by William H. Coles

Listen (4:24) Dilemma

His sweet troubled son, alone in his room; he and his wife sitting downstairs irritated by the bass thrust of the loud music coming from the second floor.   They knew he had taken drugs, they had taken him to a psychiatrist, paid for the Prozac that insurance didn’t cover; but they didn’t know that he had taken a loaded shotgun from the locked cabinet, a gun that he put with the stock on the floor and while sitting on the bed placed the barrels under his chin and pushed down on the trigger. 

After the explosion they were quickly inside the room.  The gun had fallen to the floor.  His son had fallen to one side; his face gone: the lower jaw blown away, a few upper teeth haphazardly clinging to flesh.  Nose and lower lids gone, the deflated eyeballs wrinkled like a fallen soufflé.  His son’s legs, then his arms, went into spasms; he was alive but without air.

I’m a surgeon, he thought.  Focus.  Think like a doctor and not a father. 

His wife had crumpled to the floor, her hands over her eyes, wailing.

He held his son’s head with both hands; straightened the torso.  "Get up," he said to his wife.  "You’ve got to do this."  She stood.  "Slide the pillow under his shoulders."

He let the head fall back hoping to find the glistening end of the trachea.   There were no landmarks, only flesh and blood, and bits and slivers of bone.

"Bring me a razor, a tooth brush, towels."  He needed tools . . . and he needed to keep her busy.

His wife was sobbing now.  Her bare feet made a dampened sound on the wooden floor of the hall.

He supported the head trying to find a position so his son might suck in air. He pressed the chest, to see if expulsion of air could show him the trachea.  Should he let his son die?  He saw no air.  If he lived, he’d have no life.  He’d be blind, unable to eat or taste, never smell, might be deaf.  Never talk.  He’d be trapped in the dark with no way to communicate.

She returned.  He swabbed with the towel, told his wife to press, to stem the ooze.  He used the smooth end of the toothbrush to separate tissue.  "Bring me some dental floss," he said. 

It would be a blessing for his son to die.  But he refused to wish his son had been more thorough, not left him with these decisions.  He saw the glint of the tracheal cartilage.  He slipped the handle of the razor behind it.  His son could live, at least to get to emergency.  There was the swhoosh of the intake of air.  It would have to be now, before she came back.  He still had time.  How crucial for her.  It could allow her grief to shrink to a memory with time.

His wife handed him the dental floss.  Now he could firmly isolate the trachea, knot it gently, hold it in a position until a cannula could be inserted when help came.  "Bring wet towels," he said.

He looked at the head of the son he had loved, a head he would never recognize again.  His heart ached.  He leaned forward and kissed the one ear that was left.  Was there movement?  He touched the ear again running his finger along the pinna.  Yes.  The head seemed to move, as a bee is attracted to a flower.   He could not let his son die. 

He adjusted the trachea opening to assure air would pass.

At the sight of his son, the ambulance crew froze with an instant perception of what the future might bring.

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6 thoughts on “Dilemma

  • Barbara kemp

    Basic instinct of a doctor and father. The questions about quality of life and the need for decisive action are all laid out in real time. I could never be the one to let my child go if I could save the child. The decision would have to come from somewhere else. I do believe we have examples of fully formed people with the most severe disabilities making grand contributions. Helen Keller. Stephen Hawking… Who are we to decide? So, yes, an intriguing story.