If there’s one thing I learned as a medical trainee who deals daily with death, it’s that humans want to be remembered. We want to survive the tides of the future. We want to survive death. All our lives are devoted to doing something, to leaving a mark on this earth. Too often, however, all we manage to leave is a scar.
As John Green once put it (in his novel, The Fault in Our Stars), we are like a bunch of dogs squirting on fire hydrants. We poison the groundwater with our toxic urine, marking everything as mine in a ridiculous attempt to survive our deaths.
Nowadays, this phenomenon has grown exponentially. Especially in the eyes of the younger generation, being famous is the equivalent of being alive, successful, and happy. And by constantly living on social media, eyes locked on these “superstars” and their viral videos, they convince themselves that this is what life is all about. But it is not. What truly matters is not how many people know you. It is what you are known for by those around you. Spread love and do good, and you won’t need to be a star to shine. Just like Maria.
And this is why I want to tell her story.
Maria was different. She walked lightly upon the earth. Maria knew the truth: We’re as likely to hurt the universe as we are to help it, and we’re not likely to do either. People will say it’s sad that she left a lesser scar, that fewer remember her, that she was loved deeply but not widely. But it’s not sad. It’s triumphant. It’s heroic. Isn’t that the real heroism?
April 14, 2020. Italy.
On this particular Tuesday, I was making the last round on my patients before my 16-hour shift ended. In medicine, we are used to working long and tiring shifts; however, with the novel Coronavirus pandemic in full swing, we had reached new heights. But we were all clenching our teeth and working hard to keep our healthcare system afloat. At the time, the situation was overwhelming in Italy. The sad truth was that, often, we had to make deliberate decisions on who we wanted to save and who we were going to let die because we couldn’t give them proper and timely treatment.
The heaviness of knowing that your decisions may cause the death of someone is agonizingly painful. It’s like an ocean crashing on you, letting you come afloat just to take a quick breath, before pulling you down again. It’s not easy to ignore the pleas of the families to save their loved ones. Truth to be told, it’s depressing, and I don’t think there are words that can properly express the sense of hopelessness that one goes through.
As Virginia Woolf once wrote:
English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache… The merest schoolgirl, when she falls in love, has Shakespeare to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry. And we’re such language-based creatures that to some extent we cannot know what we cannot name. And so we assume it isn’t real. We refer to it with catch-all terms, like crazy or chronic pain, terms that both ostracize and minimize. The term chronic pain captures nothing of the grinding, constant, ceaseless, inescapable hurt. And the term crazy arrives at us with none of the terror and worry you live with. Nor do either of those terms connote the courage people in such pains exemplify.
On the other hand, the pandemic has also restored my faith in humanity and brought to light some amazing stories. For example, the story of Maria. She was an 82-year-old woman who had been admitted to the hospital one week before, in the intensive care unit. On that Tuesday, I was checking on her to see if her condition was improving or not. She shared her room with two other patients. When I came around her bed, she had her eyes slightly open. Her heartbeat and systemic pressure were perfectly normal for a person of her age, even though she had great trouble breathing properly.
“Hey, Dr. Ahmet, how are you doing?” she said, managing a smile.
I smiled back. Typical of Maria: even though she was the one in a hospital bed, she always asked me if I was doing fine first.
“I’m good. Thanks. How about you?”
“I’m doing alright…” Her voice trailed off. “Actually… it’s a bit depressing, to tell you the truth. All these white walls and gloomy faces.”
“For the white walls, I could ask someone to move you to another room. Just tell me which color you prefer. And you are right. We should paint them.”
“Nah, the walls are not a big problem. It’s the gloomy faces that I would like to change…”
I tweaked the valve of the oxygen canister. “You are asking me to do something really difficult,” I said. I was completely exhausted, both physically and mentally. It had been almost a month since we began working non-stop, and at times it seemed all in vain.
“Why?” she sounded surprised, “Being happy is not supposed to be that difficult. You know, dear, I remember the old times, when we used to dance mindlessly and laugh together. I loved it. And dancing really washes away all stress.”
“But you didn’t have to deal with a pandemic,” I said, scribbling her physiological measurements on the clinical report.
Maria laughed. “Ahmet, we had to deal with a deadly war, don’t underestimate the oldsters. But you know what, it isn’t the situation you’re in that should determine your happiness. It’s you. Being positive is a choice.”
“Maria, you could be a motivational speaker.”
“I know. ”
When I was completing my round, I kept thinking about Maria’s words. It was true: happiness came from within. But sometimes it was so hard to find.
Maybe we were not even trying. For my part, I thought it would be careless to be happy among all the pain and affliction. However, Maria’s words made me think that with my depressed mood and dispirited face, I might be one of the causes of that suffering.
I would definitely not be able to fully eliminate it, but I could at least try to alleviate it. I had to. But how? It felt like wandering in a room full of darkness: you know there is a switch somewhere, but the true challenge is finding it.
The next day, I came into her room for the usual check-up routine.
“Don’t I look like a zombie?” she said as soon as I entered the ward, pointing at the tubes that ran from the ventilator to her smiling mouth.
“Not at all,” I answered, glancing briefly at her clinical report. “120/80 mmHg blood pressure, regular heart rate at 75 beats per minute, osmolarity of 295 mOsm/L. You are doing superbly. A few more weeks and you’ll be out of here.”
The smile on Maria’s face faded, washed away by something I couldn’t see. “A few more weeks?”
“Yup. And then you will be able to get back to your children and nieces.”
“Ahmet.” Her voice sounded strangely serious. Usually, Maria was the one who brought laughter to her ward. After all, she was the one who told us to always stay positive. “I have to ask you for a huge favor. ”
“Tell me; I’ll do my best to help you.”
“Look… I’ve been following the news recently…and I know how many hardships you are all enduring.”
“It’s nothing. Really. We do it because it’s what we want to do.”
I meant it.
“I know. I know,” said Maria, crisping her lips in an irritated line. “But I also know that there are too many cases and too few ventilators. You have to choose between who you will save and who you will let die.”
I didn’t answer. My throat felt like a tender patch of heat.
“Well…” continued Maria. “The favor I want to ask you is that you give my ventilator to someone else. Just let me see my children this evening and then I’ll be ready to go. And, oh, don’t tell them about this. Tell them that I couldn’t make it. This will be our little secret.” She winked at me, her big blue eyes glittering.
“But… in a few weeks, you will be out of here,” I protested, pursing my lips and exhaling slowly, to calm myself. “Why are you choosing to die?”
“Oh, my dear. Look… as Steve Jobs put it ‘death is the destination we all share. No one has ever escaped it and that is as it should be because death is the single best invention of life. It’s a life-changing agent; it clears out the old to make way for the new.’ I am old now.” And here she pointed at her wrinkles, smiling again. “And I want to give the gift of life to someone younger than me. I want to give them their second ticket to life, so that they can get to live pursuing their passions and with no regrets. Just as I did. This is my last wish. If you grant me this, I can leave this Earth in peace. And the only thing you have to tell the person who will take this bed is to not be scared of death because it will make you miss your life. You can’t beat the Reaper by living longer. You can only beat it by living well and fully. Do the things you want to do before the Reaper shows up. Because it will be too late then.”
And these were the last words I heard from her.
That evening, after her children went away, she unplugged the ventilator herself, and when I came into the room she was lying on the bed, with a peaceful smile on her face.
*Maria is a pseudonym used for privacy concerns.