"Scalpel." I take the cool metal instrument in my hand and make the first incision into the soft flesh. After I pull back the layers of skin, I'm able to locate the bleed. Just as I'm about to stitch the tear I hear the static from the viewing room speaker. A feminine voice fills the room, "Dr. Hayes Sienna Reed's husband and daughter are here waiting in your office. Would you like me to tell them to come back after you're done in surgery?" My hands freeze. How could I forget about the meeting? I give my suture instrument to Dr. Williams and respond to the woman, "No, I will be right there. Please offer them some refreshments while they're waiting." Pushing to the doors I leave the operating room behind as I run down the hall. I strip off my scrubs and adjust my tie as I approach my office out of breath. Entering, I greet Sienna's husband, "Hello Theo. I apologize for my lateness." I look over to see Kimberly holding her stuffed lamb sitting in the chair by my desk. I approach her," How are you Kimy? I see you have a new toy." I pat the sheep making her smile. Opening my drawer I reach for large folder with 'S. Reed' printed the tab. Remembering Kimberly is in the room I hesitate before speaking. Theo, recognizing my hesitation, understands that my news is not for young ears. "Kimy?" He asks. "How about you go down to the cafeteria and pick out something sweet?" At the mention of sugar Kimberly jumps up. Taking the five-dollar bill from her father she skips out of the office dragging her sheep behind her.
Now that it is just the two of us I take a seat and Theo follows my lead. Opening the large manila folder I read aloud, “ High doses of Riluzole have failed to improve patients status. Patient exhibits labored breathing even with the assistance from a ventilator. No new muscle movement. However, patient continues to communicate by blinking showing that patients brain is operating other than nerve cells.” Looking up from the page I see Theo holding his head in his hands. I hand him the box of tissues which is almost empty from these frequent meeting. Looking at him I can see the wear these last four years have had on him. I begin to remember, as I am sure he is, the first time I met him and Sienna. I remember how the tears fell from their eyes as I diagnosed her with Lou Gehrig’s Disease and told her she had no more than five years if she was lucky. That was four years ago. “Simon?” Theo interrupts my thoughts. “Can we go see her?” He asks. “Of course.” I answer and let him lead the way to her room.

We enter the hospital room and make our way past the many machines to Sienna’s bed. I take in the familiar sight of her fragile body turned in odd ways with the many tubes and needles inserted in her skin. Her vibrant red hair hangs over her pale face because she can no longer control the muscles in her neck. Theo gently adjusts her head and wipes the drool from her mouth with a towel hanging next to the bed. “Hi my little tabby cat. Did you miss me?” Theo asks with new tears in his eyes. Sienna answers yes by blinking once. Wanting to let them spend time together I say, “I need to get back, but please Theo, stay as long as you would like.” Wiping a few tears from my own eyes I make my way back to my office.

Hours later I finally finish my paper work and set out for home. However, I find myself setting out for Sienna’s room instead. I take a seat by her side after I tell her nurses to take a break. “Are you okay?” I ask as I do every time I visit her. She blinks once, as always. Then surprises me by blinking a second time, answering no. At first I worry that she is in pain. However, when I ask she answers no once again. I make my way to the IV feeding her morphine to make sure it is working and see her blink out of the corner of my eye. Confused I walk back to her. “Sienna you are getting the maximum amount of morphine allowed.” A light goes off in my head as I say this. Connecting the dots I ask, “You are not in pain but you want more morphine?” She blinks once. Worried I take her hand and ask, “Sienna do you know what that will do?” She blinks again. I drop her hand and cross the room away from her to try to make sense of this absurd idea. Sienna has always been strong, whether it is for Theo or Kimberly. She knows what an over dose of morphine will do as well as I do. It would stop her heart and lungs for good; it would kill her. I approach her again and ask my last question, “Sienna do you want to die?” She blinks once. I wait for the second but it doesn’t come.

