The charge in the courtroom was manslaughter, brought by the Commonwealth of Virginia. It was only then that the patient began to open up, and what he said was that he didn’t want any sedation, that he didn’t deserve a respite from pain, that he wanted to feel it all, and then to die. He would not speak at all for the longest time, not until the nurse sank down beside him and held his hand. He was virtually catatonic, she remembered, his eyes shut tight, rocking back and forth, locked away in some unfathomable private torment. When a hospital emergency room nurse described how the defendant had behaved after the police first brought him in, she wept. Witnesses spoke softly of events so painful that many lost their composure. In the first pew of spectators sat his wife, looking stricken, absently twisting her wedding band. He hunched forward in the sturdy wooden armchair that barely contained him, sobbing softly into tissue after tissue, a leg bouncing nervously under the table. The defendant was an immense man, well over 300 pounds, but in the gravity of his sorrow and shame he seemed larger still.
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