Chapter 24: Birth not Chosen, but Death Chosen

The Trial Court sentenced Dr. Guntapat Akaramethi to life imprisonment for killing Dr. Somsak Lahamornchai.

Gunn filed an appeal, but the Court of Appeal confirmed the ruling of the Court of First Instance. Although Gunn had the opportunity to be released on bail during the Court of Appeal trial, he chose to remain secretive and did not meet with anyone. And finally, he had to go back and put on the chains and handcuffs as he walked back to prison.

No more requests. Enough of times of torment. Now he could finally pay for his sins.

The air inside the prison was so cold that it was bone-chilling. Gunn, who was huddled with other male prisoners, woke up. The male prisoners were so crowded in the inmate dormitory that Gunn could hardly lie on his back. When he was able to adjust his posture a little, Gunn stared at the ceiling for a long time. He was drowned in his own thoughts and images of the past appeared in his memory. He used to lie on his back and stare at the empty ceiling without any freedom before, but back then he was Kantapat as a child.

The 14-year-old lay on his back staring at the ceiling of a large bedroom that was too big for a child to stay alone. The king-sized bed he was lying on did nothing to help reduce the pain in his heart. The expensive clothes hanging in his closet couldn't help him either.

After someone told his father that he had seen Gunn walking with a friend holding hands in a shopping center after school, he was banned from leaving the house. He sent a driver to pick Gunn up and drop him off at school at the exact times. When he returned from school, he had to study with a tutor his father hired. His father planned for Gunn to study medicine since he was not even born. This was so that Gunntapat Akaramethi's only son, could have the knowledge and skills to seamlessly continue the family's medical equipment import business. And of course, no news should be leaked to other family members that Gunn was walking hand in hand with his friend.

The other boy was called Pie. He was Gunn's classmate and he was the person who made Gunn's heart tremble every time he came near. That was the first time Gunn understood his own desires. It was so clear, so obvious, so easy and without any confusion. It was as if he had been destined since he was born into this world that the gender that could make him fall in love with him was only male.

"Gunn," Pie ran towards Gunn who was walking down the hallway that connected the school buildings. Gunn turned to look at the cute, small-built boy who ran towards him while looking worried. "Why didn't you answer the phone yesterday?"

"My dad took my phone," Gunn responded in frustration. "I can't even escape. Now I have to get home on time. The driver will come and wait for me at the front door at exactly 4 o'clock. If I'm late even a little, the driver will call and report to my dad."

“Oh, that's too much,” Pie pouted his lips before slowly showing a mischievous smile. It was such a cute smile. "We have plenty of time before it's 4 o'clock. Let's go." Pie took Gunn's hand and pulled. Gunn forced himself to stay where he was.

"Where are we going? We still have other classes."

"Social studies, Thai, and the club? We don't have to attend," Pie pulled Gunn back in with a bright smile. "Come quickly!"

Gunn involuntarily smiled at the person in front of him. He tightened his grip on his backpack and followed Pie obediently. The place Pie took him to was an area within the school that Gunn had never entered before. It was the area for the students who stayed in the dormitory. Pie was one of the students who stayed there. Pie took Gunn to hide behind the wall and whispered to him, "The dormitory rooftop is really cool, but we have to get past the guy guarding it first." The young man pointed to the middle-aged man who was sitting at the entrance of the building.

"How do we do that?" Gunn asked the other person anxiously.

"Wait here." Pie left Gunn standing behind the wall while he tiptoed towards the water tap in the garden in front of the bedroom. The young man turned on the tap and ran back to Gunn. Apparently, the faucet was connected to a hose that had holes in it to water the garden plants. This caused water to gush out of the end of the hose that was near the guy. He screamed in surprise, stood up and looked left and right.

"Who the hell turned on the tap?" The chubby man said in frustration and walked out the bedroom entrance towards the faucet. Pie took advantage of that moment to successfully run Gunn into the bedroom. The two young men ran up 7 floors as if they were running for their lives. When they reached their destination, the roof, they both fell to the ground because they were so tired that they were out of breath. Both boys looked at each other's faces and laughed.

"That was great," Gunn said while panting. He could feel the chemistry exploding in his body. It made his heart beat faster, full of energy and extreme joy. "I've never done anything like this."

"That's life. Sometimes you have to break the rules." Pie jumped up and pulled Gunn to follow him, "Come and look at this."

Pie led Kan to the corner of the building that only had waist-high barriers. Gunn looked at the impressive sight he was seeing in front of him. From where he was, he could see many skyscrapers in the capital city. He had seen panoramas from high places that are much more beautiful than these before because his parents often took him to dinner on the top floor of luxurious hotels, but this was the first time he had climbed to a high place in a different context. He also came up with someone he really wanted to be alone with. The warm breeze passed by both boys. Gunn and Pie looked at each other. Their hands reached out and touched before they held hands tightly. This must have been the first time Gunn felt like he could choose the things he wanted to do.

