The State of Things

I really cannot un-see it. The lifeless body lay before me. The open, fungating wound from where she bled out. Clearly this is, was a cancer. A horror washes over me of the suffering she must have had. These things do not happen in a day, nor in a month. Months of decay preceded this moment. Cells being overtaken by an invader, much stronger than their defenses, they surrendered. Allowing the mass to grow and invade deeper into it’s victim. Structure by structure gave way to the advancing front of invasive cancer cells. Left behind was a trail of necrosis, dead tissue that would be the feast for a host of scavengers, in this case maggots, everywhere. My mind braces once again against a tide of horror as I think of how she must have felt… was she even strong enough to try and wash the maggots away? What kind of place was she in where such a thing would get to this point? Although I struggled to push the thoughts away, I could not. An image of her lying in a makeshift bed, literally decomposing while still alive. This evening, nature finally brought her peace. The cancer (or maggots) had eroded into a named vessel… a fountain of red followed. She closed her eyes for the last time.

Despite this, healthcare in America ensued. Someone found her, 911 was called, without any advanced directive the algorithm kicked in. Rapid transfer to the emergency department, Code T was called bringing highly trained experts at controlling hemorrhage and resuscitation of the near dead. The ultrasound was placed on the chest showed there was still organized movement of the heart — we had to try. The heart was so empty there was not a pulse. Large catheters were place and blood products pumped as quickly as possible into the patient. A one moment a pulse was detectable yet quickly lost again. A breathing tube was placed. Chest compressions were done. After many attempts, and the passage of time, death was declared.

Such insanity. These expectations of modern medicine… at least modern medicine in the U.S. of A. Other places on the planet…she may have received comfort care from the moment she was found. Yet in other places on the planet, she likely would have had some access to care so that rotting death would not take her as she wasted away on the street.

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