In the section, On Forgiveness, Lewis tells the listener that excuses, rarely useful in real life, also get nowhere with God. He has heard them all before. Here Lewis uses a doctor's visit as a metaphor. If a patient suffers from a broken arm, explaining to the doctor that every other body part is OK is a waste of precious time. Ultimately, man's excuses stem from some element of unbelief. Man feels God will not accept him without an excuse.
The Weight of Glory and Other Addresses