Mr. Blackwell

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Status: Finished  |  Genre: Thrillers  |  House: Booksie Classic
Mr. Blackwell examines the lengths that a person will go to care for a complete stranger in this story of internal struggle, sacrifice, obsession, and redemption.

Submitted: December 04, 2011

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Submitted: December 04, 2011

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Mr. Blackwell

Note:  This is my first short story that I've ever written so I'd appreciate any constructive criticism.  Thank you, and I hope you enjoy reading!

 

It was a cold rainy day in Baltimore, Maryland.  The halls of the oncology unit were moderately lit, but still quite dark with no help from the hidden sun.  It was always like this in February, and Dr. Devin Parker thought nothing of it.  Perhaps it was because he was just accustomed to the dull atmosphere that surrounded the hospital this time of year, or maybe because it was 6:45 in the morning and he had already been awake for a few hours, reviewing his patients’ records before making his morning rounds.  Dr. Parker had worked on the oncology unit of Johns Hopkins hospital for six months now.  After graduating at the top of his class, Dr. Parker was a rising star in the hospital, quickly making a name for himself as an expert on cancer care.

After seeing his first two patients for the morning, Dr. Parker arrived at room 232, Mr. Blackwell.  Mr. Blackwell had been in the hospital for a few days, and was originally admitted with a neutropenic fever, secondary to liver failure.  He was an alcoholic, and had drank his liver into severe cirrhosis, causing liver cancer, which had since metastasized and spread to his kidneys, lungs, and all throughout his abdomen.  As a result, his PRA was through the roof, and his abdomen had swollen up like a ripe watermelon.  His prognosis was grim, and Dr. Parker had estimated that Mr. Blackwell had only a few weeks to live if he was lucky.  After reviewing Mr. Blackwell’s lab results from radiology the previous day, Dr. Parker confirmed his estimations, and paused for a moment outside of the room to collect himself and decide how best to break the bad news to his patient.  Foaming his hands at the nearest alcohol hand-washing dispenser, he entered the room, still dark from the night before.

“Hello Mr. Blackwell, it’s Dr. Parker.  How are you feeling this morning?”  Dr. Parker asked while still rubbing in the alcohol.

“Terrible,” Mr. Blackwell replied with a few coughs and a grimace while he clawed at his stomach.

“How is your pain today, on a scale from 0 to –”

“Eleven,” Mr. Blackwell interrupted.  “I feel like I got mice in my stomach runnin’ around, clawin’ all sorts a stuff they outta just leave the fuck alone,” he continued.

“So would you describe your pain as itching?” Dr. Parker asked.

“You’re damn right I would,” Mr. Blackwell replied.  “Can’t you people give me something that actually works?” he questioned.

“Is the fentanyl not working to alleviate your pain?” Dr. Parker asked while remaining objective.

“It ain’t doin’ shit,” Mr. Blackwell replied with a laugh.  “Can’t you give me somethin’ stronger, like some morphine or somethin’?” he asked.

“I’ll see what I can get for you as soon as I leave.  But right now, I need you to take your potassium, and the rest of your meds for the morning.  Do you need some water to take them?” Dr. Parker asked.

“Na, I got some juice here,” Mr. Blackwell said, swallowing his pills with bulging eyes.  “Jesus, why you people gotta make these things so damn big?  I nearly chocked just getting half of ‘em down.”

“Okay Mr. Blackwell, I’ll go get some different pain medicine for you,” Dr. Parker said, as he moved for the door.

“Don’t worry, I ain’t goin’ nowhere,” Mr. Blackwell responded with a chuckle.  “And call me Eric, man.  Mr. Blackwell sounds like I’m in trouble or somethin’.  Oh, and by the way, a horse called, he said he’s missin’ his pills,” he continued with laughter until he was disrupted by a cough.

