Suicide

Her last days…


My sister and I came into her room morning after morning and came face to face with her frustration. Frustration over being immobilized and wedged in this limbo. Frustration with our blind denial that she was dying and our assurances that all she needed to do was rest, that it would pass and she would heal.

The morning I found her on the floor after having fallen trying to reach the porta-potty next to her bed, I knew that her strength was failing. It was terrifying seeing her lying there. Such an alien picture to see the strongest woman I knew, unable to pick herself up. She needed us to help her onto it from then on.

There were accidents, and we would wash her and try to make her feel clean and dignified. She couldn’t stand it. After looking after her own paralyzed mother for so long, she couldn’t stand that we had to look after her now, even if it had only been a few days as opposed to the decade plus that she had been care giving.

One time, after coming in too late to find that she had needed to use her porta-potty, after cleaning her up I cried quietly and whispered to her, “I’m sorry… I’m so sorry. I should have checked on you sooner.” She grabbed my hand and shook her head. “I hate this. I want to die. I can’t make you guys do this. It’s not fair to you.” “No,” I said to her, “This is nothing. Please, this is nothing.”

She was not afraid of dying. She was at peace with that. Her only fear was how she could facilitate it. She speculated over the possibilities. She tried to think of what would be easiest for us. It was morbid. In my un-resigned mind, I would have none of it. She would become concerned then… She would say that she was ok, and that she needed us to be at peace with it.

One morning I came in to find her lying on her side in her bed. When she looked at me, the look in her eyes was confused and uncertain. I found half a dozen of her pain prescription bottles empty in the trash. I knew that she must have tried to kill herself that night. I was so scared, she taken so many pills. As I shakily collected the bottles out of the trash looking them over, I noticed one of them wasn’t empty. Absently I set it on the bedside table. As weak and drugged as she was she managed to reach over and snatch the bottle and angrily throw it forcefully back in the trash. I was so surprised by what seemed such a bizarre thing to do, and with such determination, I let out a confused little laugh. She didn’t say anything though. I didn’t take it back out again but I peered in to the bin and read the label. Only then did I realize that that bottle wasn’t sleeping pills or pain killer. It was her chemo medicine. She whispered hoarsely “How are you supposed to do this? What are you supposed to do? I can’t breathe, I can’t move, I can’t sit, or sleep, or eat. I don’t understand why I’m still here. I can’t live and I won’t die.”

She had talked only a couple days before, kind of incredulously, about the young Australian actor, Keith Ledger, who had died just a few months previous by an accidental overdose and how he was so young and vital and so full of promise. She wondered at how he died so easily… Lying peacefully on his bed, so accidentally gone. And here she was having taken handfuls of pills, trying to leave it all behind, and yet still she would awake, imprisoned in the torture chamber her body had become. This of course added fuel to my argument. In my blind refusal and fearful arrogance I would almost scold her, telling her that that must mean she’s not supposed to die. That it wasn’t her time.

But slowly the hooks I’d felt lodged in my chest, a kind of invisible giant of immense ache that we all tried to bury, finally began to fully realize itself and leave my mind nowhere to hide. It was a feeling that had been there since the first day she told me of the lump that she’d felt. From then on, when I looked at her, stripped now of all illusions, all I saw was the terrible cruelty that this world was subjecting her to, making her continue on when everything this world had to offer was now perched beyond her reach.

Finally came my tearful halting confession as I kneeled by her bedside: I stammered that “If that is what you want… I’ll find a way… I’ll get something...” and I trailed off so unsure and unfamiliar with what I was saying. She stared at me perplexed. “What will you get? How will you get it?” “I don’t know…. morphine… something… I’ll break into the ambulance if I have to.” She looked at me a little surprised. Maybe she hadn’t thought of that possibility before. But she was unwilling to ask that of me or of anyone. And so the offer went by, without anymore said.

My sister and I sat with her, mostly in silence, both of us not knowing what to say. Usually she would shoo us away, telling us off only half-jokingly for being such a grim and gloomy bunch. She’d long since taken to calling me McWeepy, for not being able to keep myself in check.

Anytime I’d try to speak of things I’d wished I’d done, or said, she would always cut me off and shake her head, refusing to let me speak in those terms, one time stating to me that she had no room for regrets and that I had better not either.

She said there was nothing to be said. She said all that mattered was that she loved us and that she knew we loved her. That was it, nothing else mattered. It was a stunning kind of reality for me. She was so peaceful when she spoke those words. So matter of fact, so knowing. I couldn’t quite accept it. Could not quite wrap my brain around the fact that every material thing in this world that everyone agonizes over and analyzes and cares about and strives for… were suddenly gone. Not just irrelevant or meaningless, but not even there, as if they never existed. The only thing you take with you is love, anything else, on any plane other than this earthly one, simply disappears, as if it never was.

