An older woman arrived at my house, a grandmotherly type with an unhurried walk. We said hello with tears streaming down my face. I asked her if she got tired of people crying when they met her. She laughed and said yes, making herself comfortable on my porch steps. She discretely pulled two syringes out of her big brown purse while we talked. She showed an impeccable combination of knowledge and intuition honed from years of experience. She was so kind. She was the type of person anyone would be comforted to see at the end of their lives.

She was at my house to euthanize my beloved cat. Violet was 15 years old and her ailments expedited a few days prior. I knew from my own intuition and experience that someone is near death by the steadiness with which symptoms increase, although this is by no means a hard and fast rule. Violet herself had proven me wrong many times by laying down on death’s door and then getting up for churu treats like nothing had happened.

But it was different this time. She developed a new set of incurable symptoms overnight that erased the last bit of joy she was holding onto. She either hid in her litter box or paced agitatingly, like she was trying to run from the pain. In the rare moments that she was able to be present, she clung to us for comfort. She was scared and exhausted and fought death for days. It was clear that her body was ready but she wasn’t allowing herself to let go.

So we called a poisoner.

I don’t think she would call herself a poisoner - I think she would use her proper title: Doctor of Veterinary Medicine. She specialized in end-of-life care for animals, traveling all over the mountains so animals could avoid the stress of the medical system. Violet loved her when she met her, curiously peeking in her purse as if she knew what was going to happen. I held her in my arms while she was given the first injection, a sedative. The poisoner did it so expertly that Violet’s skin didn’t even flinch at the needle. I put her down to eat some treats and she fell asleep a minute later, taking a deep nap in the moss by the porch. When I nodded that I was ready, the second syringe was administered. Three breaths later, Violet let go.

I thought of the kind woman later that day while sitting next to Violet’s body, shrouded in her favorite velvet pillowcase and tucked into a pine box. What a wild job to have: sweep in to help an animal you have never met cross over the threshold of life and death. One moment Violet was being a curious cat, the next she was lifeless on the moss. I thought I should have been more disarmed at how effortless it was, at how quickly she went from alive to dead. But it felt so natural to meet death in this way that I was just relieved we got to experience it together.

I reflected on the multitude of deaths I’ve witnessed, both human and animal. None of them had this ease. None of them were this peaceful and loving. And that’s not something we typically credit to poison.

I see how associating a medical professional with a poisoner could feel like a stretch. Medical professionals heal and improve experiences in our bodies. We willingly turn to them when something is wrong, trusting them to make it better in some capacity. But the line between medicine and poison is often paper-thin.

Many medicinal drugs are actually derived from poisonous compounds. For a recent surgery, I was prescribed a scopalamine patch as a mild sedative and anti-nausea before the procedure. Scopalamine is a tropane alkaloid derived from the poisonous nightshade family of plants. At an incorrect dosage, scopalamine could have killed me by causing respiratory failure. At a correct dosage, it greatly improved my quality of life around a scary surgery. I trusted this particular surgeron to be an expert with her tools - one of which just happened to be a poison that she wielded as a medicine.

Other drugs blur the line even further. Chemotherapy can be a life-saving treatment against certain types of cancers. But this treatment is actually administered as a poison, targeting specific cells and killing them outright. It damages the DNA of cells that divide quickly, like cancer cells, and causes them to die. It is not a perfect method because it also impacts healthy cells that divide quickly - especially in the mouth, intestines, and hair. The body feels the effects of being poisoned and can develop a lot of severe symptoms as a reaction. This whole process harms the body in the short-term in an effort to prolong life.

The difference between what we see as medicine versus poison comes down to: who is the poisoner? Intent to heal rather than harm is a good standard for most, but it’s not a universal ruling. We have things like euthanasia and chemotherapy that require some intent of harm to alleviate overall suffering. Even Paracelsus’s famous quote “the dose makes the poison” feels like an oversimplification of the ethical complexities and physical responses. It is all so much more subjective than we want it to be. Especially when we decide that the best medical decision is to use the poison as poison and end a life altogether.

Within all the varying degrees, it’s important to choose a poisoner or medical practitioner whose best interests align with yours. I could have chosen a different person for Violet’s euthanasia and it would have resulted in her death no matter what. But the compassion and experience that came from this particular older woman became something medicinal for me. She wasn’t just skillfully ending my cat’s life, she was filling our last moments together with peace, beauty, and choice.

This is this first in a long line of poison-related essays I have to share. If you would rather only read my essays about Appalachia, you can adjust the settings in Substack to receive what you are interested in - and vice versa!

Thank you for being here,
♡︎ Mila