He offered his assistance to Dr. Pou, but at first she refused him. She tried repeatedly to convince him to leave the area. "I want to be here," he insisted, and stayed.
With some of the doctors and nurses who remained, Thiele discussed what the doses should be. To his mind, they needed to inject enough medicine to ensure the patients died before everyone else left the hospital. He would push 10 mg of morphine and 5 mg of the fast-acting sedative drug Versed and go up from there as needed. Versed carried a "black box" warning from the FDA, the most serious type, stating that the drug could cause breathing to cease and should only be given in settings where patients were monitored and their doctors were prepared to resuscitate them. That was not the case here. Most of these patients had Do Not Resuscitate orders.
It took time to mix the drugs, start IVs, and prepare the syringes. He looked at the patients. They seemed lifeless apart from their breathingsome hyperventilating, some gasping irregularly. Not one spoke. One was moaning, delirious, but when someone asked what was wrong, she was unable to respond.
He took charge of four patients lined up on the side of the lobby closest to the windows: three elderly white women and a heavyset African American man.
It had come to this. Dr. T's mind began to form a question, perhaps in the faint awareness that there might be alternatives they had not considered when they set this course. Perhaps he realized at the moment of action that what seemed right didn't feel quite right; that a gulf existed between ending a life in theory and in practice.
He turned to the person beside him, the nurse manager of the ICUs who also served as the head of the hospital's bioethics committee. Karen Wynn was versed in adjudicating the most difficult questions of treatment at the end of life. She, too, had worked at the hospital for decades. There was no better human being than Karen. At this most desperate moment, he trusted her with his question.
"Can we do this?" he would later remember asking her. "Do we really have to do this?"
Excerpted from Five Days at Memorial by Sheri Fink. Copyright © 2013 by Sheri Fink. Excerpted by permission of Crown. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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