A Final Kindness

I'm just off a twelve hour shift in the clinic, and I don't know if I can go back. I think I might have reached my limit for keeping a compassionate and calm demeanor in the face of painful and disturbing things.

Evans, Phil, and Gabrielle had to sit down with some of the people with the worst injuries and talk to them. It wasn't a job I would have wanted to do, and I'm damn thankful I didn't have to. The problem was that we knew there was no way some of the worst off of them could survive. It just isn't going to happen. Neither are they going to die quickly or easily, so the choice was awful: linger in constant pain, consuming medicines that might help someone later on, or choose to die now at the hand of a friend.

Evans made it very clear that they were all able to make the choice freely. No one was to be coerced into anything, no pressure or guilt to be applied. I don't think that anyone would do that, but then I've been called suicidally optimistic more than once.

Of those with burns and other injuries severe enough to be considered fatal, nine of eleven adults chose to end their lives. There are two kids, but Evans just keeps them sedated all the time. No one wants to make that call. No one wants to ask that of children. So, we won't. Evans is saving them the agony of being awake, seeing and feeling their wounds. Some might say he is depriving them of the chance to experience their last, precious days. Perhaps.

But what quality would those days have? Evans took his oath seriously: First, do no harm. For the kids, that meant letting sleep wrap around them as they passed the bridge to whatever comes next. For the adults, that meant a quick death when asked for. Doctors have done it for centuries, never doubt that. Human suffering, constant and deeply damaging to the human psyche, will always change a person's views on morality given enough time.

I sat with them when Evans did it. Each and every one of them. I held their hands, talked with them, made them comfortable. I watched the light go out of their eyes, the vibrant motions that defined life within them fall still. No ticking throb of a pulse in the throat. No narrowing or widening of the pupils as we talked. Facial tension gone, relaxed in a way that life simply won't allow. I was glad to be there for them, but I hated it. Every minute of it.

I didn't want to watch them die. I didn't want to be there as we did what we had to do in order to ensure none of them reanimated. The peace Evans gave them was a final one, the companionship I gave them their last. If there is a great beyond, my presence was a mere transitional circumstance to tide them over until they touched the infinite. Compared to whatever wonders might lie beyond the cusp of life, my company is a poor substitute.

Those last two have decided to tough it out. They have chosen to suffer through the hours or days until they die. I get that. I would make that choice. I'm a pretty logical person, but when it comes to the thought of  my own death, I'm as emotional as they come. I'll fight every minute until the end, enjoy the pain because it will prove that I'm still alive. Both of our last patients have asked not to be given any painkillers, so that others who might need them later and live can use them.

They are brave, in my eyes. They know that there is no way to survive. They accept it, and embrace it. Just as those who chose to die embraced their fate, eyes open. I am lucky to have known such people.

I hope that on the day when I face my own death, I can show half as much courage.