The Quiet Mercy

Trigger Warning: This story contains sensitive themes related to terminal illness, assisted suicide, euthanasia, and death, which may be distressing for some readers.

February 14, 2015

CHUV – Lausanne, Switzerland

I’ve never liked February. The world feels trapped under ice, waiting for spring to thaw it out. The snow outside my office window seemed heavier today, or maybe it’s just me. The hospital hums as it always does, but there’s a weight to the air I can’t shake.

I met Alain Bieri. Forty-eight, a professor at the University of Lausanne. ALS. The diagnosis hit him hard, though he tried to hold himself together. His hands trembled as he spoke, his voice unsteady. Finally, he asked: How long do I have?

I gave him the usual answers: we’d manage the symptoms, keep him comfortable. But we both knew what those words meant. ALS strips everything away. There is no real comfort, only time—and even that is a slow punishment.

He wasn’t interested in therapy options or ways to delay the disease. His eyes kept drifting to his hands, as if they already belonged to someone else. I noticed how he flexed his fingers, almost mechanically, as if testing whether he still had control. Just before I left, he asked: What about Exit?

Exit. Switzerland’s clean, legal version of assisted suicide. But he wouldn’t qualify yet. ALS patients aren’t eligible until they’ve reached the point of unbearable suffering—when every part of their body has turned against them. I explained this to him. We weren’t there yet.

He nodded, but there was resignation in his eyes. He knew where this was going. He was already making peace with his death. I didn’t say anything more.

That look—acceptance, quiet despair—will stay with me. I’m sure of it. But I told myself it was out of my hands. That I had done all I could.

July 21, 2016

CHUV – Neurology Ward

Alain is dead.

I keep writing the words down, but they don’t feel real. He pulled out the ventilator this morning. Nadine, his wife, found him gasping, choking, his body fighting for air even though he was ready to let go. By the time I arrived, it was too late. His face was pale, his mouth wide in desperation, his hands clutched into fists.

Nadine screamed at me. “Why didn’t you help him? Why didn’t you stop this?” Her voice was raw, broken. I couldn’t answer her. I stood there, paralyzed, my mind replaying the last time I saw him alive.

I keep thinking about the day he asked me about Exit. He was asking for help, asking me to give him a way out, and I told him no. I told myself I was following the rules, doing the right thing. But was I? I left him to die alone, gasping for breath he no longer wanted. I told myself I was a good doctor, but I abandoned him when he needed me most.

His face, that panic in his eyes, the final, futile fight in his body—I can’t shake it. I should have done something. I should have helped him. But I didn’t. And now I wonder: was I more afraid of breaking the law or breaking my own idea of what’s right?

I can’t let this happen again.

March 4, 2017

CHUV – Oncology Ward

I think about Alain every day. About how I let him suffer, let him choke on his own breath when he was ready to die. I promised myself I wouldn’t let it happen again. Not after him. And now there’s Marie Schneider.

She’s sixty-seven, an artist—was an artist. Pancreatic cancer has taken everything from her. The tumors are in her liver now, her bones. Her body is a skeleton, her skin stretched thin over brittle ribs. Even with the morphine, the pain is constant, unbearable. She’s waiting to die.

Today, she looked at me, her voice barely a whisper. “I can’t do this anymore. Please, help me.”

I told her we’d increase the dosage, make her more comfortable. She shook her head, tears welling in her eyes. “No more comfort,” she rasped. “I don’t want to live like this. Help me.”

I froze. I saw Alain again, choking on air, and I knew I couldn’t let her go through that. I promised myself I’d never let anyone suffer like that again. Not when I could stop it. She was asking me for mercy—how could I refuse her?

But part of me still hesitated. The rules, the oaths, the laws—they flickered at the edges of my thoughts like distant warnings. I told myself I was sparing her pain, but was that really the whole truth? Was I sparing her, or was I sparing myself the guilt of watching her deteriorate?

I told her I’d be back later.

When I returned, the ward was quiet. I sat beside her bed, held her hand, and watched as her chest rose and fell in shallow, painful breaths. She didn’t need to say anything more. I reached for the syringe, my fingers trembling only slightly. The needle felt heavier than it should have, as though gravity had doubled in the space between my hand and her body.

“Thank you,” Marie whispered, her lips barely forming the words. Her eyes held mine, clouded with pain but also something else—trust, perhaps, or resignation.

My thumb hovered over the plunger, a single moment stretching far longer than it should have. This is right, I told myself. I’m sparing her from more pain. Yet, when I finally pressed down, I felt the weight of it—each millimeter of movement, each second of irreversible action.

Her body softened, almost too suddenly, and her breathing slowed, then stopped.

The room was silent. Too silent. I had expected something—grief, release, guilt—but instead, I felt nothing. Only the stillness.

In the morning, they said she passed during the night, quietly. I know the truth, and I carry it with me. I gave her peace. I did the right thing.

