A Chinese Proverb:
“Never make a great wish; you might get what you want”.
“Dr. Charles Fields, beloved physician, husband, father and grandfather, born April 15, 1929, of Austin, Texas, entered into rest on March 9, 2014. He was preceded in death by his parents, William and Gladys Fields of Norris, Tennessee. He is survived by his loving wife of 59 years, Alice, his three sons, and their wives, Robert and Lucille, Paul and Mary, and John and Sandra, and his many grandchildren and great-grandchildren. Viewing will be tonight at 7 PM at Mission Gate Funeral Home, 2218 Lawrence Avenue. Services will be tomorrow at St. George Episcopal Church. He will be interred at the Gateway to Eternity Cemetery.”
I reached my decision one week ago today. I made it with great difficulty, of course. I have always believed suicide to be a beggarly choice. While I am not an ardent “right to lifer”, I do not believe in capital punishment, or wars of adventure and profit. For me life is sacred, a gift to be held onto at all cost. That reasoning led me to study medicine and practice as a physician for forty years. It was a choice I never regretted.
I was diagnosed with prostate cancer two years ago. At first my urologist felt in view of my age that simple observation would be the best approach. However, the cancer was much more aggressive than most and I began to suffer its consequences. We tried simple therapy but nothing has really helped. I am not in pain but I am much weaker. I used to run 6 miles in the morning before work; now I am confined to a wheelchair and I am certain that in a few weeks I will be confined to bed in a nursing home where I will spend my last months or dreadfully, years.
In my forty years as a physician I can remember only three people who killed themselves. The first was a man who had cancer of the lung. The cancer was removed but we had to remove the entire right lung. Subsequently he had some post operative problems but all in all he did well. However, he had severe, persistent, unremitting pain. I sent him to several specialists but we could not find the cause of the pain. There was never a sign that the cancer had come back. At the time there were no pain specialists and narcotic usage was quite frowned upon—you could lose your license, in fact—so he endured the pain. Finally, he shot himself in the head. At least the pain was gone.
The second patient was also an enigma. He was a younger man, in his early 40’s. He had just been promoted to manager of a fast food outlet. I saw him in the office. He seemed happily married, his children were doing well, and he had just been promoted. A week later on a Monday, I got a call from a family member (I took care of several of his relatives). He had shot himself in the head over the weekend. My card was by the telephone. I had been off call that weekend. To this day, I wonder if he had tried to call me, and, if I had been on call, could I have made a difference. At least, perhaps, I would know the why.
The third was even stranger. She was an elderly lady, though now I am even older than she was, a retired Air Force nurse with numerous friends. I had cared for her and several of her friends for years. I saw her for a complete physical. Everything was fine. Her exam was normal. She was quite healthy. Her lab and x-rays were all normal. However, there was something about her affect that bothered me. Normally she would tell me stories about her experiences in the operating room or about her friends. This time she did not. I asked her if she felt depressed. She responded she was not. I asked her if she had thought about suicide. She responded that she had not. Several days later I got a phone call from one her friends. She had killed herself, with a gun, and left a note stating she knew she had cancer and did not want to live in pain. Of course, there was no cancer.
Three patients, three suicides, three reasons.
Most suicides seem to occur in people with cancer and depression. Maybe they feel hopeless. Maybe they haven’t got any family or friends. Maybe they have no one to talk to about their problems. That certainly is not me. I have cancer but I am not depressed. I have a good family. Alice and I have been married for 59 years. My children are all healthy and are helpful to Alice and me. They visit us every week, take us shopping and do little things for as all the time.
My son, John, though, just lost his job. He worked at a bank that was bought out by a larger bank. The large bank had gotten money from the government to stay afloat. His bank didn’t. Some of our friends called the government handouts “socialism” but they got it upside down. Socialism is when you take money from the rich and give it to the poor. Capitalism is when you take money from the poor and give it to the rich. Nevertheless John is out of a job. He is nearly 50 with two kids in college. He is having a hard time finding a new job. His wife, Sandra, went back to work. I hope they can keep their home. That is part of my dilemma. That is one of the reasons I have to do what I have to do.
