One of the benefits of being an anesthesiologist was that Jeffrey knew the most efficient way to commit suicide. Other doc-
tors didn't, though they tended to be more successful in their attempts than the general public. Some shot themselves, a messy method which, surprisingly enough, was not always effective. Others took overdoses, another method that often didn't yield the desired result. Too often the would-be suicides were caught in time to have their stomachs pumped. Other times the drugs injected were enough to bring on a coma but not death. Jeffrey shuddered at the haphazard consequences.
Jeffrey felt his depression lift slightly as he worked. It was heartening to have a goal. He took the painting that hung over the head of the bed down to use the hook to hang both IV bottles. He then sat down on the side of the bed and started the IV on the back of his left hand with the bottle containing only the Ringer's Lactate solution. He piggy-backed the bottle containing the succiny1choline onto the other, with only the thin blue stopcock separating him from its lethal contents.
Careful not to dislodge the IV, Jeffrey lay back on the bed. His plan was to inject the huge dose of morphine and then open the stopcock on the solution containing the succiny1choline. The morphine would send him to never-never-land long before the succiny1choline concentration paralyzed his respiratory system. Without a ventilator, he would die. It was as simple as that.
Gently, Jeffrey inserted the needle of the syringe containing the morphine into the IV port of the infusion line going into the vein on the back of his hand. Just as he was beginning to inject the narcotic, there was a soft knock on his door.
Jeffrey rolled his eyes. What a time for Carol to interrupt. He held off the injection but didn't respond to her knock, hoping she'd go away if she thought he was still asleep. Instead, she knocked louder, then louder still. "Jeffrey!" she called. "Jeffreyl I've made dinner."
There was a short silence that made Jeffrey think she'd given up. But then
Jeffrey heard the knob turn and the door rattle against the jamb.
"Jeffrey-are you all right?"
Jeffrey took a deep breath. He knew he had to say something or she might be concerned enough to force the door. The last thing he wanted was for her to come barging in and see the IV.
"I'm fine," Jeffrey called out at last.
"Then why didn't you answer me?" Carol demanded.
"I was asleep."
"Why is this door locked?" Carol asked.
"I guess I didn't want to be disturbed," Jeffrey replied with pointed irony.
"I've made dinner," Carol said.
"That's nice of you, but I'm still not hungry."
"I made veal chops, your favorite. I think you should eat."
"Please, Carol," Jeffrey said with exasperation. "I'm not hungry. 11
"Well, come eat for my sake. As a favor to me."
Fuming, Jeffrey set the syringe with the morphine on the night table and pulled out the IV. He went to the door and yanked it open, but not so far that Carol could see in. "Listen!" he snapped. "I told you earlier that I wasn't hungry then and I'm telling you that I'm not hungry now. I don't want to eat and I don't like you trying to make me feel guilty about it, understand?"
"Jeffrey, come on. I don't think you should be alone. Now I've gone to the trouble to shop for you and cook. The least you can do is come try it."
Jeffrey could see there would be no getting around her. When she'd made up her mind, she was not the type of person who could be easily dissuaded.
"All right," he said heavily. "All right."
"What's wrong with your hand?" Carol asked, noticing a drop of blood on the back of it.
"Nothing," Jeffrey said. "Nothing at all." He glanced at the back of his hand. Blood was oozing from the IV site. Frantically, he searched for an explanation.
"But it's bleeding."
"A paper cut," Jeffrey said. He was never good at fibbing. Then, with an irony only he could appreciate, he added, "I'll live. Believe me, I'll live. Look," he said, "I'll be down in a minute."
"Promise?" Carol said.
"I promise."
With Carol gone and the door relocked, Jeffrey removed the quarter-liter IV bottles and stored them in the back of his closet in his leather doctor's bag. He threw the wrappers from the infusion kits and the scalp needle into the wastebasket in the bathroom.
Carol had some sense of timing, he thought ruefully. Only as he packed away the medical paraphernalia did he realize how close he had come. He told himself he shouldn't give in to despair, at least not until all legal avenues had been exhausted. Until this recent turn of events, Jeffrey had never seriously enter tained thoughts of suicide. He was honestly baffled by the sui-
cides he knew of, though intellectually he could appreciate the depths of despair that might prompt it.
Oddly enough, or perhaps not so oddly, the only suicides he had known were other doctors who'd been pushed to the brink by motives not unlike
Jeffrey's. He recalled one friend in particular: Chris Everson. He couldn't remember exactly when Chris had died, but it had been within the last two years.
Chris had been a fellow anesthesiologist. Years before, he and Jeffrey had been residents together. Chris would have remembered the days when gung-ho residents warded off flu symptoms with Ringer's Lactate. What made thinking about Chris suddenly so poignant was the realization that he'd been sued for malpractice because one of his patients had had a terrible reaction to a local anesthetic during epidural anesthesia.
Jeffrey closed his eyes and tried to remember the details of the case. As best as he could recall, Chris's patient's heart had arrested as soon as
Chris put in the test dose of only 2 cc's. Although they had been able to get the heart beating again, the patient ended up quadriplegic and semicomatose. Within a week after the event, Chris had been sued along with
Valley Hospital and everyone else even remotely associated with the episode. The "deep pockets" strategy yet again.
But Chris never went to court. He committed suicide even before the discovery period had been completed. And even though the anesthesia procedure had been characterized as having been impeccable, the decision ultimately rendered found for the plaintiff. At the time, the settlement had been the largest award for malpractice in Massachusetts' history. But in the ensuing months, Jeffrey could think of -at least two awards that had topped it.
Jeffrey could distinctly remember his reaction when he'd heard of Chris's suicide. It had been one of complete disbelief. Back then, before Jeffrey's current involvement with the legal system, he'd had no idea what could have pushed Chris to do such an awful thing. Chris enjoyed a reputation as a superb anesthesiologist, a doctoes doctor, one of the best. He'd recently married a beautiful OR nurse who worked in Valley Hospital. He seemed to have everything going for him. And then the nightmare struck...
A soft knock brought Jeffrey back to the present. Carol was at the door again.
"Jeffrey!" she called. "Better come before it gets cold."
"I'm on my way."
Now that he knew too well what Chris had only begun to go through, Jeffrey wished he'd stayed in touch at the time. He could have been a better friend. And even after the man ended his life, all Jeffrey had done was attend the funeral. He had never even contacted Kelly, Chris's wife, even though at the funeral he'd promised himself he would do so.
Such behavior wasn't like Jeffrey, and he wondered why he'd acted so heartlessly. The only excuse he could think of was his need to repress the episode. The suicide of a colleague with whom Jeffrey could so easily identify was a fundamentally disturbing event. Perhaps facing it squarely would have been too great a challenge for him. It was the kind of personal examination that Jeffrey and doctors in general had been taught to avoid, labeling it "clinical detachment."