Gunn hugged Pie tightly, "Thank you for bringing me here."

"I want you to do something your heart wants," Pie's face that was placed on Gunn's shoulder turned sad, but Gunn couldn't see it. "Even if it's short, I want you to be brave. Do whatever you want. Remember this feeling."

Because Gunn and Pie missed three classes in a row, their homeroom teacher informed Gunn's father about this.

Three days later, Gunn discovered that Pie's desk was empty.

Gunn never got the answer as to why Pie suddenly changed schools, other than the teacher's explanation that it was due to family reasons. The strange thing was that Gunn couldn't contact Pie again after this. This reinforced Gunn's feelings that he had no right to choose his own life and happiness.

"Oh, I can't do this anymore. I finished my round at 7 pm... my legs are falling apart. Tomorrow I have a morning shift on top of this. I need a long break to let my body rest," the student complained fourth-year medicine student while leaving the surgery room with a group of friends. However, one of them walked away from the group, "Hey, Gunn. Won't you go back to the dorm with us?"

"Not yet, go ahead, guys," the young medical student in a university student's uniform covered with a long robe responded to his friend.

"Okay, see you tomorrow at 7 o'clock. Don't be late so we can split the progress of the case before the Residents arrive."

Gunn nodded and said goodbye to his friends before turning around and heading towards the elevator that would take him to the VIP Surgical Room, which was the meeting place between him and Tu, the hospital's palliative care nurse. Gunn met his by coincidence in the patient ward while talking to a patient about the plan for the last phase of his life. This made Gunn, the medical student, who was indifferent to medical studies since the first year and did not enjoy medical school for a second, felt that he had found something that interested him in medicine for the first time.

"You're the first medical student who has an interest in the work I do," the head nurse said as the two walked down the hallway in front of the VIP room. "In reality, it's as if palliative care work exists just to get the hospital to pass the assessment, but it's not actually supported. Many doctors don't even understand what true palliative care is. Probably no one will do this after I get it." has retired."

"But I'm really interested," Gunn said firmly. "I was taught to save lives. Since death is also another dimension of life that none of us can escape and patients whose last phase of life is in our hands, why aren't many people interested?"

"It's a complicated science," Tu turned to smile at the young medical student. "It's probably easier to just look at the disease. However, humans are always simple, like in textbooks or in the guidelines they taught doctors, especially that there are dimensions that connect the body, mind, society and the soul between the human being and death".

Gunn frowned, "I...I really don't understand."

"Take a look at my case," Tu stopped walking in front of a patient's room. He raised his hand to knock on the door and walked in with a smile. "Hello."

"You, you are here," the patient's relative sitting next to the bed immediately got up. His face suddenly looked hopeful. "My dad doesn't respond to calls. He groans and breathes rapidly. The doctor injected him with morphine, but his symptoms have not stabilized yet."

Gunn followed Tu into the room and saw an elderly, emancipated patient lying on the bed. He had an oxygen mask covering his face, which was turned on at maximum capacity. His eyes were open but they were distracted.

"The patient, 82 years old, suffers from metastatic liver cancer that has spread to the lungs and spine. He also has blood clots in his legs and lungs," Tu explained the case to Gunn. "The patient knew the disease and its stages very well. He wrote about what he wanted in his last stage of life. Ms. Som, can I show the patient's statement of intent to the medical student for educational purposes?"

"Of course," the young woman took out a piece of paper from her bag and handed it to Gunn. "Dad wrote this since he first found out he had cancer three years ago."

The handwritten document read: "I, Decha Phootrakarn, 79 years old, when I am so ill that the medical diagnosis indicates that I have entered the last stage, my intention is not to prolong my life, not to resuscitate or intubate myself, nor to use drugs to keep me alive. I wish to die in the hospital. If it is possible to euthanize me and free me from the pain I suffer, I would like it to be done. As I write this statement of intent, I am fully aware in all aspects."

"This document is called a 'living will'. It is a declaration of intention not to receive medical services that are performed to prolong life in the final moments. You can advise your patients who are still conscious to do so. We have a law "which covers this in Thailand," Tu explained so that Gunn could understand what the document was in his hand.

Gumn was still stunned by the message he had just read: "But we are not allowed to perform euthanasia, right?"

"Yes, we cannot practice euthanasia, but we can offer them good palliative care," said the nurse. "I may not be as good at adjusting medications as doctors, but take a look at what I can do."

You moved your eyes to look at the patient's face. Her eyes were full of loving kindness: "Mr. Decha, this is Nurse Tu visiting you. It may be difficult to communicate at this time, but don't be alarmed. If you can still hear me, let's try to calm our minds and relax. Think about the good deeds you have done in your life. You have organized meals for those in need for many years, think about those times."

