GUEST COLUMNIST: A tragedy that shouldn't have been

At 6:40 in the evening of Sept. 29, 1997, a life is over. Having completed for the second time in the day a battery of tests to determine if any brain function persisted and finding only silence, I disconnect Scott Krueger from his ventilator and leave him with his family to say their final goodbye. How could a boy of 18 who came to Boston and the Massachusetts Institute of Technology only a month earlier so full of promise and potential have met this fate? Move back in time three days to the preceding Friday. Scott calls his twin sister, a freshman in college in New York. They are very close. Just separating to go to different colleges was difficult and they share much with each other. There will be a fraternity party that evening and Scott has heard the freshmen will be forced to drink a large quantity of alcohol. He is apprehensive. He did not drink in high school. It is late Friday night. Scott is found on a couch in the fraternity house basement. He is in a coma from alcohol, a coma so deep that he does not move as the blood supply to his muscles is cut off by the pressure of his body, a coma so deep that when his overfilled stomach releases its contents back up to his esophagus and his throat, he cannot protect his windpipe. The food and the liquor descend into his lungs and block the flow of air, and critical minutes without oxygen begin. Just after midnight Saturday morning, Scott is rushed to the hospital. His heart has stopped. Tubes and catheters are placed and medications are administered and the heart is brought back to life. But what of the brain? The heart is just a muscle, but the brain is more sophisticated than any computer and it cannot tolerate a lack of oxygen for more than a few minutes. We work feverishly for the next three days to restore Scott to the life to which he is entitled. We sit with his wonderful family and try to find some hope in this desperate situation. But the outcome was determined back in the fraternity house; all that modern medicine has to offer is insufficient to overcome the damage that has been done. All we can say is, this should not have happened. This life that has so much to offer the world should not have been extinguished. To serve alcohol to minors is a crime. To coerce a young individual to drink excessively is morally reprehensible. Whoever purchases liquor to be served to minors, whoever organizes parties to circumvent the legal drinking age, whoever compels our children in subtle or not so subtle ways to ingest toxic quantities of alcohol must be held responsible for the consequences. Any university that finds reasons to look the other way at underage drinking over the course of many years must be accountable for the tragedies that ensue. The society that continues to glorify the "party animal" and the "amusing drunk" must also take a critical look at its values if we are to prevent similar disasters in the future. Virtually every weekend during the year when colleges are in session, teenagers are brought to our emergency department with alcohol poisoning. Most survive. But the difference between those who survive and those who do not is primarily luck. Someone brought them to the hospital in time. They were placed on their stomachs rather that on their backs. They didn't vomit and block their airways with the contents of their stomachs. Do we want to leave the survival of our children to luck? Young people go to war and die, but we justify the loss because they are fighting for principles and for their homes. Young people die each day from cancer, but we acknowledge that this is part of the human condition. There is not mitigating logic that allows me to feel better about Scott's death. As I walked into Scott's room for the last time, I focused on his younger brother who sat at the bedside. The pain on his face was almost more than I could bear. I could imagine the love and admiration he held for Scott, the good times they had shared in the past but which were not stolen from him. He was only 15 and the shock of this tragedy will likely stay with him for the rest of his life. He will have to grow up a little sooner; he will have to grow up more alone than he should be. As I turned to leave Scott's room, I looked at his face but I saw the image of my oldest son, who is now 16. How do I prevent this from happening to him? We have talked about the dangers of alcohol; he knows the facts. But will he have the self-confidence and strength to walk away when he is placed in the situation that too many of our college students face? We should not and cannot let our children die in this way. We must start holding accountable the adults who place the alcohol in the hands of 18-year-olds. What happened to Scott Krueger was no more an accident than a forest fire that burns after a lighted cigarette is thrown on parched timber. It is a statistical certainty that more deaths will occur if we do not take action, not merely mouthing platitudes but taking concrete steps, to reduce underage drinking. One of those actions is to punish those who create the circumstances that lead to disaster. We know what must be done. Do we have the courage to do it?