Monday, October 12, 2009

The Woman in the Room

When most people think of Stephen King, they think of killer cars, haunted hotels, and prom nights gone wrong. Palliative care isn't generally the first thing that comes to mind. I don't usually read Stephen King as I'm not a big fan of the horror genre. When I read "The Woman in the Room" my first thought was that King had moved away from horror for this short story. But on second thought, I think it is actually a movement from supernatural horror to a real life type horror. (The picture is from the short film made in 1983.)

John is a loving son dealing with his mother's terminal cancer and severe pain issues. It is written in the third person and most of the story is like a description of an internal dialogue as John is trying to make a difficult choice. He has found a bottle of "Darvon Complex"(propoxyphene with aspirin) in his mother's medicine cabinet and he is wondering if he could end all of her suffering.

Things get worse when she is admitted to the hospital for pain control. She has a procedure that he calls a 'cortotomy' in which a needle is placed into the pain center in the brain and that area is "blown out"(This story was written in the '70s.). This procedure leaves her paralyzed but still in pain. John continues to toy with thought of giving her the pills as he visits her daily.

"She imagines the pain. But it is nonetheless real. Real to her. That is why time is so important. Your mother can no longer count time in terms of seconds and minutes and hours. She must restructure those units into days and weeks and months." What does the doctor mean when he says this? Prepare for the long haul? Since the pain is so bad, don't focus on the now, focus on the future?

John carries the pills around with him for awhile. He tells no one of his plan. He tries to talk himself out of it. If she has a roommate, then he'll be off the hook. If she says anything about the pills he gives her, he'll just put them back. In the end, everything falls into place. He gives her six Darvon tablets and then leaves the hospital to wait for the phone call.

I'll pretend for the sake of this post that six Darvon is a fatal dose. (Although I'm doubtful that it would cause any more than ringing in the ears (from the aspirin). But I'll admit that I've never given anyone six Darvon to know.) I'm not writing about this story to endorse John's actions or judge him either way but to acknowledge the sentiment. I have often heard "Isn't there something we can give that will make this go faster?" and "It's not fair. If my dog was suffering we could put it out of it's misery, but we can't do that for my mom?" It comes up so frequently I would categorize it as a very normal feeling.

It seems King's inspiration for the story may have come from his own life.

"Perhaps it is his fault anyway. He is the only child to have been nurtured inside her, a change of life baby. His brother was adopted when another smiling doctor told her she would never have any children of her own. And of course, the cancer now in her began in the womb like a second child, his own darker twin. His life and her death began in the same place: Should he not do what the other is doing already, so slowly and clumsily?"

King also has only one brother, who was adopted, and his mother died from uterine cancer in 1974. He is also reported to have had drinking problems around the time of his mothers death, another similarity to John in the story.


Works referenced:"The Woman in the Room" Night Shift by Stephen King.

3 Responses to “The Woman in the Room”

Nurse Practitioners Save Lives said...
October 17, 2009 at 6:48 PM

Unfortunately, I have had patients ask me to end their suffering. They have used the same analogy of putting our beloved pets down when they are suffering (endstage of course). I explain that though I can somewhat understand their want to end it all, as a health care provider, I cannot do as they ask me. It is a sad thing though. I think that it's something that I would consider if I were in a tremendous amount of pain or extremely short of breath as the COPDers are. I'm glad that there is better pain control for a better quality of life now.


Amber Wollesen, MD said...
October 19, 2009 at 11:46 AM

It is very sad. It was not something I ever really encountered before I started practicing Palliative Medicine. The first time someone made a comment like that to me, I remember being so surprised that they would actually think that. Thanks for your comments.


Nurse Practitioners Save Lives said...
March 16, 2011 at 11:53 PM

Unfortunately, I have had patients ask me to end their suffering. They have used the same analogy of putting our beloved pets down when they are suffering (endstage of course). I explain that though I can somewhat understand their want to end it all, as a health care provider, I cannot do as they ask me. It is a sad thing though. I think that it's something that I would consider if I were in a tremendous amount of pain or extremely short of breath as the COPDers are. I'm glad that there is better pain control for a better quality of life now.