Gunn observed the patient's breathing. For a rapid breath, it was strangely slowing down. The young doctor was amazed.

"You love your granddaughter who is abroad and you want to see her one more time. Right now your daughter connected her to a video call for you." Tu turned to gesture to the daughter so she could hold the phone to the patient's ear.

"Grandpa..." the girl's voice on the line trembled. "Grandpa, my exams are over. I also got very good grades. Grandpa, you don't need to worry about me. You can rest assured. I will be a good girl that you can be proud of."

Just ten minutes later, the patient's pain of more than four years came to an end. The patient's breathing gradually slowed down. He opened and closed his mouth like a fish out of water for only a moment before eternal peace took over him. Gunn wasn't sure if he had imagined it, but the patient's face was much brighter than before.

Gunn learned at that time that a person's spiritual desires do not always have to be religious, but can be people, things, memories, pride in good deeds they have committed, or can be anything depending on how that person spent their life. life.

The young medical student had goosebumps from head to toe. He felt like he had found the treasure he had always wanted. This was the job I had to do. This was the science I had to learn. He found the answer to why he has to become a doctor.

So that people can truly choose their own life until the last day.

Gunn became the family's disappointment when he decided to apply for a scholarship at a provincial hospital in the far north to study family medicine. Not only that, he also decided to have an open relationship with a man regardless of the consequences. Gunn could still remember the feeling of running up to the rooftop with Foot. He could remember the moment when he felt he could dictate his own life. And he was able to remember the final moments of people who chose to die peacefully. It all came together in Gunn who was determined to implement those principles to people in need and he was really grateful that Nurse Ornanong agreed with what he thought.

Gunn, dressed all in black, with a black cap and mask to hide his face, stood to his full height after the patient breathed his last. His hand held the syringe that used to contain the deadly liquid, which was now inside the body of the first patient in his life to receive his special treatment. The drug has now demonstrated its effects by causing the patient's heart to fail and stop beating. The doctor stared at the deceased's face, which was now much brighter than when he was alive. The patient had been suffering for too long and was begging for a life he could choose. He has chosen death for the body that only had a limited time left to shorten the time it had to be suffering.

Humans cannot choose our birth, but we can choose our death. There is nothing better than being able to perfectly dictate our own life.

"Gunn," Dr. Anucha called the inmate who was recording the prison patient's vital signs in the medical records for the doctors who come to check on patients weekly. Gunn looked at Anucha, the former doctor's face and eyes suddenly became bright.

"Anucha, did you have to come to prison today?" Gunn stood up and carefully organized the patient's history. "I didn't think you'd come early. I haven't finished recording vitals yet, but I'll call the first one in line for you."

The hospital assigned doctors from the social medicine group to rotate and carry out checks on patients in the prison. Gunn had been one of these doctors before. Anucha looked excitedly at the former doctor he used to work with. Gunn was still handsome, but he had clearly become thinner. He wore his hair short, which was very different from before. With his knowledge and ability, he was able to help in the prison's medical center and did so well that the nurses and guards unanimously said that their job became much easier. When inmates get sick in the dorm in the middle of the night, Gunn can diagnose and give information to the nurse so she can provide primary care in a timely manner.

Anucha examined the inmate who was suffering from diabetes and found that his medication in take and medical records did not match. Therefore, Anucha called Gunn to ask more questions. Inmate Gunn entered the examination room and was about to kneel next to Anucha. The doctor quickly grabbed Gunn's arm and said, "Gunn, you don't have to do this."

"Yes," Gunn took a step back to remain politely at a distance.

"The patient said he was no longer taking glipizide. I looked at the OPD card and no one told him to stop taking it. I'm not sure if you know anything about this."

"Two weeks ago, the patient was sweating and experiencing palpitations. I asked the nurse to do DTX and the result was 54. I took the liberty of recommending the nurse to stop giving him Glipizide for now. His DTX for the next days was 100 to 120 without having hypoglycemia again, so we stopped it until today's appointment.

"Okay, great. In that case we can stop the medicine like you said," Anucha nodded to thank Gunn. The inmate bowed in a gesture of respect towards Anucha and went out to help the nurse in front of the room as before. If Gunn did not adjust the medication in this way, the patient could experience hypoglycemia again and could get so bad that an emergency situation could occur and he would have to be sent to the hospital.

Anucha did not have the opportunity to speak much with Gunn after that due to the large number of sick inmates. The doctor had to rush out of the prison at 2 p.m. to attend a meeting at the hospital. After retrieving her bag, phone, and ID, Anucha looked at the solid steel door. Anucha did not agree with the crimes that Gunn had committed. Murdering Dr. Somsak was a serious crime. He thought it was fitting that Gunn was now behind bars. However, as a former colleague whose relationship with him has always been good, Anucha hoped that the next time he met Gunn here, Gunn would still have a bright expression on his face and would be more proud of himself.