Situation Ethics

This story was inspired by "the starter sentence" on Cormac and Nicole' blog Icarus' Flight to Perfection.
I hope you like it.


Sometimes promises are made to be broken.

That’s my first thought when I see the man they’ve wheeled into the operating room.

It’s a miracle he’s still breathing. He’s got multiple stab wounds in his torso and neck and slash wounds on his arms. Whatever happened to him, he fought back hard.

I run through a mental checklist of the pathophysiology of “penetrating trauma,” thinking, as always, that medical jargon is worse than legalese for obscuring pain and suffering behind big words.

This guy’s got it all—hypoxia, partial paralysis, unequal pupils, and active major bleeding. Whoever attacked him got his lungs, his spinal cord and who knows what all else. I count 12 different entry wounds and then, over the hot copper scent of his blood, I catch a whiff of shit, which means his bowel has been pierced too.

Everybody’s moving fast and with purpose. The nurse monitoring his vitals looks stressed.

I am not stressed at all. I issue orders. A nurse cuts off the patient’s blood-stained clothing and drops it on the floor, kicking it out from under our feet. Someone else starts a second I.V. line. We’re pouring fluids into him as fast as he’s bleeding out. Everyone’s looking at me, waiting for me to do my thing.

Looking down at the man on the operating table, I think, if this man dies on my operating table, no one will miss him. No one will mourn him. And more importantly, no one will ever question his death.

When I became a doctor, I swore the Hippocratic oath. I said, “I will practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them.” I meant every word of that promise at the time.

But that was before I met the man on the table. His name, he had told me, was Cory and that was the first of his lies, but not the last. He stole my car. He emptied my bank account and he broke my heart. That last betrayal is the one I can’t forgive.

The men he owed money to came to my door and when they didn’t find him, they took out their anger on me. The cops who were looking for him came to my door and when they didn’t find him, they let me know they thought I was worse than scum. And then the other women came to my door looking for him and when they didn’t find him they told me their stories.

I look down at the man on the table whose karma has finally caught up with him. The words of the oath I swore go through my mind and…I let them go.

Sometimes promises are made to be broken.