My response came in parts over my days with him. First, I explained that, as his physician, I wanted to be with him through the dying process. I told him that I considered us to be in a mutual covenant. We both had a degree of autonomy that had to be respected, but I would never intentionally harm him. "Paul, our covenant includes my limiting your suffering," I said. "You are the best judge of when you need more meds for pain, anxiety and breathing. All of us will work day and night to end your distress, but we won't deliberately end your life."
With our eyes locked, Paul gave his instruction: "Just don't abandon me." And we sat there, as partners.
"I want my music. Can you get me the soundtrack for 'Lord of the Rings'?" Within minutes we had the songs playing in his room, and his demeanor changed from desolate to alert and engaged. "I love music. It's always been a motivator, but now ... I don't know." He shifted in his bed. "My goals are gone."
Nietzsche's words came to my mind, "He who has a 'why' to live can bear almost any 'how.'"