“You need in-patient treatment, and you need it now.”
“It wouldn’t cure me, though.” Lily Valley stared from across the desk.
“No,” replied Dr. Primary Care, with frustration in her voice. “We’ve been over this in your previous appointments. There’s no cure. Only management to help get you as much time as possible.”
“How much time?”
“Probably about another year.”
“All in the hospital?” Lily asked.
“Yes.”
“Then what good is that?”
“It’s another year.” Care spoke slowly, belaboring the obvious.
“No, I get that, but...” Lily rolled a hoof in the air. “I mean, what good would it be?”
“It’s time you wouldn’t have otherwise.”
“How long would I have otherwise?” Lily asked.
“Looking at these function tests and your bloodwork... six weeks. Maybe two months.”
“So I can live for two months, or I can spend a year hooked up to IVs and tubes, bored out of my mind, trapped in someplace everypony hates.”
“I understand, it’s frustrating—”
“How many times have you been terminally diagnosed?” Lily asked. “How many times have you been here, where I am now? In some doctor’s office like this—” she waved a hoof around in a wide arc, “—with somepony sitting across from you, telling you that you have a... a thing, or whatever... and you have two months?”
“...Never,” Care admitted.
“Oh. Never. Right.” Lily leaned forward. “So I don’t think you do understand.”
“Okay, maybe I don’t know how you feel.” Care sighed. “But I understand medical facts, and I understand this, Ms. Valley: your condition is painful. It’s going to hurt, and it’s going to get worse. If nothing else, in-patient palliative care could at least make you comfortable.”
“So give me two months of pain meds, and I’ll deal with it on my own,” Lily said.
“Are you completely nuts?” Care stared at her.
“What?” Lily looked nonplussed.
“Do you have any idea how stupid I’d have to be to give you two months of painkillers?” Care asked. “I hate prescribing more than a few days.”
“Why?” Lily asked.
“Because they’re strong opiates,” Care said. “The kind that get misused.”
A slow-forming smile dawned over Lily’s face. “I don’t believe this.” She broke into giggles. “I’m dying here, and you’re worried about me being a junkie?”
“No.” Dr. Care thought for a moment. “In your case, that’s really not what I’m most worried about.”
“Then what?”
“What if I do write that prescription?” Care leaned back in her chair. “And what if, a few days later, somepony finds you dead next to an empty prescription bottle?”
They both said nothing for a long time.
“I don’t know.” Lily shrugged. Her voice was quiet. “What if I did? Wouldn’t that be my choice to make? What if... what if I thought about it, and it was for the best?”
“What would it make me if I wrote it, knowing that?” asked Care.
Uncomfortable silence hung heavily.
“Look, I don’t have time for hypothetical questions.” Lily snorted. “Here’s the thing: either you’ll write a prescription, or you won’t. Either help me spend my last days without pain, or don’t. Just tell me which one, so at least I know.”
The two of them stared at each other, locking eyes for several long seconds.
“Please.” Lily reached out and put her hoof on Dr. Care’s.
Dr. Care hesitated. Her face gradually softened and she let out a resigned sigh. She pulled her prescription pad in front of her and stared down at it for a little while, thinking.
Slowly, she started writing.
“Here.” She slid the sheet across her desk. “Two months’ worth, so you won’t need refills. Directions are on the scrip. Read them. I’m writing a note in your patient file that you’ve followed previous prescriptions closely, and that I have every confidence you will this time. Got it?”
“Thank you,” Lily whispered.
“They’re stronger than what you’re on now,” Care noted. “And they’re dangerous respiratory depressants at high doses. Five or six could be lethal. Ten or more, no question—you’d pass out and never wake up. So don’t OD.”
“I’ll definitely be careful.” Lily nodded.
“Good. I guess we’re done, if there’s nothing else I can do for you today.”
“No, I need to get going,” said Lily. “Stuff to get in order. Ponies to say things to.”
“Sure.” Care nodded. “I understand.”
“Thanks, Doctor.” Lily turned to leave. “See you around.”
“Hey, good luck with everything. Remember,—”
“Follow the directions, yeah,” said Lily. “I will. I will.”