A Fair Contract

“Is there a reason you’re not increasing her dose?” My voice trembled as I confronted the hospice nurse in the dimly lit kitchen, the hum of the refrigerator loud in the silence between us.

She looked at me, tired, sympathetic. “Ms. Adams, there are regulations. Your mother’s doctor—”

“But she’s in pain!” I snapped, my knuckles white against the counter. Beyond the door, my mother’s ragged breathing pulsed through the house, a metronome of suffering.

Natalie Adams—my mom—used to be a force. She was the one who argued with teachers, who organized protests at City Hall, who’d somehow made a home for us after Dad left. Now, she barely opened her eyes, her body shrunk and lost in the hospital bed we’d wedged into our living room. Cancer had eaten her from the inside out, and the chemo, the radiation, the endless pills had left her a stranger, hovering somewhere between sleep and agony.

I remember her voice, slurred from the morphine, as I sat beside her that morning. “Sarah, I just want it to stop.” Her hand found mine, trembling, bones pressing through thin skin. “Promise me you’ll help me.”

But what could I promise? I wasn’t a doctor. I wasn’t God. I was just her daughter, stuck in paperwork and protocols, fighting a system that seemed more interested in legal liability than in the woman I loved.

The rest of my family didn’t make it easier. My older brother, Mark, flew in from San Diego two days before Christmas. He walked in, took one look at Mom, and said, “We need to do everything we can. You can’t just give up.”

“She doesn’t want any more treatment,” I argued. “She signed a DNR, Mark. She’s suffering.”

He glared at me, jaw clenched, all the years of resentment between us flaring into open war. “How can you say that? She’s our mother. She fought for us, and now you’re just—what? Letting her go?”

I wanted to scream. Instead, I went to the kitchen and cried, biting my sleeve to keep from waking her. It felt like everyone—my aunts, the nurses, the hospice social worker—had an opinion. But none of them could hear her at night, whispering, “Please, Sarah, I can’t do this anymore.”

The days blurred into one another: medication schedules, insurance calls, arguments about living wills. Each time she surfaced from the fog, she was a little less herself, and I was a little more desperate.

One night, after Mark had stormed off to the guest room and the nurse had gone, I sat by Mom. The house was silent except for her breathing—a harsh, uneven rasp. I took her hand. “Mom, do you want me to call Dr. Patel?”

She shook her head, barely. “No more doctors. Just you.”

I pressed my forehead to her hand and tried not to sob. “I wish I could help you. I wish I could make it fair.”

She smiled, faintly. “Life isn’t fair, honey. But you can make it kinder.”

The next morning, Mark found me with the morphine bottle. “What are you doing?”

“She’s in pain, Mark. The nurse won’t increase the dose. She wants to go.”

He stared at me, horrified. “You can’t—Sarah, that’s illegal. You’d go to jail!”

“So what, Mark? We let her suffer because of a law? Because of a contract she signed with her insurance company years ago?”

He stormed out. I heard him calling our aunt, telling her I’d lost my mind.

I sat by Mom for hours, watching the sun move across the living room rug. I thought about the so-called fair contract—the one that said how much pain she was allowed to feel, how many pills she could take, how many days she’d be forced to linger. I thought about the promises I’d made, and the ones I couldn’t keep.

When she died two days later, I was there. I held her hand, whispered stories from our childhood, and told her it was okay to let go. Mark wasn’t in the room. He couldn’t watch.

The house was too quiet after. The nurse packed up her things, handed me a stack of paperwork, and left. Mark flew back to San Diego. The funeral was small, awkward. People kept saying, “She fought so hard,” as if fighting was the only thing that mattered.

After everyone was gone, I sat on the porch with Mom’s old mug, the one with the chipped rim. I thought about everything we’d been through—the battles, the bureaucracy, the impossible choices.

Is it fair, I wondered, that we call this mercy? That we make families choose between the law and compassion, between contracts and kindness? Would you have done it differently? Would you have let her go?