“Goddamnit! Hold him down,” said the Chief.
His tone, which had been ironic and jovial as he bantered with the patient moments before, was now weary and annoyed.
As the Chief rammed the blunt plastic rod beneath the skin of the man’s chest, under his collar-bone and into the incision in the hollow of his neck, the man bucked and screamed again. Nurses and medical students grasped his limbs to keep him on the table. The surgeons had taken every necessary measure to make the procedure safe and painless. They chose to place the catheter into the patient’s jugular vein under sedation to avoid the greater risks and side-effects of general anesthesia. They had even injected local anesthetic at the incision site and along the track the catheter would take from his mid-chest to the point where it entered the vein in his neck.
Not that local anesthesia could deaden such a large area. It mostly helped tamp down soreness after the procedure. But it needed do no more, because of the type of sedative used. Besides making a patient sleepy, the chemical was an amnestic; it reduced a human’s powers of memory to those of a goldfish.
As we wheeled him back to the recovery room, I leaned over the patient and asked, “Uh, how do you think that went?”
“Beautifully,” he said.
“No pain?”, I inquired.
“Not a bit,” he chirped, “and you know, I’m surprised how lucid I was. That was the best operation I’ve ever been through.”
I stopped dead in the hallway. At that moment, I understood the feeling my friend had a week previously when he found out his parents aspired to zombiehood. They were, he had discovered, people who wanted ‘everything done’. He had tried to explain the predicament this created for him, and though I thought I had understood the situation based on our common experience as medical students, his complete perspective eluded me at the time. I thought his parents were just wrong because they knew no better. Of course, we two medical students were horrified, since we knew what ‘everything’ really was and where it led: dull suffering, delirium, dead eyes in a live body, chest heaving to the click and hiss of a ventilator, then death, inescapable in spite of ‘everything’. I hadn’t seen the other side of my friend’s dilemma: what is it like for the zombie? To become a zombie – a dying person bent on continuing to die – was to abandon a previous, more natural course but perhaps it was not a wrong act. Perhaps the transformation was like telling a goldfish in a bowl that it was doomed to swim in a twelve-inch circle until it died. The goldfish would suffer withering psychic agony for the three seconds it could recall the revelation, then it would return to contentment, unharmed. The vicarious regrets of the living just might have a similar effect on a zombie, even the regrets of their former, living self.
And as the gurney bumped against the recovery room doors, I realized that I had faced this riddle once before and failed to resolve it. The riddle had come that time in the context of a story a co-worker told me. We worked together at a landscaping business. The guy was a mechanic, so he worked in the shop, while I worked in the field. Still, I got to know him well enough through shared lunch hours and down time with broken equipment to decide he was a decent guy. He was honest and, as a practicing Catholic, always trying to be good. And he was good, sometimes to a fault as he freely lent money to people who were unlikely to ever pay it back. Then he told me a story about when he was in the service.
He was stationed at a boring, isolated post. For miles around, there was nothing but irrigated fields, sage brush, and a few abandoned missile silos. Nothing moved on the landscape but jack rabbits and a few stray domestic animals. The jackrabbits were wary and hard to catch, but the strays would come to a kind word and an offer of food, so they were the ones that got tossed down the missile silos for fun. At first, the fading echos of the animals’ cries and the sparkling static on their fur were entertaining enough. Later, gasoline on that crackling fur added novelty to the routine.
He saw nothing wrong with ‘dog toss’. These were animals, after all, not conscious beings with a soul. As such, they could not truly suffer. What happened to them, as long as it was relatively quick and served a human need, didn’t matter. He thought this because he had been raised a moral realist and a deontologist. Good was a ghost in the ether, inhabiting certain acts and objects, imbuing them with its nature. All else was morally neutral. Other things rated only via human largess backed by tenuous relationships drawn between the hosts of good and those other things that his moral educators felt uncomfortable excluding from their calculus. Other things rated as bonus points. No one was going to hell for ‘dog toss’.
No one was going to hell for what happened under sedation with an amnestic agent either. The healthy body (even just a relatively healthy body) was a host for good, and that end didn’t just justify the means, it made them irrelevant. Proof lay smiling on the gurney in recovery, ready for the next step in his embodiment of good, where his catheter would carry toxins to his blood to kill his tumors, his appetite, his hair follicles, his sense of smell, the lining of his mouth and colon, all to clear a space for good between his diagnosis of metastatic cancer and his death from it.
The doors swung shut and the surgical team turned away toward the suite of operating rooms where the next case waited. I did not follow. These three were related riddles, but they were not quite the same. Though I could now see it whole, the third puzzle still remained, and it was still the hardest. My friend’s parents were motivated by moral realism to have everything done. But whether their end came by age, chronic illness or catastrophe, the change from living to dying would come to them and sweep away any thought of ghosts and duty to ghosts just as surely as an amnestic sedative swept away all memory of pain and indifference to pain. Then it would be up to us – family, friends, doctors, hospitals – to tend to the ghost, or not. That was the hard part. Because we could deal with the creature before us, be it living or not, on its own terms, instead of trying to realize an apparition. And that meant denying metaphysical duty.
I stood for another moment while the surgical team gained some distance on me.
“I ought to walk out that door and just keep going,” I thought.
Instead, I put my head down and set off after the surgeons. I knew that I wasn’t doing the dutiful thing, but I was pretty sure that didn’t matter. Maybe all I could do was deal with what was in front of me, zombies and all. But even if I wasn’t up to the task of replacing them, I couldn’t keep serving ghosts, theirs or mine.
Interesting career history. And I’m sure as hell not to going end up as a zombie. I say hold the interventions, and hand me a bottle or Scotch.
What? When I get to be 70, I want my dialysis!I’ll need it after my heart transplant. Ah, the quality-adjusted-life-years I’ll enjoy.