Dr. Parker left the room, and exhaled slowly, attempting to regain his composure.  He wanted to mention the prognosis to Mr. Blackwell, but he hadn’t been able to bring himself to do it.  Although he had been with the hospital for six months now, Dr. Parker had still never had to tell a patient that they were dying.  He had read textbooks about the best way to approach such a scenario, but lacked any real world experience.  He decided that he would go to the med room, get some morphine for Mr. Blackwell to tide him over until he finished his rounds, and then go back to break the news.

He gave Mr. Blackwell’s morphine prescription to his nurse, Anna, and left to finish up with his other patients.  He could not help but feel distracted as he talked about white blood cell counts and platelet levels, when all he could think about was Mr. Blackwell and how the conversation would go.  When he finished his rounds and came back, Anna was already in the room along with a student who was on her first clinical, and was describing the protocols for hanging I.V. fluids.

“You can never leave a saline bag up for more than 24 hours, and these lines have to be changed every week.  Otherwise, bacteria can start growing in there, and lead to all kinds of nasty infections, and we don’t want that, do we Eric?” Anna asked with a big grin.

“Hell no we don’t,” Mr. Blackwell replied, excited to be helping out with the teaching process.  “Oh hey doc, we were just talkin’ about you.”

“Is that right?” Dr. Parker asked with the crack of a smile.

“Yup, we’re talking about meds, and how you’re the only one allowed to order ‘em around here,” Mr. Blackwell continued.

“Well, that’s great Mr. Blackwell, but right now, I need to talk to you in private,” Dr. Parker said, looking over at the two women.  With that, Anna and her student started making their way out of the room, and closed the door behind them.

“You must have some bad news for me then, huh man?” Mr. Blackwell asked, easily reading Dr. Parker’s saddened face.

“Yes, unfortunately I have reviewed your recent blood work, along with the rest of your chart, and I’m afraid you don’t have long to live,” Dr. Parker started, his hands trembling with nerves.  “Pe-people with your prognosis generally have a few weeks to live if they are lucky, and I’m very sorry to say, that it is a rough few weeks,” he continued, his mouth now dry from the anxiety.  It was so deafeningly quiet in the room that he could hear Mr. Blackwell’s morphine drip.  Determined to have the conversation be over, he managed to choke and stammer his way through the rest of his speech.  “Pain… pain levels increase, and although we try to provide great end-of-life care here at the hospital, the discomfort associated with your illness is unavoidable.”

“Holy shit, that’s a lot to take in,” Mr. Blackwell said with a serious face, turning towards the dark window, the rain streaming down its glass surface like tears.

“I’m very sorry to have to tell you this Mr. Blackwell, I know it can’t be easy to hear,” Dr. Parker said compassionately.

“Man, how many times I got to tell you to call me Eric?” Mr. Blackwell asked. “I know you’re just tryin’ to stay professional and all, but sometimes you just gotta lighten up, it’s alright.  Now I heard what you are sayin’ about these next few weeks, and I want to feel like I can talk with you, ya know what I mean?  I ain’t got any family, and all my friends are dead.  I just want someone to talk to.”

“I’ll be sure to try and remember that…  Eric,” Dr. Parker said with a reassuring smile, his eyes starting to water up from all the emotion that filled the room.

 

The next few days were as Dr. Parker predicted.  Eric’s pain shot up sky high, and although he was receiving high levels of morphine, he was not comfortable.  It became difficult for all the employees to deal with, and everyone wanted to do something to help, but due to state laws, they were restricted to pain meds, warm blankets, and cold beverages.  It was especially hard for Dr. Parker.  This was his first patient that he could not save, and no matter how hard he tried, Eric’s condition continued to deteriorate.  Every time he had to go in the room to talk with Eric, or even just walk by, he had to witness his patient’s pain and suffering.  Eric would scream and moan all day, and it only got worse at night.  He would often yell out about wanting to die, and his cries quickly began to scare the other patients.  After complaints began to stack up, they ended up having to move those in the rooms bordering Eric’s room further away so that they could get some sleep.