The next morning, when I came into see her, she whispered to me to please call the doctor, that he would give us something. Outside her room, my sister and I collapsed into tears once more as we had done so many times before in that very spot. Brett looked at me and said grief and fright in her voice, “You know what she’ll do, right? We have to get it. I have to do this for her. She doesn’t want it for pain, you know that, right?” I knew that.

I called the doctor. I told him, without actually telling, what was happening. He knew. He said we needed to make her comfortable. He said he would prescribe morphine for her. My sister left only a few moments after I got off the phone and drove the 180 mile round trip to Bishop to get that bottle from the pharmacy. I went to her room and told her that Brett had gone to get it… that it would only be a few hours more, now. That it was coming. She nodded without saying a word, relief filling her eyes before they closed and she slipped into the shallow fitful sleep that had been the only crumb of relief she had been able to have for so long.

She woke up over and over in the next few hours, asking again and again where Brett was. She’s coming, she’s on her way…..

When Brett finally did return in the early evening, she only gave her the prescribed amount of morphine for pain. But when I said goodnight to her that night, inside I knew it would be the last time I spoke to her. Letting go that night was one of the hardest things I’ve ever done. Prepared for it as I was in the past days, still those few moments before she fell asleep as I tucked her in like I had many times, were brutally heart breaking. I lay for awhile with my head resting on her shoulder. I told her I loved her. She smiled and mouthed the words back to me, her voice no longer audible.

The next morning when we came into see her, she was not awake. She lay on her side unconscious. Her face was very pale and her breathing was shallow.

I stood there, off to the side next to my Dad as her body took its final breaths. The sound after that last tiny out-breath left a deafening silence. My mind went blank as the tears just flowed down my face. My Dad hugged me tight and said that she was gone. I wanted to close my eyes and look away from the face that was not hers anymore. All the light of her was gone. My Dad told me to go tell the others. As I walked down the hall, I was numb and stunned. When I saw my sister, she knew instantly from whatever she saw in my face. I kept walking as she passed me. I found my brother in the next room. He looked at me and I blurted that she was gone. His eyes were clear and hurt. He hugged me and everything came crashing in. The sound that came from me was out of my control. It felt as though I were outside my body watching myself.

I will always love you mom
Kat.


After two years of remission Donna’s breast cancer metastasized. Over the next four years, despite endless bouts of chemo-therapy, the cancer reappeared in her lungs and spine. The lesions in the lungs caused them to flood with fluid, which had to be drained periodically. Since the draining procedure could not be done under anesthesia puncturing either lung and risking collapse was not only dangerous, but also excruciatingly painful. Each procedure drained over a two liters of fluid and gave her some degree of relief, before the lungs gradually re-flooded.

Years of chemotherapy had destroyed her immune system. In her final month of life she could not shake off a bout of stomach flu. She vomited up every morsel. She was starving and fighting for every shallow breath her flooded lungs would allow.. The slightest exertion exhausted her. Even talking was too much. She could barely whisper out a simple request. The bone cancer in the spine ached unrelentingly. She could not lie down without flooding the lungs. The oxygen machine beside her bed churned day and night. Without food and short of breath her cells were without energy. She could not summon the strength necessary to get up off her bed and take the step onto the porta-potty without help. She was literally drowning alive. No position gave her comfort. Her sleep was fitful. She was being relentlessly tortured, day and night.

Realizing that her body was beyond recovery, she dumped all her chemo pills and refused further medical treatment. The weeks of relentless torture she was going through could not be endured for long by any of us. Our helplessness could only be alleviated via escape. It drove all of us except Kat and Brett from her room.

The week before she died, Donna made three uncharacteristic private observations that disturbed me deeply.

“Shoot me.”
That request held significance between the two of us. We had often discussed the ethics of euthanasia. I had, in fact, practiced it on our animals. During the twenty five years of our marriage, I had taken on the responsibility of putting down all our aging pets. I had often said that if one did not have the personal fortitude to put down one’s own pet and preferred instead to leave that final execution to a stranger, one did not truly deserve the loving exchange that pets brought to human life. The manner of execution was not an issue for me. I had been a big game hunter in Africa during my youth. I knew all too well how to make a clean kill with a well-placed bullet.

The relevance of her request burned into my consciousness. The gulf between human and animal was too vast. I knew I could not do it. Not with a gun.
“I could never shoot you, my dear”
She said nothing more about it, but the inference was clear. She wanted an end to the torture.

