 Looking down, it was hard to argue. Stage four cancer. When Miss Ruth had been asked her pain level earlier this morning, she had replied with no hesitation. Ten out of ten. I marked it down in the notes and felt my fair share of sadness for the old woman. My sister had said, her glowing eyes staring into mind, no one could see my sister anymore since her death, except for me. It's funny, when my sister was alive we weren't very close, but now she was with me nearly every second. Now she was always there to guide me and help me through the harder choices in life. Okay Sarah, I replied, feeling the syringe as far as it would go. If you work in healthcare, you know that upon each shift the narcotics are measured by the oncoming nurse. But there are ways around that. As her breathing slowed, I filled up the morphine with tap water and checked its level before the next shift would. No change. I knelt down by the old woman and held her hand. Was I sorry for my part in this? Absolutely not. She was enduring more pain than anyone should have to. And before you judge me, I want to ask you this. Would you let your dog wither away and die from stage four cancer? Or would you take him to the vet and help him move on to the next life? Why should Miss Ruth be any different? I whispered into her ear. And she did. Her heart slowly stopping and a warm smile falling over her face. My only regret was that her family hadn't been here while she had passed. But it wasn't worth the risk. People didn't trust nurses and doctors like they used to. And there was more than a small chance that one of her family members might notice her increased dosage. This is how it had to be. And this is how it always had been. That night I took out the journal stowed under my bed and withdrew the small knife that was cradled inside it. I cut a small mark on the inside of my arm and used the fresh blood as ink to write a single mark in the back page of the leather. That made 65. Wow, was it really that many? Hey Sarah, I shouted into the adjoining room. Yes, brother. Would you believe we're at 65 already? I was so damn proud of what we had achieved together. All those souls that had been given a reprieve from pain and a journey towards the light. I'm proud of you, Robert. Get some rest. My smile grew wider. I knew it wasn't good to be dependent on others for your feelings. But the thought of my family being proud of me, well, it filled my heart with joy. Sarah was the last one I had left. And even though she was a ghost or something else, it felt like our relationship was more alive than it ever had been. Still, life is never without its challenges. Three days later, a new patient was brought under my care. Mr. Davis was a retired engineer and he had recently been diagnosed with a fast-acting form of pancreatic cancer. Get some rest. I whispered, filling up the syringe with morphine like I had done so many times earlier. But this time it didn't go as planned. Mr. Davis gripped my wrist tightly and pulled my eyes in front of his. I don't want any medicine, he said. And I could tell he meant every word. Still, I had a job to do. It's just to dull the pain, I said, pushing the needle towards him. I don't want the fucking medicine. He continued, his voice far too loud now to provide the concealed environment I needed. Okay, okay, sir, I replied, turning my back and checking the morphine level on the bottle. He gave me an angry, hazy look and then drifted off to sleep. That night when I was back at home, I prayed that she wouldn't find out. My hands locked together as I sat on my knees and looked over at the crucifixion painting my mother had insisted I receive after her death. God, please don't let her hurt me. When I finished my prayers, I did something I hadn't done since we were children. I locked the door. It wasn't more than five minutes later when my sister's voice could be heard in the outside hallway and the scratching started. God, why were her nails so long now? Or did they continue to grow after you died? I always forgot. You didn't do God's work today, did you, Robert? I pretended to be asleep. I pretended that I didn't hear her. But it never worked. Robert. The dead voice screamed. The old house's very foundations shaking violently with her anger. I couldn't, okay? He told me he didn't want any. And with that, the steady scratching on the door increased. Its only interruption, being the even worse, slams against the old oak frame as she desperately tried to get inside. I tried not to think of the punishment that awaited if she did. Horror filled me now as I could hear the hinges begin to creak and bend farther with each heavy jolt against it. Jumping out of bed, I braced my back against it. Please, Sarah. I called out gently. Tears beating to fill my eyes now. Please don't hurt me. And after a moment, the slamming did stop. A steady scratching took its place. That was somehow more gentle than before. I tried to hide my terror as I peeked through the small gap under the door. Her dead eyes were waiting for me. And they glowed like embers as I stared back. I know you do, Sarah.