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award for the Cowart family. Moreover, Houston believed that such an award would provide the financial means necessary for Don Cowart’s ultimate rehabilitation. He therefore encouraged Cowart to see the legal proceedings through. In February 1974, the lawsuit was settled out of court—one day prior to trial. Almost immediately, Don’s demands to die quickened. There had been talk before with Art Rousseau of getting a gun. Don had asked Leslie Kerr if she would help him by injecting an overdose of medication. Now Cowart even talked with Houston about helping him get to a window of his sixth-floor hospital room, where presumably he would leap to his death. All listened but none agreed to help. On March 12, 1974, Don was discharged from Parkland. He, his family, and his doctors agreed that his condition had improved sufficiently to war- rant his transfer to the Texas Institute for Research and Rehabilitation in Houston. Nine months removed from his medical residency, Dr. Robert Meier of TIRR found Cowart to be a passive recipi- ent of medical care, although the philosophy of treatment in this rehabilitation center encouraged patient involvement in treatment decisions. Previ- ously Don had no say in his care; now he would be offered choices in his own treatment. All seemed to go well during the first three weeks of his stay, until Cowart realized the pain he had endured might continue indefinitely, thanks to a careless comment by a resident plastic surgeon that his treatment would be years in completion. Faced with that prospect, Cowart refused treatment for his open burn areas and stopped taking food and water. In a matter of days, Cowart’s medical condition deteriorated rapidly. Finding his patient in serious condition, Dr. Meier was deeply perplexed about what to do next. He believed it his duty to help Cowart achieve the highest measure of rehabilita- tion, but he was not inclined to force upon the patient care he did not wish to receive. Faced with this dilemma, he called for a meeting with Ada Cowart and Rex Houston to discuss with Don the future course of his treatment. Ada Cowart was outraged by Don’s condition. She had been discouraged from staying with her son at TIRR, and in her absence his burns had wors- ened. He was again near death, due to his refusal of whirlpool tankings and dressing changes. It was agreed in the meeting that Cowart would be transferred to the burn unit of John Sealy Hospital of the University of Texas Medical Branch in Galve- ston, where his injuries could again be treated by burn specialists. On April 15, 1974, Don was admitted to the Galveston hospital, in chronic distress from infected wounds, poor nutrition, and severe depression. His right elbow and right wrist were locked tight. The stubs of his fingers on both hands were encased in grotesque skin “mittens.” There was practically no skin on his legs. His right eye socket and closed left eye oozed infection. And excruciating pain remained his constant nemesis. Active wound care was initiated immediately and further skin grafts were advised by Dr. Duane Larson to heal the open wounds on Cowart’s chest, legs, and arms. But Cowart bitterly protested the daily tankings and refused to con- sent to surgery. One night he even crawled out of bed, hoping to throw himself through the window to his death, but he was discovered on the floor and returned to bed. Frustrated by Cowart’s behavior, Dr. Larson consulted Dr. Robert White of psychiatric services for an evaluation of Don’s mental competency. White remembers being puzzled by Cowart: Was he a man who tolerated discomfort poorly or per- haps was profoundly depressed? Or was this an extraordinary man who had undergone such an incredible ordeal that he was frustrated beyond normal limits? White concluded, and a colleague confirmed, that Cowart was certainly not mentally incompetent. In fact, he was so impressed with the clarity of Cowart’s expressed wish to die that he asked permission to do a videotape interview for classroom use in presenting the medical, ethical, and legal problems surrounding such cases. That filmed interview, which White entitled Please Let Me Die, eventually became a classic on patient rights in the field of medical ethics. Having been declared mentally competent, Cowart still found it difficult to gain control over his treatment. He and his mother argued con- stantly over treatment procedures. Rex Houston helped get changes in his wound care but turned a deaf ear to Cowart’s plea to go home to die from his wounds or to take his own life. In desperation, Cowart turned to other family members for assistance in securing legal representation, but without suc- cess. Finally, with White’s help, Cowart reached an attorney who had represented Jehovah’s Wit- nesses attempting to refuse medical treatment, but he was not optimistic that a lawsuit would free him from the hospital. Rebuffed on every hand, Cowart