I returned to my patient and looked at him. His breathing, temporarily relieved by the oxygen increase was now worsening once again. "Mr. Li?" I asked him, speaking loudly in case he was hard of hearing. "I have a doctor's order not to assist your breathing mechanically. Do you understand?"

Looking in my eyes, he nodded his understanding.

"Is that your wish Sir?" I asked him. "For me NOT to do anything?"

He smiled slightly. "Yes." He panted. "It's… " A pause to breathe. "My time."

"As you wish." I told him

We loaded him onto our gurney and wheeled him out to the ambulance. Once in the back I hooked him up to my EKG machine in order to allow me to watch his heart rate. I put my pulse oximeter on his finger, looking at the display for a reading. The pulse ox registered the amount of oxygen saturation in a person's blood. A normal reading for a person breathing room air was around 99%. Mr. Li was breathing one hundred percent oxygen and his reading was 74%. Yes, he was dying fast.

"Mr. Li?" I addressed him. His eyes creaked open to look at me.

"I'm gonna start an IV on you." I told him. "Maybe they can give you something at the hospital to, you know, help you with the pain and the discomfort."

He smiled, nodding at me.

I went to work, setting up a bag of saline and hanging it from a hook on the ceiling of the ambulance. His veins were so fragile that I was forced to use the smallest needle that we carried, the kind that is meant to be used on infants, in order to establish the line. I threaded it in slowly, cognizant of the fact that advancing it at this rate was probably painful for him.

"I'm sorry Mr. Li." I told him when I finally secured the line. "I don't like to do it that slow but your veins are not in the best shape. It's better to do it that way than to miss it and have to try again."