But sitting here now, I feel something cold inside me. Not regret exactly, but an absence. A void. Shouldn’t I feel more? Shouldn’t there be some greater weight? Instead, there’s only silence.

November 5, 2018

CHUV – Respiratory Ward

It’s been over a year since Marie. I’ve told myself, over and over, that I did the right thing, that I spared her from suffering. But today, as I sat with Jean-Luc Weber, I felt something else. A heaviness. A sense that something inside me has shifted, and I can’t shift it back.

Jean-Luc is sixty. Idiopathic pulmonary fibrosis. His lungs are scar tissue now, his breaths shallow and painful. He gasps for every inhale, his chest barely rising. His wife, Sabine, sits by his side, holding his hand, but I’m not sure he even feels her anymore. All he knows is the struggle to breathe.

He didn’t ask for help. Not directly. But I could see it in his eyes—the way he looked at me when I adjusted his oxygen. There was a pleading, though he said nothing. His body was speaking for him, begging for release with every desperate gasp.

I stayed with him for a long time today. Watching. Waiting. He’s not ready yet. But when he is, I know what I’ll do. I won’t hesitate. I won’t fail him the way I failed Alain.

But what struck me today—more than the look in Jean-Luc’s eyes—was Sabine. Her quiet acceptance, the way her gaze lingered on me when I checked his vitals, as if she could sense something. For a brief moment, I wondered if she knew. If she could see the line I had already crossed, even though I hadn’t yet taken that final step with her husband. Her eyes unsettled me. I left the room quickly, brushing off the unease, but it lingers.

December 10, 2018

CHUV – Respiratory Ward

Jean-Luc is gone. I made sure of it.

His body had reached its limit. Each breath was a battle he couldn’t win. Sabine sat by his side, whispering to him, her eyes hollowed by exhaustion. She didn’t notice when I adjusted the morphine, just a little more than what was needed. The room was heavy with the sound of Jean-Luc’s labored breaths—each inhale a fight, each exhale a surrender. I adjusted the morphine dose with steady hands, though inside, I felt a familiar unease gnawing at me. Sabine sat by his side, her hand in his, whispering words he likely couldn’t hear anymore.

His breathing slowed—just a fraction at first. I watched his chest rise, then hesitate, then fall. My pulse quickened, though outwardly I remained still.

Another breath. Slower. Shallower.

Then nothing.

The silence rushed in, filling every inch of the room. Sabine didn’t look up, didn’t speak, only sat with her hand still clutching his. I waited, my own breath caught in my throat, though for what, I wasn’t sure.

I should feel something, I tell myself. Grief, guilt, something. But I don’t. There’s only a cold certainty inside me now. I know what I did was right. He was drowning in his own body, and I gave him release. He couldn’t keep fighting.

But as I left the room, I caught Sabine’s eye. She wasn’t crying. She wasn’t speaking. She just looked at me, and something passed between us—an unspoken understanding, maybe, or suspicion. Her gaze lingered on me a moment too long. For a fleeting second, I thought she might ask me what I’d done. But she didn’t. She just nodded, tired and silent.

I’ve crossed a line, but I don’t regret it. Or do I? I can’t tell anymore.

October 10, 2020

CHUV – Empty Room

Five years.

It’s been five years since Alain died. Maybe it was the first time I truly understood what I was meant to do. Or maybe it was the first time I understood what I had become.

Today, I ended another life. But this time, it was different. She wasn’t terminal. She wasn’t gasping for air or writhing in pain. She could have lived longer—months, maybe years. She could have fought. But I saw something in her, something fragile, something that would eventually crumble under the weight of time.

When I entered her room, she smiled at me with that sweet, gentle smile the elderly have, unaware of what I was about to do. Her frailty was evident—thin skin, brittle bones, but there was still life there. Her chest rose steadily, if weakly. Her eyes still twinkled with some recognition of the world around her.

I stood at her bedside, syringe in hand, frozen for a moment. Was this mercy, or was this something else?

She didn’t ask for this. She didn’t beg. But I knew—didn’t I?—what was coming for her. I told myself it was kindness, sparing her the slow crawl of indignity that would come. Sparing her the helplessness I had seen in so many others.

My hand steadied as I approached her. She closed her eyes, and I pressed the needle to her skin, hesitating for just a second longer than usual.

She didn’t flinch.

The plunger went down, smooth and quick. Her chest rose one last time, then stilled.

And then I left the room, my breath calm, my heart steady. No one would question it. They never do. I saw the future for her, the slow, cruel march toward a life she wouldn’t want.

She didn’t ask for this. She didn’t beg.

But I knew. I knew this was the right thing to do.

I prepared the syringe. I watched her chest rise one last time, then fall into stillness. There was no struggle. No pain.

And then I left the room. Calm. No one will question it. They’ll call it natural causes. They always do.

No one will ever know.