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This writing was accepted for publication in the 84 page perfect-bound issue... Down in the Dirt magazine (v098) (the September 2011 Issue) You can also order this 5.5" x 8.5" issue as an ISSN# paperback book:						This writing also appears in this 6" x 9" ISBN# paperback “Wisdom in Broken Hands” Order this 6" x 9" ISBN# book:

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A Second Opinion

U. Ebiz

    Takeshi had booked himself a flight to a large southern city and a room for three nights. He told the hotel waitress that it was his first visit to America – she recalled him chuckling at photographs on the breakfast menu, that he’d ordered steak and eggs and barbequed fries and a double side of pancakes, and then not eaten a bite. From the restaurant he had gone to the hotel lobby and asked for a taxi, showing the bellhop a web page he had downloaded before leaving home of a nearby gun club. The owner of the gun shop told the police that Takeshi had wanted to shoot something big – he’d asked for something like Dirty Harry might have used. He had chosen a ‘45 from the display cabinet, paid the fee to rent gun and firing range for half an hour, and as he’d never touched a weapon before the shop owner gave him some instruction and stayed with him to make sure he got the hang of things. Takeshi shot 50 rounds into various targets – once he found the Bin Laden target he stayed with it, as it made him laugh – and then he took a cab back to his hotel to get some sleep. Later that afternoon he took another cab back to the gun shop, fired off another 50 rounds at Bin Laden, then returned to his hotel room. A few hours later Takeshi went to the gun shop once again, rented the ‘45, and put the first bullet through his own head.
    The medics were there within minutes. They’re used to handling creatures that once were men, brain and blood all over the ceiling, but not dead yet.
    They dropped Takeshi off at the nearest ER spraying blood with each pitiful attempt to breathe, his oxygen saturation already down to 80% and dropping. His passport said he was in his mid-twenties, though the nurses remembered that he’d looked like a child to them laying there on the gurney, so small and pale and helpless.
    The trauma room was crowded with nurses, orderlies, X-ray and respiratory and lab techs – all jammed into that intense little box, they were inserting intravenous lines and filling vacuum tubes with blood and applying monitoring leads and checking vital signs. They were eager to help, only the trouble was, help with what?
    That decision had to be made by the doctor on duty that day, Dr Jason Chu, who had just recently completed his training. A few moments of examination made it painfully clear to Jason that any coherent contact with the planet for this patient was in his past. He’d put the gun under his chin and aimed up. The bullet had passed through his throat and the roof of his mouth and then through the front of his brain and out the top of his head. The brain damage was massive, grey bloody tissue was oozing from his skull.
    But not dead yet. His heart was still beating. The left side of his body was already flaccid and hopeless, but his right hand kept writhing slowly into the air above his body, and furiously contorting, as though he was giving them all the finger. His body was not yet at peace with the decision his mind had taken.
    Jason knew they couldn’t bring him back, but could they actually help him to die? Clearly the man had made plans to go out like a light, but instead he was jerking, oozing, grimacing, gasping, drowning in the blood of his own mangled tongue, fading horrifically surrounded by a room full of strangers. If they just gave him morphine for relief it’d all be over within seconds.
    The problem was this: in the long-run his brain was ruined; in the short-run he was about to drown in his own blood from the throat wound; sometimes the kindest thing is to let nature take its course. The trouble was, this death was far too gruesome to just stand around and watch. To act or not to act, hook the guy up to a machine – to force his body to live, despite his obvious intentions – or let him go?
    Jason knew that legal responsibility for the decision was all his. But in matters of ultimate belief, of pure empathy, he liked a group decision, he still preferred to resort to democracy. He was loathe, or perhaps only too unsure of himself, to impose his feelings about life and death on others.
    The trauma team on duty that day had gone into other people’s disasters countless times. They’d saved their share and felt great about it. They’d lost enough too, and felt lousy together. They’d pumped on chests and pushed in tubes and fired jolt after jolt to jump-start dying bodies in that room. You can be a virgin in horror just as in sex, but there were no virgins here.
    Jason looked up towards his team – they were all huddled together, leaning over the gasping, tormented body – and muttered,
    “My vote is to push morphine and leave him alone. His brain is done. It’s rotten like this but he wanted out and it’s too late to go back now.”
    The trauma nurses liked Dr Chu a lot. Over the years they’d seen countless new grads pass through the ER, and Dr Chu wasn’t cocky like a lot of them. He was steady and hard-working and always sincere and polite with the patients. Nurses appreciate that. He was a nice kid, he was smart but he didn’t have much experience, and they didn’t want to see him get himself into trouble.
    “But he’s a suicide, doc -” one of the nurses pointed out, and when Jason returned a querying look, she continued, “Maybe the shooting was a mistake, just an emotional outburst, maybe he didn’t really want to die -”
    “Could be,” Jason agreed, “but he did this with his brain in one piece, you think he’d want to live with only half of it left?”
    An older nurse – known fondly around the ER as The Coach – murmured almost apologetically, “Yeah, doc, but still, the family might sue you if you don’t intervene -”
    “I suppose they could,” Jason agreed pensively, “and if we keep him alive maybe they’ll sue me for treating him against his will -”
    All those eyes faced the young doctor, worried, horrified, caring. Jason understood that the nurses were trying to protect him. No one imagined there was a simple answer here.
    But Jason was neither trained nor paid to be indecisive, and in the trauma room ambiguity was intolerable –
    “All right,” he muttered, “we’ll tube him –”
    – and on that order the room surged back into action. Staying busy is the best way to avoid moral doubt. Hands authoritatively re-positioned Takeshi’s shoulders and head, the breathing machine rolled into place, suction catheters and lighted blades materialized for the doctor’s grasp. The team was on auto-pilot.
    Jason signaled for a nurse to inject a sedative to finally ease the patient’s tortured spasms – which promptly terminated his fragile breathing: had they stopped then, Takeshi’s deed was done. Squatting behind the patient’s head Jason took the curved steel blade handed to him with a bright light at its tip and manipulated it far down the patient’s throat while suctioning out bits of clot and tissue and blood. Then he pushed in a long thick plastic tube through which air was soon injected into those lifeless lungs.
    Death diverted, at least for a moment, the team set down their tools, and stepped back to gaze ambivalently at their handiwork.
    “Well,” Jason sighed, “he’s probably going to die anyway from the bleeding into his brain –”
    – to which The Coach sympathetically agreed, “At least he’s not gasping for air any more doc -”
    With the matter of breathing now passed reliably to a machine, the patient was soon moved out of the ER to be cared for by another squad of professionals in the intensive care unit. The trauma room was quickly inhabited by new patients who demanded and deserved – and got – the team’s total attention.

