Cliff’s troubles began after he returned from Iraq. Steady work was hard to come by. His wife seemed like a total stranger, and his two teenage daughters’ constant bickering infuriated him. Cliff spent as much time as possible out of the house.

He was not surprised when his wife filed for divorce. Cliff moved to Florida, where he found a hard job with long hours so he could forget what he left behind in Maine. When the economy tanked in 2008, he found part-time work at a motel and saved money by living in one of the many empty units. He ate mostly fast food, especially after the fire he started with the hotplate in his room.

After a year passed, Cliff noted a bluish-black mole on his right forearm. Since it did not hurt, he left it alone. The mole grew larger. Cliff was going to show it to the guys he worked with, but they seemed to care for little else except the Miami Dolphins. When the mole began to bleed, he covered it with a Band-Aid. When he developed a tender, hard swelling under his right arm, he swore he would see a doctor but could not figure out from his papers what his health insurance covered. When he awoke one morning 18 months later, he was so dizzy he fell out of bed. He called 911 before passing out.

Loneliness is hazardous to your health. Married cancer patients live longer than single cancer patients. Recent research analyzing data from 750,000 cancer patients revealed that unmarried patients were more likely to present with late stage cancer and to die from their cancer than married patients. In addition, single patients were half as likely to receive appropriate therapy and comply with medical treatments. Furthermore, chemotherapy and radiation were easier for people to tolerate when they had care from a spouse. These results demonstrate the critical importance of emotional and logistical support from a loved one. Not surprisingly the importance of companionship in affecting treatment, compliance, and outcome is found with other diseases as well.

How are we to live? The Bible stresses the importance of companionship in all settings of life. After God created Adam, the first man, God said: “It is not good for the man to be alone. I will make a helper suitable for him” (Genesis 2:18). Such a companion for Adam was not found among the animals so the Lord created Eve, the first woman, out of Adam’s body. Then came the institution of marriage: “For this reason a man will leave his father and mother and be united to his wife, and they will become one flesh.” (Genesis 2:24). How is a spouse to act as to provide support that promotes good health? “A wife of noble character…brings (her husband) good, not harm all the days of her life” (Proverbs 31: 10 and 12).

While most marry, marriage is not for everyone and not for all phases of life. The Bible also stresses the importance of family as a source of companionship: “God sets the lonely in families” (Psalm 68:8). And the Bible also teaches the importance of friends: “A friend loves at all times” (Proverbs 17:17). We must seek companionship throughout life’s journey since the health implications of loneliness in patients with cancer and other diseases are enormous.

After Cliff was admitted to the hospital, he was found to have stage IV metastatic melanoma. Chemotherapy and radiation therapy to the brain were begun immediately but Cliff’s condition declined. The nurse assigned to his case was saddened when she entered Cliff’s room, empty of anything except for Cliff lying in his bed. Out of her own pocket, she bought flowers for his bedside table and two “Get well” cards for his dresser. She offered to call his family but Cliff shook his head. He did not want to bother anyone back home. She called anyway. Cliff’s ex, daughters and brothers, brokenhearted about Cliff’s self-imposed exile from his family all these years, left Maine immediately. Unfortunately, by the time they reached the hospital, Cliff had stopped breathing.

Though a cancer diagnosis was included on Cliff’s death certificate, I suggest the cause of death was loneliness.

Dr. Delvyn C. Case, Jr. is a hematologist/oncologist, writer and director, and consultant to the Department of Spiritual Care at Maine Medical Center in Portland.