No Physical Symptoms Part I
Dana sat alone in the sterile room, antsy to get this over with yet savoring her final moments prior to the procedure. More than any other time she could remember. A pen was flipping through her fingers as she had quickly completed the endless stack of paperwork that now sat next to her on three separate clipboards. After recording a video, which she assumed was to remove the hospital’s liability, they told her it was for research purposes only and everything still had to be in writing. She couldn’t have flipped through and signed or initialed any faster, but every page had the same title plastered in large bold letters to ensure it was impossible to ignore: “VOLUNTARY EUTHANASIA; NO PHYSICAL SYMPTOMS.”
The A/C turned on loudly and Dana readjusted her hospital gown so the back would close, even if any attempt to keep the cold air out was futile. She didn’t mind that the last outfit she would wear was unfashionable, but it annoyed her how uncomfortable it was. It still wasn’t clear why she couldn’t just wear her own clothes given the circumstances. Every time she had thought about this moment, it involved sitting in a warm bath or crawling into bed in her sweatpants, wrapped up in a thick comforter with a glass of wine, waiting for the medication to overpower her body. None of that was ever real though. And Dana always told her doctors “I don’t have the balls to do it,” truly knowing she didn’t possess the mental strength to perform the action.
When euthanasia was legalized three years earlier, Dana did extensive research to find out how strict the applications were. At first it was only available for the most extreme cases of age and late stage life-threatening diseases. Then two years later – in the most controversial, yet ultimately successful, ballot amendment in the state’s history – California voted to give people complete freedom to choose when and how to end their life through medical means. Letting someone in dire condition die on their own terms was widely supported, but this law had been derided by activists arguing it was now legally easier to put yourself to sleep than one of your pets. There were a lot of conditions to the final law, but immediately aware that a case would be elevated to the supreme court rather quickly, Dana had signed up the first possible day. A sense of relief immediately washed over her.
As required by law, there was a six-month waiting period from Dana’s initial request and the procedure itself. She also spoke to her psychiatrist every week. But no matter what anyone said to Dana, this time only made her more confident it was the right decision. The process was ideal. Quitting her job, selling or gifting all her possessions, meeting old friends one last time, and taking a final trip around the world was like getting to execute a will herself and having a deadline that eliminated procrastination in the completion of her bucket list. Just the knowledge she was ending it on her own terms yet not surprising anyone rescued Dana from her previously debilitating depression, and there was endless mileage to the jokes she could make that made anyone around her uncomfortable. This didn’t ‘cure’ her though, and she was steadfast in the belief that the pain would only come back worse if she decided to reverse course like every other patient had at some point during the waiting period. This was something she was determined to go through with.
The biggest thing that still made Dana reluctant was going down in history as an assisted suicide pioneer. She would be the first to have the procedure. At first no one was legally allowed to publish her name until twenty-five years after the time of death, but people had seen her face and once it was clear she was going to do it pictures leaked, many with the foolish hope it would make Dana change her mind. Yet the more publicity she got, the more determined she was to not be known as the girl who got so close then quit, believing it would make life an even bigger hell than before. Even today there were a mob of protesters outside: gorgeous men and women throwing themselves at her, all sorts of mental health professionals and pharmacological reps promising advice or miracle cures, and even one philanthropist holding a check for four million dollars. She hated that these people pitied her. Their offers only disrupted her pre-death relaxation and made her feel more broken.
Dr. Little opened the door. The already confessional nature of their final conversation was strengthened by his black suit, the formality of which made Dana more uncomfortable than his typical brown or blue jacket. But no matter the wardrobe, the sight of him put her at ease. He was the only psychiatrist who had lasted more than one year with her. All her previous doctors were condescending and dismissed her intelligence, but she loved Dr. Little and if anyone could have cured her it was him. Despite feeling a bit of personal failure, he had refused to abandon Dana on this final journey. Her dad said he wouldn’t come watch her ‘desert’ him. Her sister had stopped talking to her. Friends said they couldn’t do it. Dr. Little was the only one there with Dana and she believed some sense of personal obligation complemented his professional and legal ones.
