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An excerpt from

Indignitas

David Llewellyn

If it was up to Dr Cartwright all terminations would take place at one o’clock on a Friday afternoon. One o’clock allowed time for patients to be booked in and made comfortable. One o’clock sanctioned time for the paperwork, for there were many forms to be filled. One o’clock would bring a final check-up and a last-gasp prayer for divine intervention. One o’clock dried the tears before bedtime, at least for those in the profession. It was just a shame it was four-thirty on a Wednesday afternoon. Four-thirty! Who the hell would schedule a final appointment for four-thirty?

Dr Cartwright popped his head around the Treatment Room door. ‘Joan, I’ll be with you in a minute. I just need to have a quick word with a friend.’

From the multiply-adjustable bed in the centre of the room, Joan Merryfield raised a hand as far as she was able and attempted a smile. The pethidine was holding its own. Dr Cartwright preferred pethidine. Morphine had its place but it prompted too many unpredictable behaviours. He would be the first to admit that Joan did not look at all well and he remembered why he had brought the appointment forward. No matter how many drugs they pumped into her, she was never going to be free of pain again.

Not long now. Let her say her goodbyes.

Dr Cartwright left Joan in the company of her sister and the capable care of Practice Nurse Khan.

He hurried the few steps down the corridor, past his consulting room, and on to what Evelyn Parks liked to call the Therapeutic Suite. In reality this was Evelyn’s pastel-painted office, festooned with comfy chairs and freshly cut flowers.

He knocked and entered without waiting. Two women were deep in conversation.

‘Sorry to burst in,’ he began. ‘I was just hoping to have a quick word with Nancy before she goes.’

The younger woman – a middle-aged Evelyn Parks – had been expecting the interruption.

‘Is that alright with you, Nancy?’ asked Evelyn. ‘I’m sure the doctor won’t keep you long.’

‘Of course,’ said an always polite Nancy Thurlbeck. ‘I hope there’s nothing wrong, Doctor?’

Evelyn shuffled forward in her seat. ‘I’m sure there’s nothing to worry about. I’ll be back in a tick.’ She gently patted the elderly woman on the knee and left them to talk.

Dr Cartwright took the chair vacated by the psychotherapist. As a younger physician he might have sat closer, holding Nancy’s hand, but thirty years’ experience and a head full of grey hair had lent him an air of authority that was reinforced by being able to look a patient straight in the eye.

‘How are you feeling?’ He felt an urge to take a pulse but that wasn’t why he was here.

Nancy wasn’t at all sure how she was feeling. It was two weeks since she’d made the decision to end her own life. Nancy was 73 years old and she’d suffered from Lupus since the menopause. At first, the symptoms of extreme fatigue had been dismissed as her time of life but then the pain in her hips, knees and elbows flared, followed soon after by the tell-tale rash. Once the diagnosis was confirmed, the consultants were able to control the worst of the symptoms but there was little they could do for the real problem, the one she’d married in 1968.

‘That’s what Miss Parks has been asking me in thirty different ways. I’ll tell you what I told her: I really don’t know.’

‘I can imagine.’

‘I’m not sure you can, Doctor. Not really.’

‘Nancy,’ said Dr Cartwright, ‘I’ve met your Brian, remember?’

Nancy shook her head sadly. ‘I am so sorry. I’d love to be able to tell you he’s not always like that but I’m afraid what you saw was Brian on a good day.’

‘Grief and bereavement affect different people in different ways.’

‘You don’t have to, Doctor. I’ve spent the best part of my life making excuses for that man. He is what he is.’

‘And what’s that?’

‘Your Miss Parks has a good word for it. She says he’s a twat.’ Nancy giggled and then remembered herself. ‘Just don’t tell him I said so. Please.’

‘Nancy, do you know what we do here?’

‘Yes, you put an end to suffering.’

‘That’s right, Nancy. But people suffer in lots of different ways. I think you’ve been suffering for a long time.’

Nancy nodded, almost imperceptibly.

‘Nancy, I’m going to tell you something because I think I can trust you.’

Dr Cartwright waited, needing a sign that she understood that whatever was said would be kept in the strictest of confidences.

Another small nod of the head.

‘The thing is, I think we can help, although I appreciate that this is very late in the day.’

‘You can make me better?’ There was a faint glimmer of hope which soon faded. ‘Only I’m not sure that’s what I want any more.’

‘No, Nancy, we can’t make you better.’

‘Then what …?’

Dr Cartwright pressed ahead. ‘Nancy, we don’t just help patients with their own passing. Sometimes we help other people as well. Sometimes we help people who don’t necessarily want to go.’

‘I don’t understand.’

Dr Cartwright knew he had been vague. ‘Nancy, we kill people.’

‘I know. You’re going to kill me, and I’m grateful, really I am.’

‘Nancy, we don’t just kill people who want to be killed. Sometimes we kill people who deserve to be killed.’

‘I’m not ...’ Nancy stopped herself.

‘Nancy, if you want us to, we could kill your husband.’

There was another hesitation, and then, ‘I don’t think he’d want that. Not Brian.’

Dr Cartwright was a patient man, but today he was a patient man in a hurry. ‘Nancy, suppose we didn’t give him a choice.’

Over the last year or so the doctor had come to recognise the delightful moment when the penny finally dropped. He saw it now in the flicker of a smile and the widening of Nancy’s eyes.

‘You mean …? Oh! I see. At least I think I see.’

‘But it does cost.’

This stopped Nancy in her tracks and the excitement left her face. ‘Oh, I don’t think he’ll pay. Not for that.’

Dr Cartwright leant forward. ‘I’m sure we can work something out, if you’d like us to go ahead.’

Nancy was struggling. ‘I really don’t know.’

‘Think of the children, Nancy. Would they miss him?’ Dr Cartwright had done his homework. The Thurlbeck’s had two grown up children: a daughter who was still very much afraid of her father and a son who would have nothing to do with the man.

‘Well, no, but–’

‘And you’d want them to get their inheritance. I’m sure they could do with the money.’

‘He won’t give them any money,’ she said quickly. ‘Even when Sandra …’

‘Even when Sandra what, Nancy?’

‘… I’m not to talk of it. But when? How?’

‘Well, there are a few things we’d need to sort out,’ said Dr Cartwright, ‘but with your approval I can set the wheels in motion.’

‘Oh, Dr Cartwright, I don’t know what to say, but thank you, thank you for thinking of me. Only …’

‘Only what, Nancy?’

‘Only it’s not wrong, is it, Doctor?’ Nancy needed reassurance. They often did.

‘No, Nancy, I don’t believe it is.’

There was a knock on the door.

‘That’ll be Evelyn,’ said the doctor. ‘You can talk it over with her if you’d like. Let me know what you decide.’


Dr Cartwright left the two women talking and hurried back to the ward to end the life of Joan Merryfield, peacefully, holding the hand of her sister.