Chapter I

Mildred Sheffield descended from the train onto the platform and then down the stairs to street level. Across from the station a wide lawn spread out before her, a gently curving, porous driveway and a solid walkway beside it leading to the porte cochère and entrance of the Verity Clinic. As the train rumbled away behind her, she began walking towards the building.

She had just finished her month of supervised recuperative leave. Her last patient had passed in the gentle fashion that was by then so customary of those who chose to escape their suffering, and whom the clinic assisted in doing so. As always, Mildred felt a slight trepidation to be returning, to be receiving a new patient, one that would inevitably leave as well. It was a cycle that would continue over and over until no one remained who was afflicted with the terrible disease.

Nevertheless, she felt confident and competent. She had received the best training in dealing with the care and eventual loss of her patients. During her recuperation period, she had received all the psychological and emotional aid that she felt necessary. The clinic cared deeply about the wellbeing of their employees. On the one hand, it was sheer practicality: there were only so many people who were able and willing to do the work of supporting the terminally ill and guiding them gently on to the next life. On the other hand the clinic administrators truly felt an obligation to do their own part, at one step of remove, in making sure that neither their patients nor their workers should suffer unduly.

Mildred had already had an opportunity to peruse the case file of her new patient, one Miss Ada Noble, aged forty-five, well progressed in the disease. She likely had about two months before the sickness would take her naturally. She was closer to the end than Mildred preferred. The pain and the debilitation would by now be quite bad. There was a certain amount of palliative care available, but even the most effective pain killers were insufficient.

The woman had clearly taken some time before deciding that a compassionately administered unnatural death was preferable to lingering, a delay which made the work even more difficult. As with her colleagues, Mildred’s job was not only to provide for her patient’s every psychological and physical want or need, but also to assess whether the patient honestly, in their true heart, wanted to make the terrible decision to die early.

After the ravages of the pandemic, after millions of people watched impotently as their friends and their children and their parents died in terrible pain, often only to succumb later themselves, after so much suffering, most of society came to the conclusion that it was better to offer an escape to the afflicted. Perhaps it was as much for the physically healthy, who could not rightly be said to have maintained their psychological health after so much loss, and loss of such a nature. And yet, if anything had been learned throughout the ordeal, it might be described as a renewed appreciation for the sacredness of life.

There was as such a strong tension between the desire to ease suffering and the desire to maintain and, when possible, celebrate life. The best conclusion, a compromise of sorts, was to allow the patient to decide for herself, and to support her in the decision. But the decision could not be made or accepted lightly. Often, after a wave of vomiting and nausea and nerve endings that felt as though on fire, a sufferer would plead for a quick end, only to recant later after returning to a more moderate level of discomfort.

Of course that was in the early to middle stages, which could last years. Few now made it all the way to a natural end, and it was always horrific for those who did. However, for each individual, there was a different line that could not be crossed. Many were able to last another week, another month, sometimes, although infrequently, another year; time in which they could bring their affairs into order, in which they could mend broken relations before it was too late, in which they could tell their loved ones how much they loved them. Thusly prolonging life, while it could be borne, was the reason for the work that was performed by Mildred Sheffield and those like her.