Dr. Little came closer and leaned against a wall across from Dana’s bed. His eyes focused on the stack of clipboards and nodded, asking Dana: “All done?”
She lifted her head with a smile, letting out a few light laughs as she said “poor choice of words, Doc.”
Dr. Little sighed as he pulled his head back and closed his eyes. Her sense of humor had only gotten darker in recent months as he listened to her milk all the jokes she could out of this. He relaxed quickly, opened his eyes and told her “I’m glad you’re enjoying this,” sincerely.
“Sorry. I couldn’t resist witnessing that uncomfortable expression one more time.” Dana put her arms to her side and placed her hands on the bed as if ready to push herself off. “Are they ready?”
“Don’t worry. They’re not in a rush.” The hospital bed rolled slightly as Dr. little sat down next to Dana. “Let’s take a minute. Has anything changed since we spoke last night? How are you feeling?”
“I’m calm. I can’t remember the last time my mind was so quiet.” She hadn’t noticed she had picked the pen up again and caught herself rolling it through her fingers. “I’m still having trouble sitting still, but it’s not the usual nerves. I’m just impatient.”
“Well, it’s ok to enjoy a quiet moment, you know?” Dr. Little paused. He waited a moment. He gently grabbed Dana’s hand to stop the pen. “Even just one. You used to fight for those.” She looked over at him as he turned his head to directly meet her eyes. “You sure you want to do this?”
“Yes.” Dana said with a little head bob. Dr. Little maintained strict eye contact to ensure the severity of this conversation was visibly clear while she continued in a warm tone. “Knowing this was coming caused all new quiet moments. I can’t take it away, that would ruin everything and put me right back on edge.” Dana turned her head and looked down at the floor. “I hated that part of me. In a way, I got rid of it six months ago. But it’s just waiting for me to blink before it comes back.” She took a deep breath.
Dr. Little put his hand on her now slouched back. “Do you still want to do this?”
“Yes.” Dana sat up straight then jumped off the bed. Looking towards the wall, she closed her eyes and savored another long, deep breath. She could taste the sterility and got a slight whiff of rubbing alcohol. Breathing in again, eyes still closed, Dana leaned hear head back. She opened her eyes to the ceiling, let the warm air out between her dry lips, grinned and turned towards Dr. Little. “You don’t need to ask again.”
“I do.” He remained soft, but slightly more austere, then said in his professional voice that Dana knew well: “I legally have to ask three times.” A slight pause. “Dana Chester.” He stopped again, swallowed hard and looked down, then picked his eyes up, locked stares with her again, and got through all the required language quickly in a single breath. “Dana Chester. Do you want to commit suicide by voluntary injection of sodium thiopental, pancuronium bromide, and potassium chloride?”
Dana paused. The combination of blunt and clinical language had successfully caught her off guard, but it did not change her mind. The small tear rolling down Dr. Little’s cheek reminded her of all the people who had cried with her over this decision. This was the first time he showed this type of emotion though and his hand also trembled on his thigh. She reached forward to place her own hand on top of his. He looked down quickly then started to lift his head very slowly as if to avoid scaring away a frightened animal. He was greeted by a gentle glance from Dana. “Yes. I wish to kill myself by voluntary injection. I wish to commit suicide today.”
A shiver rippled down Dr. Little’s spine causing his shoulders to jerk up. Dana was an ordinarily cold person, but rarely said anything with complete sincerity. There wasn’t even a hint of humor in that declaration, so he was confident no final change of mind was coming.
Dr. Little would be joining Dana in the history books and be faced with innumerable interview requests. There was already an offer on the table from a book publisher. But he had no wish to share the story of his greatest failure or expose his patient’s privacy. His plan was to use any new notoriety to fight this dangerous enabling law, still believing it was just an easy way out for people in dark places, no matter how many restrictions the law contained or what he witnessed with Dana. Ignoring the potential ethical and selfish implications, he had shared this plan with her many times over the past few months. She knew how his life had been and would continue to be impacted by her. He didn’t need to remind her.
Dr. Little did need to remind her of one more thing. One more time. “You don’t have to.”
“I want to.”
