The first one, B, is the son of one of our most-loved faculty members. He was involved in the non-medicinal use of prescription narcotics. He went out partying with some friends, took some recreational prescription narcotics, crashed around 3 AM with everyone else and never woke up again.
I attended his funeral. Almost the entire residency did. His father is back at work and we are nervously awaiting the time when he gets called in in the middle of the night to do an ICU admission on a patient like S.
S is a staff medicine patient. He was involved in the non-medicinal use of prescription narcotics. He went out partying with some friends, took some recreational prescription narcotics, got dropped off at home, and was found twelve hours later barely breathing in a pool of his own vomit. He spent days in the ICU on a ventilator and now has anoxic encephalopathy. We didn't anticipate he would ever do anything; he now responds to simple commands and smiles when music is played to him on an iPod. He doesn't talk or do much else. He'll require 24 hour care, suctioning, turning, and therapy to keep him from getting bedsores. We don't know if anything is left of his frontal lobes and personality. His family lives at his bedside, announcing every tiny motion and change, agonizing over fevers and the days when he doesn't respond to anything.
I can't decide, O Best Beloved...if it were my child, which would I choose? Either is a future too painful to contemplate.