It had a periodicity to it, but not like anything man-made. Instead, it was like a geyser. As it rose to the surface it swirled chaotically around hidden shelves and side-channels, so its interval was uneven. The uncertainty contributed to our tension, the nephew’s most of all.
“Yeeeeeeeeeee!” she screeched, then closed her mouth and relaxed again.
Between screams, she looked as peaceful as a Buddha. Perhaps, her caretakers speculated, the discomfort of prolonged immobility or some occult infirmity drove the screaming. We had given her increasing doses of pain medication, to no avail. Perhaps she somehow had enough consciousness remaining to experience the dislocation of facing the present without access to the immediate past, not knowing moment to moment how she got in the bed, why she felt like she did, whose arm lay at her side, whose mouth was screaming. We had given her anxiolytics and she just kept screaming. Perhaps she was bedeviled by visions. We gave her our best potions against inner demons and her timing did not falter.
“This is Hell,” said the nephew, “She is in Hell. I want this to stop.”
She had chosen well, or someone had. Sometimes, the decision about who would oversee the death defaulted to hereditary proximity, geographic factors, and availability. This nephew had some connection to her beyond practicality. Of course, he spoke for himself. No one knew what her vocalizations signified. We had taken our best guesses and come up short. What he wanted now was not a treatment. He wanted a cure for it all. To be clear, it was not euthanasia he was requesting. He wanted us to ablate whatever remained of her consciousness. He wanted oblivion, or at least its appearance.
It wasn’t killing, but it was taking something away from someone who appeared to have so little. We were always wary of treating extrinsic things, of giving medications to fix a person’s bad relationships or discomfort with herself. It was different for the dying though.
Everything was becoming extrinsic for her. She couldn’t be crying out for something. That time had passed. At best, her screams expressed something which we could not know, but something which was less specific, less relevant to anything inside, as she came closer to death.
He was right. The screams meant what he said: this is Hell; I want this to stop. I had an obligation to her and no choice in the matter. Of course he spoke for himself.
“I will do as you wish,” I said.