up my work?

On the news: a Japanese tsunami survivor swept by the sea of death to a rooftop said: “I remembered my family, and I knew, for their sake, I must stay alive.” For three hours, separated from all he had and owned, he became the most hope-tormented man in the world. He prayed to live. He was rescued.

We wait during Lent – for life.

On TV: a white-haired Japanese family doctor finds himself the lone physician in a stricken community. The new work in his makeshift clinic, though urgent, is familiar, for he has cared for and comforted people for forty years. But the sea, unbidden, has washed his office and his old work away, prising it from his hands.

What do I have in my grasp that I, for my pride, would not give up?

Ash Wednesday has slipped from me,, and my heart finds another thought: there are no ashes in our church, but if there were, would I be frightened by their sting on my forehead? Or would I feel a joyful sorrow since surely there is no gain without pain, no crown without the cross?

Ashes signify death, and death intrusively imposes itself upon us, sometimes in the strangest ways. But, for all the losses we endure in life, until we have lost life itself, there is, we will say in our liturgy, this prayer and hope: “Bring us with all your saints to the joy of Christ’s resurrection.”

Never are we left in the dust.

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*In the Christian liturgical calendar, Lent is the penitential period of 40 days from Ash Wednesday to Easter. It was traditional in ancient times for Christians to have ashes rubbed on their foreheads on Ash Wednesday as an outward symbol of what they were experiencing internally. A fast in Lent is a way to draw our attention to our relationship with the things that hold us in thrall, and to teach us to give that attention to God.

Eld Lee Chung Horn