 

About a week after he had told Eric about his prognosis, Dr. Parker entered the hospital, frustrated with the constant rain that had thoroughly soaked his blazer, and slammed his stethoscope down on his desk.  His office had become a wreck over the past week, with random papers flung every which way, ruffled up scrubs thrown out across his chair, and a stack of half eaten cafeteria food trays, which had accumulated on his coffee table.  He had not yet gotten a chance to sit down when Eric’s nurse, Anna, arrived and started knocking incessantly on his door.  Being in no mood, he responded with a sharp “What!”  He accompanied this with glaring bloodshot eyes he had received from the three straight nights he had attempted to sleep without any luck.  Anna could see through the glass door that Dr. Parker’s condition was deteriorating and she knew that the following conversation would be a struggle at best, but she decided to enter the room regardless.

“Doctor, I think we both have a common interest in what is best for our patient, but I must object to what is going on with Mr. Blackwell,” she started.  “It’s just not right that he is in that much pain.  There must be something more that we can do.”

“What would you like me to do?  I can’t very well prescribe him any more pain medication… he’s already at the hospital limit of the strongest medicine we can prescribe… there’s absolutely nothing I can do,” Dr. Parker responded with a sneer.

“What if we were to sedate him?” she questioned, fumbling for other ideas.  “If he were asleep, perhaps he wouldn’t have to feel this much pain.  Couldn’t he be placed in a medically induced coma or something similar?”

“Coma?  Are you insane?  That won’t do anything but mask his pain, he’ll still feel it,” Dr. Parker snapped back, storming angrily over towards Anna, stopping a mere six inches from her face.  His cold shadow cast over her like a twisted tree, and she could feel the freezing raindrops as they fell from the strands of his hair onto her forehead.  She stared deeply into his eyes, quickly noticing that they were not the bright blue globes that she had fallen in love with when he had first joined the unit, but had been replaced with cold, dull, red spheres, glossed over like the frost that covered the windows of the hospital.

“Devin,” she said in a calm voice, “You can talk to me… I know this is really hard for you.  Please… let me in… I want to help you,” she continued in a soft whisper.  She closed her eyes and searched for his lips, kissing him as she slowly raised her arms and ran her fingers over the sides of his face and through his wet hair.  They stumbled over to the curtains and shut them quickly before falling onto the couch, barely making it there in time.

 

“I’m sorry Anna, I shouldn’t have blown up at you earlier, it wasn’t fair of me,” Devin said, gently stroking her face.  “I’m just so torn up over this whole situation, and I don’t know what to do.  I just hate to see someone in that much pain and suffering.”

“I know you do, I feel the same way.  Sometimes I think it would be better to just let someone die quickly and painlessly rather than let them live in agony for weeks,” Anna replied, going in for another kiss.  “What’s the matter?” she asked when Devin didn’t kiss back but instead stared blankly into space while in deep thought.

“That’s it,” Devin shouted, his eyes wide with excitement.  “Anna you’re a genius… I have to go,” he said as he quickly stood up and got dressed.

“What are you talking about?” Anna asked with confusion, but Devin had already dashed out of the door.  “You’re welcome I guess,” she said to herself in the now empty room, as she too slowly stood up to get dressed and return to work.

“Eric, I have something important I need to discuss with you,” Dr. Parker said panting as he entered the room, out of breath from the sprint from his office.  After having rested his mind and been given an idea from Anna, Dr. Parker had finally come up with a possible solution.  “Now, it isn’t exactly legal what I want to discuss with you, but this just isn’t right.  Sitting by idly watching you suffer is too much for me to bear, and whoever came up with these laws has obviously never worked in a hospital a day in their life.  I want to ask you if you would consider a lethal injection.  It would put you out of your misery, and without it, I’m afraid that you’ll just go on for another few weeks in extreme pain.  Eric, does this sound like something you’d be interested in?”

