My small nephew, almost five, gave me a drawing for Christmas. It featured me as a caterpillar with my name inscribed on the segments. In the picture I am surrounded by butterflies. I have some vague suspicions about what this omen augers for the new year.

One of the butterflies has darker, colored-in eyes. "What's that one?" I ask him.

"He's dead," replies my nephew. He has an acute awareness of, and curiosity about, death, as I supposed most people his age do.

"Really. Why?" I ask.

"It was his time," he tells me casually, the way he might describe his lunch. Then he adds, "It's the circle of life."

Do we ever really understand death any better than we do at age five? That's practically the same lame explanation I half-assedly muster when I'm pretending to accept the miserable reality that we're all stamped by God with an inscrutable bar-code expiration date, like dairy products, after which we get tossed off the earth.

During my Christmas at the home where I grew up, my nephew frequently requests rescue stories. He's quite keen on the fact that I am now, technically, a fire fighter. I would have to transform grotesquely into a werewolf and devour a bleating lamb before his eyes before I fell off his list of Favorite Things. His adoration is amusing to my family but faintly tinged with embarrassment for me; I know it's not particularly deserved and I rather suspect he'll realize this someday in a dramatic reversal of affections. In the meantime, I'm a hero and I don't take this responsibility lightly.

So I'm in something of a quandary about what kinds of stories to tell. Unfortunately, many of the tales that he would find the most exciting also feature endings that are dubious at best for the patients involved. He wants to hear about cutting up cars on the Beltway, rescuers bathed in flashing red lights as we use the jaws of life to tear into a vehicle and free the trapped victims. He's all for helicopters swooping down into parking lots to grab desperately injured patients and fly them to the regional trauma center. I sense I am talking along a thin line. He wants reality because he's trying hard to understand and come to terms with it, but he also possesses scant defense against the horrors of life on earth. He's not prepared for the whole story.

Of course, there's also the consideration that I owe to my patients; none of them deserve to have their most vulnerable moments recounted to a four-year-old as a thrilling story. So I tell some general tales of mayhem, focusing on ones with happier endings in which people do not die. I skip the details, omit enduring images of gore or suffering, and focus more on how the ambulance works and what I do with patients. This approach isn't entirely satisfying to him. He asks for more stories, and I wonder if he isn't already flirting with that line between fascination and revulsion, fear and courage. He wants a story that might give him nightmares, the tale that makes his mind feel cold. He wants to see what he can take.

It might take him anywhere, this desire: onto a fire truck, into a spotlight on a dark stage, behind the barrel of a gun, to a place utterly unlike home. My stories represent a lure and a threat, like the death that would end far too many of them.