The idea of leaving her to continue suffering had to be confronted. Euthanasia was suddenly no longer just an intellectual exercise or a merciful animal killing. Putting down each pet had always been a heart-wrenching struggle. In the moment of death, they knew exactly what was happening. I had to steel my resolve every time, and then live with the memory of it until it faded. Now it concerned a human life. The need was immediate, very real and very personal.

A week later, without telling me, she had decided to end her own life by taking an over-dose of morphine. What concerned her was that the over-dose might not work. In this indirect manner, in the earlier conversation she was leaving me the message to make absolutely sure that she did not come round again.

If the overdose did not work and she started to recover, I had to kill a person I loved dearly. This time, I was sure, the awful nature of the memory would never fade. The alternate option was worse, leaving her to suffer.

The instant finality of a bullet in the brain was out of the question. The only way to ensure certainty without being charged with murder, or at least man-slaughter, was to smother her. On that final night, after Brett woke me to say that she was going, I agonized with what I had to do if the drug failed. I sat beside Donna’s bed throughout the early hours before dawn, listening to her labored breathing, praying that the over-dose of morphine would work. My mind kept shying away from the horror of having to do it. Which of the two horrors was worse? Smothering her and living with the memory of my last act with her? Or living with the self reproach I would feel if I left her to die in agony, knowing that I had failed to accede to her last request? I was a child, wrestling with a serpent in each hand, knowing that a bite from either would poison me.

Mercifully I was not put to that supreme test and left to dwell forever over the memory of it. Donna, thorough as always, had taken a dose large enough to kill an ox. Her labored breathing stopped in mid- morning. She passed without awakening. None of us will never forget the silence that followed the expulsion of her last breath.


For me euthanasia is no longer simply the pseudo-intellectual exercise I once engaged in during the national debate over Dr. Kervorkain’s televised experiments. It assumes an entirely different dimension when confronted in real-life circumstances. I am humbled by the thought of the millions of family members who have been, and still are, forced to grapple with the awful reality of it.

To this day I cannot truthfully say that I could have gone through with it if the over-dose Donna took had failed. I have to believe that I would have found the personal resolve. Sitting by instead and watching her suffer as she drowned in her own fluids would, I believe, have haunted me far more cruelly. In my view, when terminal illness is on the line, euthanasia is strictly a family issue. Since it evokes the deepest family feelings of love and care, merciful termination of suffering has nothing to do with either Church or State. The buck stops and rests on the shoulder of the eldest family member. There may be concern that the act would be abused by some. But that in itself, cannot be allowed to hold the hand of mercy from the majority of us.

Facing criminal charges for murder or manslaughter only adds to the burden of such a heart-wrenching decision. Any argument against it by religion is fundamentally subjective. In any event, a personal request from the sufferer is all that really counts. Merci-killing is a final act of love, not hate. It is not an escape from reality, but direct engagement in it. Maturity calls. The aftermath is between the perpetrator and a merciful God.

Suicide.
“This is so undignified.”
Donna gasped that out as she sat on the edge of her bed, too weak to rise and do her toilet. Those were also among the last words she ever spoke to me. She had resolved within herself to die that night.

Was Donna morally right to take her own life? In ancient times there was no question that each individual owned that ultimate right. In fact, we were morally obliged to do so as a question of personal honor once we became a burden on our family. So who and what authority stripped us of that basic human right? Religious dogma? Political edict? Surely such a supreme act has to be between each of us and our God.

I believe with all my heart that Donna owned that right. I do not believe for an instant that because she exercised that right she has been denied entry into the heaven of her choice. If God loves anything in the human spirit, He loves personal courage. Donna had that - and then used it in her moment of supreme crisis. Who would dare suggest further eternal spiritual suffering added to the physical? Surely not a merciful God!

Donna did not believe that one God fits all. The exclusive concepts of God espoused by any religions appalled her. In her view every one of us has our own ideal of a personal God whom we pay homage to in our own particular manner. That God loves us for who we are – both in our weaknesses and in our strengths. He/She is silent witness to our lives and shares every thought word and deed with us, in triumph or in suffering. And if such a Supreme Ideal of God is not that personal Lover to each one of us, then what use is such a God if He does not empathize with us in our final hour?

So I say this to Donna’s departed spirit: May your loving and compassionate God rest and bless you. The memory of who you were and how you conducted yourself in this life and the courage you demonstrated in your final hour will never fade from our hearts and minds.



Reason for Being

“Life is pointless.”

