A sixty year old woman who lives alone feels her throat begining to swell. This is not the first time it has happened -- she has a history of angioedema -- so she knows what to do. She takes her closest epi-pen (She has ten scattered about the house) and injects herself with the lifesaving drug, and then calls 911.
She is still having some trouble swallowing when we get there. "It's getting easier," she says. "Thank you for coming so quickly."
I listen to her throat. There is a good flow of air.
She is sitting on the short steps that lead from the living room up to the second level of the house. "I was scared there for a moment," she says. She is a short, squat greyhaired woman, who speaks very deliberately. "It's been quite a week for me. I didn't need this."
"What hospital do you want to go to?"
"This is not how I wanted to spend the night." She sounds like she has the weight of the world on her shoulders.
"Someone has to let the dogs in," she says. "They can't be left outside. They're too old."
I offer to do it, even though I hate dogs. I open up the back door, and say, here, pouchies, then I hear some chains rattling and the rustle of two big dogs approaching and then I see they are German Shepards. I have had some terrible experiences with German Shepards in my life -- one taking a bite out of my butt when I was riding my bike as a five year old, and then another dog -- Stormy -- terrorizing me in the neighborhood when I was in junior high. But these dogs are nice, and give me no trouble and come right in and approach their owner who gives them hugs and tells them to be good, while she puts some water in their dishes.
On the way in to the hospital, the woman tells me she had just been diagnosed with cancer and is scheduled for surgery in January. "I'm going to have to put them down."
"They seem okay."
Her voice quivers. "No, they are old and incontinent and there will be no one to take care of them when I'm sick. With the surgery, and then the chemo, and the radiation, I don't want to put them through that."
"Don't you have family in the area? Someone to look after them."
She shakes her head. "No, it's just me."
"That's too bad."
"They've lived good lives."
"I guess maybe being put down isn't the worst way to go. In this job, you come to feel good for people who die in their sleep."
She breaks into a smile, as she looks almost inward. "You can't get much better than to die in the arms of someone who loves you."
And then there is silence between us.
She cries quietly.