I am now 85 and have had a most wonderful career in medicine and a very happy home life to boot. My main concern is my wife. She appears healthy now but is also in her mid 80’s and has subtle but definite signs of Alzheimer’s disease. She will at some point need nursing care or intensive home care. We have enough money for one of us to be in a nursing home but not for both of us to be in a nursing home. The kids would help out but it would be ruinous for them as well. We could sell the house, I suppose, but that would destroy my wife and probably not help our finances very much. I never thought that, after more than 40 years in medicine, it would be the cost of medical care that brings me to my knees! But it has.
They say when someone dies he sees his whole life. What would I remember?
Of course, I would remember my wife, my children and my grandchildren.
I would remember when “she proposed”. I can still picture it. We had gone from church to a small Italian restaurant. It was summer and the school year was about to resume. She told me she had been awarded a scholarship to study in England and would leave shortly for England, unless she had a reason to remain here. I told her I cared for her very much, I would miss her, and when she returned we would be married. She said she was unsure I would wait. It was now or never. I chose now. We were married later that month. I often recounted this story to friends and family showing how she proposed to me, which upsets her to no end.
I remember how nervous I was on our wedding night. I remember how beautiful she was. I can still see her smile, her bright loving eyes just as they were.
I would remember the day John was born. It was Christmas day and 24 degrees below zero. I was a resident. I drove my wife to the emergency room and then drove to the resident’s parking a mile from the hospital. By the time I made it back to the hospital she had already delivered and, because of the cold, I had my first and only asthma attack.
I also remember the sadness I felt last year when Alice was in the hospital with pneumonia. As I entered the room, I saw her lying in bed, trying to eat, her left breast uncovered for all who passed to glare at, peas and pieces of meat lying on her exposed chest, a nurse nowhere to be found. I cleaned her chest and wiped her face and covered her breast and vowed I would be there for every meal. Since then, her mental status has never been the same and I am sure she has Alzheimer’s disease.
I remember something that happened when I was a medical student. I was assisting at a surgery. The surgeon had done this type of vascular surgery a thousand times. It was difficult and stressful, but he had done it well enough to be highly respected in the community. As I watched him work, there was a spurt of bright red which caught him on his glasses. He tied off the bleeder and shouted to me to get him a special scalpel so that he could get to the area of the bleed better. I handed him the scalpel but its edge caught his glove and tore it. The surgeon cursed, took the scalpel, lifted it near the light above and thrust it into the back of my hand. I screamed for an instant. The surgeon re-gloved and went about his business. I went to the emergency room to have the wound stitched. I did not tell them how it happened. I knew if I would tell anyone the surgeon would have me expelled from school. I wanted to be a doctor more than anything.
I remember so many of my patients—the hardest job was telling a patient he had cancer. I never could get used to that. Now I understand how he felt when I told him he had cancer.
Well, I can’t wait any more. First, I need to write a note to Alice. Let me see.
You have given me so much happiness over our years together.
I have proposed to you every day of our life together.
Forgive me. I will always love you.
Where is the revolver? Alice always helps me find my things. It must be here in this drawer. No, perhaps the next drawer. Yes, here it is!
I just need one bullet. Let me see. Got it. I really am nervous!
I raise the gun to my forehead. God, my hand is shaking and I’m sweating. God, I can’t. I can’t do it. I have to put the gun down. I got to rest a few seconds.
“Hey, who’s there?
“It’s me, dad. Dad, put the gun down.”
“John, I got to do this.”
“No way, dad. Mom would die if you did this.”
“Let go John. Let go of my hand.”
“No way, I got to.”
“John. John. Stop. Stop. I can’t breathe. It hurts. My chest hurts–bad chest pain. I can’t breathe. Help me. Help me. I can’t breathe. I can’t breathe.”
The gun falls to the floor, never needed, never used.