    But some hours later, as his shift was coming to an end, Jason found that his thoughts kept returning to that ambiguous moment in the trauma room. It felt to him that he’d made a mistake. He finally had time to review the CT-scan of the patient’s head, which only magnified the extent of the disaster he had already presumed: the bullet had passed through the root of Takeshi’s tongue, then bounced off the base of his skull and torn through his optic nerves, sending fragments of metal and bone ricocheting in all directions, but mostly through his frontal lobes. Frontal lobes are where time exists, knowledge of past and future, of right and wrong, of the difference between trees and dogs. Never again could that man hope for even a guilty mind. And if his body survived he’d be blind, he’d be mentally retarded and, as the bullet had demolished his tongue, unable to speak. Not even to say he was hungry, or depressed, or in pain.
    Heavy of heart, before going home for the night Jason walked across the hospital to the intensive care unit: maybe the patient had died, and solved the dilemma. He found Takeshi laying peacefully, comatose, his head and throat now covered with tidy white bandages, amidst the tireless and hypnotic beeping and humming of machinery and tubes that were steadfastly keeping him alive.

    The administration soon identified Takeshi’s parents in Japan, and informed them that the hospital had saved their son’s life. A few days following the accident Jason overheard his nurses saying that the parents had arrived to see their son.
    Jason wanted to just stay busy right where he was in the ER. But sincerity can be a tyrannical solace, and so once again he walked dourly across his hospital to the intensive care unit, to at least offer his sympathies to the family.
    He found the parents standing at the foot of their son’s bed. They stood close together, heads bowed, hands clasped at their waists. Two frail and tragic figures, like images in a painting which had accidentally been drawn on the wrong canvas. They lifted their heads slightly when the doctor was introduced, but would not look into his face.
    The translator quietly explained what she could. Takeshi had left a letter behind to apologize and say goodbye to his parents. Buddhists, they felt immense sorrow, but no moral fright at their youngest son’s decision to end his time on earth. He was a good son; they had no choice but to respect his action. At the prospect of taking him back to Japan – a failed suicide on mechanical life support – bewilderment, shame, and pity had overcome them.
    Jason stood silently, his head bowed by way of condolence, waiting patiently for enough time to pass that at least dignity might be satisfied.
    At last he murmured, somewhat thickly, to the translator, “Please tell them that I’m so sorry we couldn’t do more to help.”
    Told these words, Takeshi’s mother grasped her husband’s arm and finally looked up to face Jason, standing there in his white coat and hospital insignia. She must have presumed him to be an official representative of the institution. She began to whisper to the translator, excited, persistent, eventually repeating, pleading, a single phrase over and over again.
    “What does she say?” Jason asked, and the translator hesitated, and then murmured,
    “She is only, distraught, you understand -”
    “Yes, of course. But what is she saying? Is there something she wants us to do?”
    “She says,” and the translator opened her palms towards Jason, “and I hope you can forgive me, Sensei – but she says, ‘You rented him the gun, can’t a man even shoot himself in peace?’”

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