reluctantly became more cooperative. White secured changes in Don’s pain medication before and after the daily tankings, making treatments more bearable. Psy- chotherapy and medication helped improve his overall outlook by relieving his depression and improving his sleep. Encouraged that he might still regain sight in his left eye, Don more or less accepted his daily wound care and even agreed to surgical skin grafts early in June 1974. By July 15, his physical condition had improved enough to allow him to transfer out of the burn unit of the John Sealy Hospital to the psychiatric unit of the Jennie Sealy Hospital in the University of Texas Medical Branch under White’s direct care while his wounds continued to heal. Amid these changes there were still periodic conflicts between Cowart and those around him over his confinement in the hospital. There were reiterated demands to die and protests against treatment. A particularly explosive encounter between Cowart and Larson occurred on the day preceding his second and last major surgical pro- cedure in the Galveston hospital. Cowart had agreed to undergo surgery to free up his hands, but the night before he changed his mind. The next morning, Larson angrily confronted Cowart with the challenge that, if he really wanted to die, he would agree to the surgery that would enable him to leave the hospital and go home where he could take his own life if he wished. Anxious to do exactly that, Cowart consented to the surgery, which was performed on July 31. Don Cowart’s stormy stay at Galveston finally ended on September 19, 1974. He had been hospital- ized for a total of fourteen months, but at last he was going home. His prognosis upon dismissal was listed simply as “guarded.” Cowart was glad to be back in Henderson. The little things counted the most—sleeping in his own bed, listening to music, visiting with friends. But it was different for him than before the accident. He was totally blind, his left eye having failed to recover. His hands and arms remained useless. He was badly scarred. A dropped foot now required that someone assist him in walking. Some of his burn sites still were not healed. Everything he did required the help of others. Someone had to feed him, bathe him, and help with personal functions. The days seemed endless. He tried to find peace in sleep, but even this dark release was impossible without drugs. While he couldn’t see himself, Don knew his appearance drew whispers and stares in restaurants. He had his tapes, talking books, television, and CB radio. He could use his sense of hearing, though not as well as before due to the explosion and burns. And he could think. For a while, he could see in his mind’s eye the memories of earlier times. Then the memories started to fade. Ada Cowart had lost much, but she never lost her religious faith. There had been times when even she had admitted that maybe it would have been best if Don had died with her husband. She recon- ciled her doubt with the thought that no mother can give up the life of a son. Ada never gave up hope that Don could find new faith in God. Homecoming brought peace for a time. As Don’s early excitement for returning home gave way to deep depression and despair, however, conflict returned to their lives. They argued about how he could occupy himself, how he dressed, his personal habits, and his future. Frustration led to a veiled suicide attempt, Don stealing away from the house during the night to try throwing him- self in the path of trucks hauling clay to a brick plant. The police found him and brought him home quietly. For the next five years, Cowart lived in a shadow world of painful rehabilitation, chronic boredom, and failed relationships. His difficulties were not for want of trying. With Rex Houston’s encouragement and assistance he tried pursuing a law degree. Fortunately, his legal settlement with the pipeline company provided the financial means for the nursing care and tutorial assistance which would be required because of his massive handicaps. Cowart tested out his abilities as a blind stu- dent in two undergraduate courses at the Univer- sity of Texas in Austin during the fall of 1975. He spent the spring at home in Henderson preparing for the tests that were required for admission to law school. In the summer of 1976, he enrolled for a part-time course load in Baylor University’s School of Law. Don handled his studies at Baylor in fine fash- ion despite his handicaps, but the strain was tremendous. He was forced to live with other peo- ple, his independence was limited, and his sleep problems persisted. When a special relationship with a woman ended abruptly in the spring of 1977, his life caved in. He tried to commit suicide by taking an overdose of pain and sleep medica- tions, but he was discovered in time to have his stomach pumped at the hospital emergency room. He had trouble picking up his studies again, so he dropped out before the spring quarter was completed.