Leaving her room is a blur. I don’t remember walking down the hall to my office or opening a medical book and looking up ‘euthanasia’ in the table of contents. I don’t remember flipping to that page. All I remember is the words on that page swirling through my head ‘Killing’, ‘Inhumane’, and ‘Illegal’. Then my mind replaces the words with a picture. It is a picture of Sienna with no IVs, no machines feeding her, just her laying on the white sheets seeming to be in a state of bliss while her chest no longer rises. Slamming the book closed I bring myself back to reality. How could she ever ask me to kill her? My Job is to make people better, to save them! I could never live knowing I was responsible for ending someone’s life especially Sienna’s. She is like family to me. Realizing that my pacing is most likely disturbing anyone working late on the floor below me I sit down. I remember when Sienna was admitted here after her disease took a turn for the worst. That was almost three years ago. Three years she has been laying in that hospital bed being fed directly into her stomach, needing nurses to bath her, going through endless blood tests, MRIs, head CTs, and Spinal taps. No wonder she is giving up. No wonder she wants me to help her die. Even though she does want me to help her I can’t. I couldn’t do that to Theo and Kimberly. Making up my mind I lay on my couch. Understanding that I most likely won’t rest, there’s no reason to go home. Closing my eyes, my conversation with Sienna continues to replay in my mind robbing me of any chance of sleep.

“Dr. Hayes your eight o’clock is here for you.” I awake to the voice of my receptionist. Rubbing my eyes, I see her in the doorway looking professional and polished. Then I look at my own disheveled state. “Dr. Hayes? Are you alright?” She asks. “Yes, I came in very early to review some charts and seemed to have dozed off.” I lie. She says she will alert my patient that I am running a few minutes late, and then exits my office. Sitting up, memories of the nightmare from my few hours of sleep come rushing back. I am in Sienna’s room injecting her when security bursts into the room tackling me to the ground. I was arrested as nurses try to restart Sienna’s heart but there’s no hope. She is dead. Shaking off the dream I try to straighten my clothes the best I can and then alert my receptionist that I am ready for my patient.
The next week is not any better. I toss and turn through sleepless nights and try to avert the Reed family from my mind the best I can during the workday. A constant battle continues with my conscious on what to do. One Thursday, six days after Sienna asked me to kill her, I walk by her room. Hesitating outside I reach for the door handle and gingerly enter her room. The sight of her breaks my heart. This is no way for someone to have to live; her mind is trapped in a dying body. I approach her. Taking her hand I kiss her forehead. Voice trembling I say, “I love you as if you were my own child Sienna. Every day I wish that you had a different fate but if this disease is your fate then I will help you escape it.” Through the tears blurring my eyes I see her blink three times. A special single she created for Theo and Kimberly to tell them that she loves them. I drop her hand and move to the locked box containing the controls for the morphine. After typing in the four-digit code the case unlocks. I look at Sienna to make sure and see her blink one more time. I press the arrow to increase then close the case. Again I take Sienna’s hand and hold it until her chest no longer continues to rise. With her eyes closed and a slack expression I have failed to ever see her look so peaceful. I detach the many wires and lay her arms by her side. I stand by her side and move her vivid hair away from her face. “Goodbye Sienna” I say turning to leave. I close her door and make my way back to my office to call Theo and Kimberly.

I stand in line to pay my respects a few days later. Seeing Kimberly I step out of line and give her a hug as well as a pat on the head for the sheep she is still dragging around. Theo approaches a moment later and I hug him as well. The day I called him he sat in my office crying for hours but now he seems to have made peace with the fact that she is gone. The two off them step away to great other mourners and I make my way to see her. I kneel next to the coffin and whisper, “Hi Sienna, I hope you’re happy. I hope you can run and laugh where ever you are.” I stand and unclip the hospital band that was kept on her wrist. “You don’t need that anymore.” Turning away from her I say to myself, “It will always be our secret Sienna.” The police never did come for me. My medical license was not suspended and the swat team did not burst through the windows to tackle me. Sienna’s heart failing to beat was accepted simply as a result of her disease. Time passed and Theo and Kimberly found their own peace with the fact that Sienna was gone. I continued to save patients lives and never again attempted to play god. However, every year on the day that Sienna died I remember the decision I made and to this day I believe it was the right one.