Essay:The doctor, the mother, and the child: an allegory

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You are on life support in a coma after a near fatal car accident. You are relatively young, and otherwise in decent health. The doctor informs your mother that you have a 60% chance of surviving, but that you likely will not awaken for nine more months, striding away hurriedly. For whatever reason, your health insurance won’t cover the cost of your bills, and the hospital is so misanthropic that they will not keep you on life support much longer without payment in advance for a month of life-saving medical intervention. Due to the criticality and delicacy of your predicament, it would be impossible to transport you elsewhere without seriously jeopardizing your life—you would probably die if your mother chose to wheel you away by ambulance and hook your body to drastically inferior equipment—the present equipment represents a multi-million dollar investment in cutting-edge, state-of-the-art equipment found nowhere else in the world, and which should not reach the general market for another year or three. We may reasonably assume therefore that any attempt to disconnect you from this miraculous machine and reconnect you to vastly inferior equipment would result in your death, 97% of the time, plus or minus 2%.Your mother is faced with the dilemma of whether to pay a thousand dollars a month to sustain you, or allow doctors to pull the plug, guaranteeing your death. Your mother flips a coin—heads, she pays your bills and you stay on life support, tails, she does not pay for your bills and doctors remove you from life support. She, however, puts the dilemma in terms more meaningful to her—heads, I do the best to provide for my son, even though it may be difficult, perhaps too difficult—tails, I do not pay for my son—I feel as though I cannot support him. Holding her breath in utter anxiety, she flips the coin. Heads. She wonders whether she should obey the results of this coin toss, resolving to accept her responsibility for your life—you have no one else to help you, everyone else is too poor, apathetic, or even “misanthropic” to support your cause—your return, readjustment, and rehabilitation to life.

The doctor soon reappears to inform your mother, that, on further review of your case, if you survive this vulnerable state, from which you should emerge in several months, unless you die beforehand, your mother will need to spend a thousand dollars a month for roughly twenty years on further medical services to rehabilitate you, and that the first few years will be the most difficult. The doctor refrains, reading the disbelief, the brokenness, and the deep confliction on your mother’s face, and consoles her, telling her “the first few years will be the most difficult, but as he becomes increasingly autonomous, each year shall grow successively easier to care for him. His personality will become ever more distinct and you recognize him ever more distinctly—he will regain his identity, and remain the same person you have always known. I would be very worried over the next weeks—this is the most dangerous time in his recovery. But if he survives this critical period, you will probably have your son back. You will need to care for him, yes, but you will have your son back.” The doctor strides away once more. The mother, deeply divided and emotionally distressed, feeling helpless, decides to flip the coin once more, as if to charm her bewitched predicament, her ethical dilemma. She flips it, but drops it. It rolls under a chair, and she bothers to recover it. She pockets the coin and walks away. “I can’t be a mother, I can’t provide for him”, she thinks, tearful but resolved. Heads.

Three weeks later, the doctor, sympathetic to the man whose mother abandoned him, exhausts his last lifeline—the collection agency will no longer grant his requests to extend the payment deadline. Ledger lines now recording a loss of $800, the doctor tries ever more desperately to contact the mother of this abandoned man—but he knows just as well as the collection agency that the mother has rescinded her responsibility, and has refused all further contact. Pulling an inventory on records, the collection agency also knows that he lied for a full week , claiming he was in contact with the mother, and that she had agreed to pay—she just needed to gather the money. “Damn”, thought the doctor, “I should have covered my tracks… but then again, what more can I do? The mother still has guardian rights, and she won’t renounce them. I called her once, telling her that I would pay for the bill, but she refused, because she had resolved against this. She couldn’t stand to see him if he survived. I told her he could live with me, but she still refused… damn law! She preserves guardian rights until he gets out of the coma! And it looks like he’s going to pull through! Damn woman! She won’t even let me give her the money! And I still can’t reach her! I am running out of time, and she has apparently left the state… we don’t even know which state she’s in!” Swiveling around in angry gusto, the doctor leaves home with volancy. As he drives home in the dark, he darkly reflects “this mother abandoned her child, ignored all attempts to save him, and, if I can’t reach her and eke that god-awful permission from her, he will die because of her negligence! Even when I told her repeatedly my wife and I would support him and cover all expenses!”

11:59 p.m. Facing your body, but averting his gaze elsewhere in some distress, he waits for a last-minute call from your mother, an audio recorder ready—for weeks, he has tried to reach your mother. “If only I could get her consent! I could pay for the bills, and I would even pay twice the bills worth to save this man’s life! Damn collection agency… good enough to pull the plug, but too good to let me pay the bill—‘she could sue’. Bullshit! I don’t care if she sues for a million dollars—these bastards deserve to pay for pulling the plug on so many other people. But not on my watch! Not in my unit! Not on my floor!” The doctor begins to feel more nervous as the clock continues to tick—12 midnight is the deadline. For all his adamant internal dialogue, he begins to despair, as the unreal reality of death approaches this man. He fidgets. “If only I could weasel from this bitch permission to pay… I’ve called from nearly a dozen different phones, and left her twice as many messages… perhaps I have been harassing her, but I will not defend her behavior. And I’ve tried everything to track her down, but the police department is partial to her—won’t tell me anything about her credit card transactions or her cellphone number… they know her number, and can access the credit information… can’t violate her right to privacy but she can kill her child! ” He hears shuffling from down the hall. “This is it. She has to call now, I have to record her permission, I have to show the janitor, I have to get it to the collection office tomorrow morning…” Bill the janitor knocks on the door—the hospital has assigned him tonight to the regrettable but legally ordained task of pulling the cord. The doctor swivels and greets him catatonically—he’s invested himself emotionally in this case—it will be the first person killed on his watch who would probably survive. “Bill was always so friendly… why does he have to do something so cruel?”

12:03 a.m. No call. Nothing in the outlet. You gurgle to death.

Who killed you?