Death was now staring Dr. Little in the face, within arm’s reach. Dana slid off and grabbed his hand to help him stand up. She lifted her other hand to wipe the tears from his face then gave him a hug. Embracing her in return, he sniffled and took the moment to regain his composure.
They separated as Dana laid back down on the bed and Dr. Little walked over to the door, waving to a group in the hall. “She’s ready.”
Five nurses and surgical assistants in scrubs walked into the room, silently surrounding her bed. One on each side kicked a switch on the wheels and they began to make their way out the door when Dana looked back at Dr. Little. He called over to her: “Good luck.”
“Thanks for sticking with me. Thanks for everything Doc.” She looked back at Dr. Little grinning at her while he wiped another tear with his dark sleeve.
The bed crossed into the hallway and Dana lost sight of him. She looked forward and settled into the bed, calm, ready, but unable to stop from welling up. Then she thought about his final words to her and smiled again. Dana decided it was the best thing he could have said. ‘Good luck.’
Dr. Jacobs was at the forefront of the young field of surgically-driven mental health solutions. But in the past few years she began fighting the battle for euthanasia in what some found to be an offensive 180-degree shift. Opponents viewed it as giving in instead of finding proper treatment, while she argued that severe cases of depression, bi-polar, psychosis, schizophrenia and numerous other conditions were just as life-threatening as a heart condition or cancer, so patients should be given the same options. There were sealed court hearings over some ethical complaints she received from her last hospital hanging over her head, yet she still easily found work as every patient she ever worked with had nothing but raves for Dr. Jacobs.
The surgical suite had much less equipment present than when prepared a typical operation since the procedure was so simple. Only one IV drip with two bags and monitoring equipment, including an EEG, were necessary. The Anesthesiologist Dr. Chan had pre-mixed the requested combination of ketamine and lysergic acid diethylamide in the first IV, and the final trio of sodium thiopental, pancuronium bromide, and potassium chloride was ready in a second bag. Typically, he would make the recommendations based on the procedure and ask more questions, but given the experimental nature of this situation he deferred to Dr. Jones and Dr. Wagner: the lead neuroscientist. The two of them assured Dr. Chan that the first IV solution would produce a desired euphoric effect when combined with the stimulation from an EEG helmet. Then they could attach the second.
In order to properly develop this program, Dr. Jones began investigating induced-hallucination therapy as a method to provide a pleasant mental experience for the patients. Once she enlisted Dr. Wagner they discovered how to create specific, controlled hallucinations, and after several trials using a set of electrodes to put patients into desired scenarios they became confident in building their own environments or situations via a computer program. This part of the procedure was highly confidential since the potential for abuse of this method was high.
Dr. Jones and Dr. Wagner stood waiting for Dana to arrive as Dr. Chan finished washing his hands on the other side of the room.
“I’m feeling good. I think it will be easier and go more smoothly than we thought,” Dr. Wagner said.
“Dana is definitely the perfect first subject. Once we finish with her and the publicity gets out there, the world will understand why it is so important.” Dr. Jones smiled at Dr. Wagner. Then her expression grew more cautious and she paused. “I hope.”
“Don’t worry. Every big advance in medicine has skeptics.” Dr. Wagner said. “This will help a lot of people when they know what we can do.” He patted Dr. Jones on the back.
The two doctors were interrupted by Dana’s cart slowly being pushed through the large swinging doors of the surgical suite. She surveyed the all-white room to find the emergency equipment all pushed off to the side next to some glass cabinets housing additional tools. This made sense to Dana. But the presence of a defibrillator next to the other equipment positioned in the middle of the room made her laugh. one more element to remind everyone hospitals were used to saving people, not killing them. She immediately recognized the electrode helmet from her pre-op consultation with Dr. Wagner, sitting on a small metal cart with a laptop.
Dana noticed the gap that she was being rolled into between the IVs and cart. That’s when it hit her that she was currently on her death bed and had been for over an hour already. This caused a rush of relief since this bed was much more satisfactory than a cold surgical one, especially after being stuck in the disappointing hospital gown.
