It’s never nice and always a sombre affair when removing the breathing tube from a terminal patient’s throat. I never got used to it.

Glen Miller (I’ve changed his name) was in his late fifties. He had been on the ward for the last few weeks, moved here after all attempts to save his life had been exhausted. The police guard had been sent home when the doctors knew he’d never wake up. Being left in the room alone with him still made me nervous.

The day before, I had given him a sponge bath. It seemed pointless. I guess even the dying need to keep their dignity, even if they were a murderer. As I lifted his arm, he twitched. I knew this could happen, though all I could do was imagine him gripping his strong bear-like hand around my neck and strangling me to death. I dropped it and hurried back. I thought of all the people he had asphyxiated in his time. That sort of evil clings to their soul like a dirty stain, infecting the air around them.

Being the one to remove his breathing tube, I was conflicted. On the one hand, this man would no longer be a living memory to the crimes he committed; on the other, he was still a human, no matter how vile.

As I pulled on the tube, the familiar sound of disturbed bodily fluids gurgled up, brushing past his vocal cords, giving up a raspy tone. It was as if he wanted to speak one last time, maybe a deathbed confession, though it was not.

When the tube was free, his lungs gradually deflated for the last time, unable to do this on their own. It can take as little as four minutes for the patient to pass, and up to a week at the worst case. Part of me wanted it over and done with now, so this creep could be taken away, placed in cold storage, until the right thing was done and a crematorium could wipe this man off the face of the Earth. The other part me wanted him to suffer and to lie there struggling for air, an ironic punishment for the lives he took.

There were no family present. I didn’t know if this was because he didn’t have any, or they chose not to be here. I stood and watched him, waiting to see if his chest would rise. Dr Thompson checked for a pulse. I waited anxiously.

Minutes later, the patient was pronounced dead. I left the ward and made my way outside. There was a light rain and chill breeze as I jogged across the campus. I took shelter and lit a cigarette. Every time I did this, I thought of all the people I had cared for with lung cancer, their slow painful deaths, but that didn’t stop me. I’d be the one to stop before it was too late, I told myself. A mantra I had been using for far too many years. As a nurse, I felt like a hypocrite. It was the only thing that would calm me after removing a patient’s life support.

I returned to the hospital and washed my hands and face before re-entering the ward. The patient was already gone. I looked around for the paperwork I’d needed to fill in, but it wasn’t there. I checked the nurses’ station, nothing. I made an announcement for Dr Thompson to return and set about my next task.

It was never quiet in this ward, the patients never talked, and rarely moved. Only the sound of respirators would fill the air, but now it was eerily silent. Not a single machine was operating. A dread filled me. I felt rooted to the spot. Fifteen separate machines, all silent.

I heard the sounds of groans coming from behind one of the curtains. I pressed the emergency button and rushed to the man’s aid. Flinging back the blue plastic sheet, I saw an elderly gentlemen struggled to breath. The monitor on his apparatus was dark and vacant. I rolled it out of the way to see the plug had been disconnected. Frantically I pushed it in. The man’s eye’s rolled back into his head. I had visited him only an hour ago, he’d been in a coma for the last month. Now he was conscious.

I told Mr Bennet to clam down, everything was going to be fine.

His struggles became less and less, as the machine rhythmically inflated his lungs. I wondered if he was breathing on his own now. I had no time to check.

The alarm still blared, and no-one had responded. One by one I checked the other equipment. All fourteen remaining devices had been disconnected. I feared the worst, as unresponsive men laid silently in their beds. By the time I finished I was exhausted. I caught my breath as four employees, two doctors and two nurses ran into the room.

I explained what had happened. They raced to help the patients.

I sent out another announcement for Dr Thompson, stating it was an emergency. I then returned to help the others.

Twenty minutes later, ten of the patients were pronounced dead. Thankfully, the other five had survived. Mr Bennet was now off the apparatus and breathing on his own. It was a miracle.

The police arrived soon after. I told them what happened and that I was there when Dr Thompson had pronounced Glen Miller dead. They asked where he was now. I said I didn’t know, that I’d asked twice for him to return, but he didn’t.

The police set about searching the hospital for Dr Thompson. I asked if he was a suspect. They told me to stay where I was. I asked if I they believed me, and they said nothing.

I sat at the nurse’s station, my knee bouncing with anxiety. An officer stood at the ward entrance, to stop anyone leaving. One nurse, who I barely knew, cried loudly. Her colleague tended to her. The doctors paced.

The radio on the officer’s shoulder burst into action.

Suspect car found heading for the interstate.

“What’s going on?” I asked.

The officer acknowledged the report and left his station.

“Do you think they were talking about Dr Thompson?” I said.

“I’ve no fucking idea,” Dr Stewart answered, still pacing.

My mind went back to when Dr Thompson checked the man’s pulse. She did seem eager to make sure he was pronounced.

What if he wasn’t dead, and he killed him when I was out of the room?

A cold shiver ran down my spine. I had been alone with him on many occasions. He’d driven me to work. Given me home made cakes. If he was a psycho, he had plenty of times to kill me. That chilled me.

An orderly arrived with a gurney, to take away one of the dead patients.

“Sorry, Sam, I don’t think you’re going to be able to do that just yet, this is a crime scene,” Dr Stewart whispered, being careful not to let the remaining patients hear.

“Sam, did you take Mr Miller when he died?” I asked curiously.

“No, first time up here today,” he said with a sinister grin, “not the last by the look of it.”

“So who did?”

“I’ve only just started, night-shift. You’d have to ask refrigeration.”

I picked up the phone and called, no-one answered.

Something didn’t feel right. I left the ward and took the elevator down to floor -1. I entered the morgue. As soon as I did, I wished I hadn’t. A man in a white coat dropped a brain onto a scale, another wrote on his clipboard.

“Hey,” I said from the threshold of the double doors.

They looked up in unison.

“Can I help you?”

“Sorry to bother you. Has a Glen Miller been brought down here today?”

The man whose hands weren’t covered in blood sighed. He calmly walked over to a desk and checked some paperwork.

“Uh, yes, he’s in room 43.”

“Can… can I see him?” I asked nervously.

“Any reason?”

“A doctor has gone rogue, I want to make sure he’s definitely here.”

The mortician walked towards the cabinet and pulled. Ice cool air wafted out. Slowly I approached.

With apprehension I stared inside. It was Glen Miller. For some reason, I wished it was Dr Thompson. That would have made more sense. Murdered by a serial killer, stolen his car and gone on the run. But no, it wasn’t. And that made me feel sick. I had been so close to that man. Did he just snap this evening? Or was he looking for the best time to get away with murder.

---

Later that night, his car was found outside his house. They found a single bullet wound to his head. This was after, the police stated, he had shot the family dog and his wife. His son was in the car when they found him. His dad had told him to call his grandparents. He had done that, and it was them who had entered the house and called the emergency services, after finding their daughter-in-law, slumped on the couch. He had shot both of them before putting the gun to himself.

There was no note. He had no history of violence. No motive.

I wondered if it was having to end the life of so many patients. Them having to live in a state of limbo, half-dead, half-alive. I knew it drove me crazy. We allow dogs to be put down when they are in pain. But a human? They have to suffer, and in our case, suffocate to death. Maybe he was right to pull all those plugs out, end their suffering. Who knows? It’s made me think. Is such an existence cruel and unusual punishment? Maybe I need to ease some suffering.