I am a doctor. I work with homeless people, street sex workers, injecting drug users. The suffering many of my patients endure is beyond many of our worst nightmares. The idea of suicide is something many struggle with every day. The suffering involved in their living is far greater than the suffering they endure in dying.
It is my job to not just attempt to ease their suffering (which is often very difficult) but to assist them in finding within themselves ways of living with their suffering; finding courage to endure and find meaning in their lives. It is not my job to kill them or to assist them to take their own life because they 'suffer too much'. Nor ought it ever to be the job of any doctor.
I am working with a young woman who, 18 months ago, was was raped and set on fire by her boyfriend. The burns she sustained are disfiguring and give her a daily reminder of the trauma. She is suffering from major depression as well as post-traumatic stress disorder.
She awakes from nightmares in a cold sweat and relives the memories of the rape and attempted murder, where it is as if she is out of her body, watching it happen again, powerless to do anything to stop it. Her suffering is as severe as any I have seen and while there is much I can do to assist, I cannot eliminate her pain.
Another of my patients is an old lady with severe, intractable back pain. She is addicted to pain killers and they have stopped working. She has tried all the other alternative medications and therapies and they have failed. She has been to the chronic pain clinics, seen the surgeons — you name it, she has done it.
There is little that can be done. Her suffering is just as severe as any of my dying patients endured. From time to time she contemplates suicide. I cannot assist her to take her own life and it is important that I cannot.
My role, when all else fails, is to sit with her, to understand her powerlessness and mine in the face of her suffering, and help her find a way through.
"I am often struck by my patients' resilience and courage. Their darkest times do pass, as does the desire to end their lives."
The kind of suffering I see is extreme. However, all of us suffer, to a