One by one, the media witnesses approached the microphone to describe what they saw at the execution of Byron Black. Speaking at a podium outside Riverbend Maximum Security Institution in Nashville, each said a version of the same thing: Black, 69, had suffered before he died.

The lethal injection had been scheduled for 10 a.m. The curtain to the death chamber opened a half hour later, revealing Black strapped down tight to the gurney and covered with a white sheet. Minutes after the massive dose of pentobarbital started to flow, “he began breathing loudly and sighing,” said a reporter from the local NPR station WPLN. Black raised his head and looked around, then said, “It’s hurting so bad.”

“I’m so sorry,” his spiritual adviser replied.

Another reporter said she saw Black lift his head multiple times. “I can’t do this,” he said. After that, he “audibly gasped.”

Of the seven media witnesses, several had also attended Tennessee’s last execution, carried out in May. This one was different. “It was unanimous among all of us that we saw him in distress,” said Steve Cavendish, editor-in-chief of the Nashville Banner. “We heard him in distress.”

Lawyers for Black had repeatedly warned about the risks of executing their client, a man whose physical and mental health had significantly deteriorated over the years. In addition to a diagnosed intellectual disability, Black had dementia, brain damage, kidney disease, and congestive heart failure. For much of July, Supervisory Assistant Federal Public Defender Kelley Henry had fought to require the state to deactivate Black’s implanted defibrillator/pacemaker. A judge held a hearing in Davidson County Chancery Court and ultimately ruled in Black’s favor, concluding after two days of expert testimony that the lawyers had proved their case: There was a risk that the device would attempt to restart Black’s heart during his execution, sending painful shocks through his body. “This risk can be completely avoided by deactivating [the device],” the judge wrote.

But the Tennessee Attorney General’s Office appealed to the state Supreme Court, which invalidated the ruling. As the execution approached, a Nashville hospital put out a statement saying that it had never agreed to deactivate the device and emphasizing that its staff “has no role in State executions.” On the eve of the execution, the U.S. Supreme Court declined to intervene, and Gov. Bill Lee rejected a plea for clemency.

Ultimately, Black’s death appeared to have fulfilled the very fears of his attorneys and advocates.

Black spent 36 years........

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