An already depressed second year medical student, Deborah, finds herself even more confused about the meaning of life after her aunt sustains a head injury and is in critical condition. Auntie Jenny’s convertible car collides with a utility pole and the impact ejects the woman (who was not wearing a seatbelt) onto the concrete road where she smacks her head. Five days later, Jenny remains in a vegetative state and connected to a ventilator. Deborah’s mother and Auntie Sal keep vigil over their unresponsive younger sister.

Deborah has been slacking – missing classes, sleeping a lot, and uninterested in most activities she formerly enjoyed. Previously she has suffered from insomnia and has fifteen barbiturate sleeping pills remaining. She questions the medical librarian as to how the drug works and the physiologic effects of an overdose. In the seventh grade, Deborah was hospitalized and out of school for one month with unexplained abdominal pain. In retrospect, her mother now admits that Deborah was likely suffering from depression as a child but no diagnosis was made and no treatment provided.

Jenny’s medical status remains unchanged. Deborah’s mother gives her an ultimatum: “You’ve got to make up your mind. The living or the dead” [p 119]. Deborah envies Jenny. No more worries about finding answers to important questions. Survival itself seems to be out of her control. Jenny’s fate rests in the hands of her close relatives who confer with the doctor about whether to continue artificial life support or “pull the plug.”


There are plenty of characters in this story to feel sorry for. The medical student’s emotional life has taken a serious turn, and it is uncertain whether her passive, anhedonic state can be resuscitated. The unresponsive aunt’s very existence is in jeopardy. In a sense, both Deborah and Jenny are in a vegetative state. Let’s not forget the immediate family members who must make the difficult choice between discontinuing advanced life support measures versus continuing aggressive treatment (even though the likelihood is that Jenny will remain in a persistent vegetative state).

The depressed medical student is in a unique position to ponder questions of life and death as well as contemplate the complexities of both. “Death feels familiar somehow. As though I’ve already been there. Death is a mindless, reassuring drone” [p 110]. She also remarks, “I am thinking about the body itself. I know what it contains, but what makes us alive?” [p 115].

With regards to critically ill individuals and intensive hospital care, the story highlights the hardships of waiting and feelings of helplessness on the part of family members. The story additionally acknowledges the ever-present hope that time and prayer will make things better. Survival is a strain.


Primary Source

Heavier Than Air (pp 107-120)


University of Massachusetts Press

Place Published

Amherst and Boston



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