Continued (3) ....
Over the years I have come to feel that there are only two groups of people in the world: heroes and victims. Every day I see many patients who regard themselves as victims: victims of their childhood and their parents, victims of poverty and addiction, victims of their illnesses—simple or complex, acute or chronic, curable or incurable—victims of their suffering and pain, victims of others, victims of government, and even victims of themselves and of negative characteristics from which they believe there is no escape. Looking at their way of thinking and at the direction their lives take, I have learned one thing: it does not matter why we believe ourselves to be victims. Even if we have the best reasons, the consequence remains the same. We are victims, and to be a victim means that we are “less” while many other people and things are “more” than us; we are “below” while our suffering and pain stand above us; we are “small” while everything else is greater and larger than we are.

Against this way of seeing, I have sometimes had the privilege of meeting courageous people such as Teresa, who are heroes in my world. People who are always more, always higher. They remind me of the image of Christ carrying a cross upon his shoulders, a crown of thorns upon his head and a scourged body, yet carrying his cross proudly to the summit of the hill of life in order to create, upon that cross, a magnificent image of himself.

Heroes who wake each day and cry out: Where is the cross of my suffering? Give it to me so that I may take it upon my shoulders and climb the hill of life’s difficulties. Give me my share of suffering in this world and I will accept it openly and proudly; and if I can, I will carry the weight of your suffering as well.

For me, Teresa was a living embodiment of the heroes I had always admired, and this was why I did not want to miss saying goodbye to her. With all my heart, and with pride, I went to say my final farewell. Yet there was something still more remarkable: something that had happened three weeks before her death.

She had sent me a form to sign. In this document, an Advance Care Directive, she had requested not only that she not be resuscitated in the event of cardiac arrest, but also that ventilation, antibiotics, and any other medical intervention intended to prolong her life be withheld. I was astonished and postponed signing it until I could meet Teresa, because I wanted to understand her reasons and make sure she understood precisely what her decisions meant. Apart from one fall from her wheelchair two months earlier that had fractured her cheekbone, there had been no new serious acute problem suggesting the imminent death of someone who, for more than thirty years, had defeated death again and again through the force of her love of life.

I saw Teresa for the last time in my consulting room two weeks before her death. As always, she had a joyful smile on her face and showed no sign of anxiety or sadness. She joked with me that if I did not sign the form, she would request that after her death I be the doctor who signed her death certificate. I think she had understood how much I hated the idea of being the final doctor to sign the document recording death’s victory over her thirty-year struggle. With complete calm she told me she felt the time to leave had come. She was in no hurry for it, but she knew she did not have much time left. I explained that medically there was no reason to think her death was imminent, although that possibility had of course existed at every moment of the previous thirty years. She was completely determined, but in the end she agreed that if she developed an infection it could be treated with antibiotics. Perhaps she accepted that concession simply to restore some peace to me. I signed and stamped the documents.

On Monday morning, when I sat down at my desk, there was a note waiting for me saying that Teresa’s interpreter had called to let us know that Teresa had died peacefully the previous day.