“Hell yeah I’m interested, but what do you mean it ain’t legal?  Will you get in trouble for doin’ it?” Eric asked, concerned for his doctor’s well being.

“I’ve come up with a way that will be undetected by the coroners.  I should be fine, but I want to know if this is what you want.  I just can’t sit by quietly knowing that there’s another option for you,” Dr. Parker said.

“Okay, Dr. Parker, I’m listening,” Eric said.

“Call me Devin, we’re friends, Eric,” Dr. Parker said, causing Eric to sport a toothy grin.  “Now a typical lethal injection has three parts, sodium thiopental which is a barbiturate for the pain, pancuronium bromide which is a paralytic, and finally, potassium chloride which induces hyperkalemia and causes the heart to stop beating.  If I were to give you this, it would work sure, but the coroner will be able to detect it in your system, and will know that I gave it to you.”
“So what do you want to do instead?” Eric asked.

“There is an experimental treatment developed in Europe that involves injecting alcohol into the veins.  It will cause tachycardia, and eventually, a heart attack,” Devin continued.  “Now the bad news is, that it would hurt like a son of a bitch, but I’ve got a solution for that.  I’ll go down to the med room before hand, and get you some oxycodone.  Now, I don’t want you to take the pills orally like they’re supposed to be taken, but I want you to crush them up, and snort them.  This will produce a high ten times more powerful than heroin, and that should ensure that you feel no pain.  Also, your chart doesn’t currently contain any advanced directives, but with your permission and signature, we can add one that states that you do not wish to be resuscitated should you experience a heart attack.”

“But what about the alcohol in my system?  Won’t the coroner be able to detect that as well?” Eric asked.

“They will, but your chart says that you have a history of alcohol abuse, so maybe you snuck some into the hospital with you when you were admitted,” Devin said with a wink.  “I’ll give you as long as you need to think it over—”

“Let’s do it,” Eric interjected.  “I’m tired of fightin’ and strugglin’ and I’m in the worst pain I’ve ever been in my life… I just want it to be over.”

“Okay Eric, tomorrow morning I’ll come in a little bit early and it should be pretty empty around here.  I’ll have everything set up… and don’t worry about me, I’ll be fine I promise you.” 

 

The next morning, Devin entered the hospital at 6:30, dripping from the pouring rain outside.  After a quick stop at the med room, he went straight to his locker, and fished in his backpack for a water bottle that he had filled up with vodka.  Since it was so early, most of the employees had not yet arrived on the unit for the day, and only a few night nurses remained.  He had no problems staying undetected as he smuggled the alcohol into Eric’s room.  Devin gave him a last drink along with the oxycodone that he had brought from the med room, and stepped out of the room momentarily to allow Eric to take them as he had directed.  He quickly stepped back in with a syringe, and grabbed the vodka, drawing up 25ccs of the alcohol before placing the bottle along with Eric’s belongings.

“It’s been a pleasure knowing you Eric,” Devin said, his eyes fighting back tears.

“Back at cha Devin,” Eric said with his signature grin, now high from the drugs.

Moments after the vodka was injected, Eric’s pulse began to race.  A nurse checking in saw that Eric was in tachycardia, and called the code.  Devin, who had left just minutes earlier to avoid suspicion, rushed over from down the hall, and entered the room as Eric’s vitals flat-lined.  The nurse was about to start CPR, but Devin informed her that Eric had an advanced directive stating that he did not wish to be resuscitated.  At 7:09 on a Saturday morning Eric was dead.  He had not experienced any pain, and Devin knew that it was what Eric wanted.  Devin was not a religious man, but as he stared out the window at the end of the hallway, he began to feel absolved, as though a great weight had been lifted from his chest.  He felt a tear drip down from his right eye, and he smiled as he saw the rain slowly come to an end, and snowflakes begin to fall, covering the ground in a pure sheet of white.


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