Taken out of context, that next statement, also made by Donna the day before she died, seemed to refute everything she lived for: Throughout our years together as husband/wife, partner/friend, I had seen her do everything humanly possible into putting all her care and a distinct reason for being into her life. She had three grown kids who all admired and adored her. She was step-mom to four more of my other children who all felt the same way towards her. She neither drank nor smoked. She exercised regularly and took good care of her diet. She had a strong work ethic and took pride in everything she did and did it excellently. She had attended personally to the wants and needs of her paralyzed mother, every single hour of every day for the past ten years. She had chaired the PTA and a woman’s charity organization. She had helped to turn a remote ranch out in the Nevada desert into a functioning non-profit research foundation. She believed deeply and truly n the existence of God and in a consciousness that survived physical death.

Why would a person who had lived such a principled and productive life, remark in her final moments, that human existence is pointless?

It took months after Donna had passed for me to contemplate on those words and gradually penetrate the depth of thoughts and feelings that might have gone through her head and heart in those last devastating weeks when she finally realized that all hope was gone and that no miracle was forthcoming. I will attempt to share what I believe to be her reasoning in the epilogue. What needs to precede that is to put Donna’s last statement into context with her illness and the way she dealt with it. This can be done via the series of video-taped interviews I had with her at various intervals over the years during her battle with cancer.

I believe that Donna’s articulate commentary on her cancer and its treatment, and how that affected her outlook on life, can perhaps be of assistance in helping others to gain an added degree of perspective on the ravages that merciless plague is creating among so many millions of families..

We will never know the exact number of people who have died of cancer over the centuries, or be able to evaluate the degree of pain and hopelessness the victims and their families who suffered with them. Eight million have died of cancer in the last year alone. Perhaps as much as quarter billion dead from cancer in the 20th Century The numbers are staggering. They far exceed the casualties of all the world’s wars that men have fought and died in. All cancer war wounds prove fatal. Remissions may last for years, but in the end the victims die from their cancers –their deaths are not natural and do not come at the allotted time required for a full life experience. Not one of those deaths is pain-free.

Few war stories tell of the heroes who fought and died in the heart-rending battles with cancer. The stories that are told do not begin to describe the true depth of ravaging heart-ache that has been wreaked on helpless families who can do nothing but sit and watch a parent, and worse still, a child, suffer extreme levels of pain and gradually waste away for months and years on end. No medals of honor are handed out for feats of special bravery. No public memorials are erected to commemorate the tens of millions who have fallen. There is no way of evaluating the loss to their families , or the mourning they have do, so alone. There is no national ceremony. There are no State funerals for our millions of cancer warriors.

No life, no matter how menial, is without merit or profound significance. Each of us has our own unique story which is worth relating in context with the events of the period we live in. If individual human life has any purpose, it is to build depth of character and thereby, via shared experience, contribute to the on-going evolution of our species consciousness. Ordeals build and test character. The greatest gains come via pain. It has always been that way. Ancient societies designed and set their own painful puberty ordeals for their children to learn from. Today, our ordeals and tests are mostly intellectual. Yet physical pain remains as the supreme test.

The central questions that underlies all terminal illness are: : Is it God, who invests pain and death upon us? Or is it accidental? Does the ordeal of cancer have spiritual purpose? Or is it simply meaningless cruelty? For those who spend so many years dying of cancer, they are profound questions that never leave their consciousness throughout the ordeal and which need answering. If some believes in accident, then they struggle as hopeless victims of meaningless cruelty, and their life as well as their death, no matter how bravely they fight, is indeed pointless. On the other hand, choosing to believe in God allows them to see themselves not as helpless victims, but as chosen initiates. They become warrior fighters and the ordeal of cancer becomes the test of their love.

Those of us living without constant pain and the constant specter of death hanging like the sword of Damocles above our heads, yet seeking to gain a deeper perspective into some of the profound questions of life, can learn from seeing how a person with depth of character deals with the ordeal of extra-ordinary pain. Donna was a person of character. Cancer put her belief in self and in God to the supreme test. For seven long years all in our family, saw how she dealt with it. Her daily struggle, not just with the discomfort of deadly disease and the hair-loss, which made public appearances awkward; but with the endless hassle over the prescriptions for all the additional medications she had to take; the hours on-hold on the phone trying to deal with the flaws in the health system, tracing her records and X-rays misplaced somewhere between the local hospital in Bishop and the Cancer Center in Reno; making appointments and long-range travel arrangements from our remote farm for endless check-ups and chemo and radiation treatments; all of this while running a large house-hold, tending to a paralyzed mother and caring for a child with Downes Syndrome. Her patience and wry humor at the irony of her situation, made us all wonder where she found the patience and wry humor to deal with it, and if if we ourselves could have handled the sheer tedium of it with such fortitude. She never once, throughout all those years, called on any of us for special sympathy. Her thoughts and comments about breast cancer and the specter of death that haunted her consciousness for so many years, and about life itself, provide meaningful insights into our reason for being.