Free Diagnosis Death by Richard L. Mabry Page A

Elena wanted to do was start planning for her move. "David, I appreciate the offer, but I'll have to pass."
    "Well, would you like to meet afterwards for lunch? You can tell me about your interview."
    She had to give him full marks for persistence. And he was a friend—perhaps the only one she had. "Sure. Call me when you're ready."
    The coffee was brewed by the time Elena hung up. With cup in hand, she sank into a kitchen chair, leaned her elbows on the table, and wondered if her nightmare had been an attempt by her subconscious to cleanse her soul of the guilt it felt. Or was it a portent of trials yet to come?

6
     
     
     
     
     
    T he ICU was a terrible place to start the week, but Elena was drawn to it this morning like iron to a magnet. She had to talk to Erma Pulliam again. If the woman was to do the right thing for her husband and herself, she had to do it soon.
    Elena pushed through the double doors into the unit. Off to her right, a nurse glanced at her and ducked into a patient room. Did the nurses resent her visits now? Chester Pulliam was no longer her patient. There was never any change to report, but conveying that information to her took precious minutes out of their already overcrowded day. Should she stop bothering everybody? But just as it was impossible not to explore a sensitive tooth with your tongue, Elena couldn't stay away.
    As she paused outside Pulliam's door, Elena heard the rhythmic chuff, chuff, chuff of the respirator. Apparently the patient still had no spontaneous drive to breathe. The machine was keeping him alive.
    Elena tapped lightly on the door and entered the room.
    "Dr. Gardner." Erma Pulliam tried to smile, but Elena saw there wasn't much behind it. "Nice of you to come by."
    The first thing Elena noticed was a plastic tube taped to Chester Pulliam's right nostril, the end plugged to keep a milky fluid from dripping out. There were a couple of vials of pills at the bedside, along with an old-fashioned pharmacist's mortar and pestle. The nurses would use those to grind medicines before inserting them into the feeding tube. No more need for IVs.
    The feeding tube represented an intermediate stage. Surgical procedures came next: a gastrostomy to provide a permanent means of feeding and a tracheotomy to allow unrestricted airway access. These operations were an accepted part of the road to what physicians called a vegetative existence. Nice words, but they failed to describe what would happen to the patient—and to his family.
    Mrs. Pulliam didn't know what lay ahead of her, but Elena did. Once more, she led the woman into the hall for their conversation.
    "Has your family been here yet?" Elena asked.
    Mrs. Pulliam shook her head. "We have two sons, both married and living on the other side of the country. They couldn't get away to come here, but they both said it didn't matter." She nodded toward the room they'd just left. "'That's not my dad in there,' they said. They want to remember him the way he was."
    "And what did they say about taking him off life support?"
    Mrs. Pulliam wiped her eyes with a tissue, then began shredding it. "They think I should do it. But I . . . I can't. It seems so wrong."
    "Do you have religious scruples about it? I can ask the hospital chaplain to talk with you."
    "No, I recognize the difference between taking someone's life and not prolonging the existence of a body with no brain function. It's just that I don't know if I have the courage to do it."
    Elena patted the woman's shoulder. "I know how you feel. I've been where you are."
    Surprise showed on the woman's face. "And what did you do?"
    Elena swallowed hard. When could she stop reliving that awful experience?
    "That's all right. I can see it's hard for you to talk about. I shouldn't have asked."
    Elena shook her head. "No, you need to know that you're not the first person to agonize over this decision. I finally came to the conclusion that it was best for Mark—and for me—to take him off life