The Sisterhood - Michael Palmer [42]
“And how do you feel about the whole thing, David?”
Dr. Armstrong’s voice was soft. There was an openness in her expression that made him certain there would be no recrimination from her.
“I think it’s a bitch of a situation, if you’ll pardon the expression,” he said. “I mean it’s always harder to decide not to use treatment on a patient than it is to just go ahead and employ every medicine, machine, and Operation you can think of. That’s why we end up with so many patients who drag on as little more than vegetables.
“Personally,” he continued, “having watched several of my own family members die prolonged, painful deaths, I think there are times when a doctor must make the decision to hold off and let nature take its course. Don’t you agree?”
Hold off … Let nature take its course.… There was something about the words, the way they were said. Margaret Armstrong closed her eyes as they echoed in her mind, then yielded to other words. Other words and the voice of a young girl.
“It’s all right, Mama.… I’m here, Mama.”
“Don’t you agree, Dr. Armstrong?”
“Mama, tell me what I can do to help.… Does it still hurt as much? Tell me what I can do to help.… Please, tell me what I can do.…”
“Dr. Armstrong?”
“Oh, yes,” she said. “Well, David, I’m afraid I agree much more with Dr. Huttner’s approach than with yours.” How long had she drifted off? Were they expecting an explanation?
“How do you mean?”
No, she decided. No explanations. “The way I see it, following your philosophy, a physician would constantly be confronted with the need to play God. To decide who is to live and who is to die. A medical Nero. Thumbs up, we put in an intravenous. Thumbs down, we don’t.”
David responded with an emotion and forcefulness that momentarily startled even him. “I believe that the major responsibility of a physician is not constantly to do battle against death, but to do what he can to lessen pain and improve the quality of patients’ lives. I mean,” he went on, less vehemently now, “should every treatment, every operation possible be used on every patient, even though we know there’s only a one-in-a-million or even a one-in-ten-thousand chance that it will help?” In the silence that followed, he sensed that once again he’d used a verbal cannon where a slingshot or perhaps even a velvet glove had been called for.
At this point, Winnie Edgerly, a straightforward if somewhat plodding woman of about fifty, felt moved to enter the discussion. “I cast my vote with Dr. Armstrong,” she said earnestly. “I wouldn’t want any tubes pulled out of me if there was even the slightest chance. I mean, who knows what might happen or what might come along at the last minute to help. Right?”
“Now don’t get me wrong, Mrs. Edgerly,” David said, carefully minimizing the intensity in his voice. “I am not advocating pulling out any tubes from anyone. I’m arguing that we should all think twice—or more than twice—before putting the tubes down someone in the first place. Sure they can help, but they also can prolong hopeless agony. Does that help make my feelings any clearer?”
Edgerly nodded, but her expression suggested that she did not agree.
Finally Dr. Armstrong said, “So, David, how does all this apply to your Mrs. Thomas?”
“It doesn’t,” he said shortly. “The treatment program for Mrs. Thomas has been clearly spelled out by Dr. Huttner. It’s my responsibility to carry those plans out to the best of my ability. That’s all there is to that.”
Armstrong seemed about to say something further when the overhead page sounded, summoning David to the emergency ward. “When it rains, it pours.” He smiled expectantly at Dr. Armstrong.
“But I’ll bet you don’t mind getting wet like this at all,” she said. “I’m very happy for you, David.