The death bed got set in place and the three doctors came in to surround Dana. Her eyes adjusted to the bright light as she looked up to them. All the nurses that had pushed Dana in had left the room, following her request that only those necessary witness her final moments, leaving her alone with the doctors.
Dr. Chan stood next to the metal IV stand, rigid enough that he could have held the bags himself. He was struggling to look down at Dana, his aversion to eye contact assisted by a conscious decision to stand next to the light facing down at Dana.
Dr. Jones and Dr. Wagner were in high spirits though, and she greeted Dana with a grin and cautious enthusiasm. “Hi there Dana, how are you feeling?”
“I’m great. I’m really great.” Dana was happy at least these two doctors weren’t as uncomfortable as everyone else.
Removing the grin, Dr. Jones asked “are you ready?” in a more serious tone.
“Of course.” Dana replied. With a devilish smile she added “It’s a good day to die.”
Dr. Jones broke eye contact and tilted her head off to the right a bit, not quite laughing but allowing a light gasp to escape between her lips. “I’m happy you’re in good spirits.”
A hearty laugh came through Dr. Wagner’ blue mask as he thoroughly enjoyed Dana’s cavalier comment. Still finding new ways to find new jokes about her situation, Dana told him “Be careful Dr. Wagner. With that attitude you might keep me alive. And we can’t have that.”
“Murder has been one of my favorite hobbies for years, so I’m excited to be in the big leagues now.” He thought he needed a better finish, so he added “I’m happy you’ll be my first” with salacious raised eyebrows.
“Just go slow Doc.” Dana and Dr. Wagner erupted in laughter as Dr. Chan had stepped back from the commotion, now a couple feet away with a slightly gaped mouth that was trying to form any expression that hid his massive discomfort. Having spent a lot of time with Dr. Wagner, Dr. Jones was used to this dark humor, so she had little reaction outside of an awkward smile of acknowledgement to both her colleague and patient.
There was a brief silence after the laughter stopped. Dr. Wagner had picked up the helmet and preparing to place it on her head. Dana still wasn’t nervous and had grown even more eager to enter the final dream state she had been promised. “Did my story work for what you needed? Did you get all the pictures of my mom?”
“Yup. Today you’ll have the best picnic ever with her.” Dr. Jones gently squeezed Dana’s arm and gave her a warm smile. “We even visited that pond you told us about so we could get a real sense of it. It’s a beautiful place.”
Dr. Wagner was placing the electrode helmet on Dana’s head as she responded: “Yeah… We went there all the time when I was a kid. It’s what I miss the most.”
“Well you’ll see her again soon.” Dr. Wagner said as he patted Dana’s shoulder and nodded over to Dr. Jones, signaling they could get started.
Dr. Jones looked down at the computer screen briefly then said: “Ok Dr. Chan, can you get the first IV ready?” She lifted her head back up to look Dana right in the eyes and ask “Dana. Do you have anything to say?”
Dana had six months to think about this and still couldn’t decide. She just knew she wanted it to be short.
“Thank you doctors. Thank you for everything. Ok…’I’m ready.’” Dana said with enthusiasm, shifting in her bed to raise her shoulders. “No that’s too generic for last words. ‘I’m done here?’ That just doesn’t say anything. And even for me that’s morbid.” She was increasingly somber as she said “’I tried…’ Too sad. It needs to be kind of serious, but not too much.” Dana’s face lit up and she shifted her eyes up, letting out a deep sigh before settling on her final words “So it goes…”
The two doctors gave Dana obligatory grins but otherwise blank stares and she got frustrated. She didn’t want to say anything else though, so she just lightly nodded her head to them, keeping her disappointment her doctors weren’t Vonnegut fans to herself.
Dana hesitated for one more moment before looking up at Dr. Wagner, then right into Dr. Jones’ eyes. Dana smiled, closed her eyes to take a deep breath, then opened them up with a gentle nod towards the two doctors above her. Then she stared up at the bright overhead lamp, focusing on a single small bulb among.
She felt the prick of a needle in her arm and a warm sensation quickly came over her whole body. She got drowsy and let her shoulders and face droop down, closing her eyes. Then she started to drift away.
Read part 2
Leave a Reply.