The Sweet Good-bye

Another weekend, another chunk of writing to read ;^)  This piece was part of a series of personal essays that I wrote a while back.  

“Justice?”  is what Dr. Jack Kevorkian was heard to softly utter upon hearing that he was sentenced to 10 to 25 years in prison for the second degree murder of Thomas Youk, a fiftysomething Detroit, Michigan accountant who had been suffering from ALS, also known as Lou Gehrig’s disease.  Mr. Youk had apparently requested the good doctor’s assistance in speeding his death, a request which Dr. Kevorkian granted.  Publicly.  On CBS’s 60 Minutes, during prime time.  A little in-your-face to be sure, but how else could he bring this issue more blatantly into public consciousness?

Judge Jessica Cooper, who had not allowed the deceased man’s family to testify during the trial, and who was not swayed by the family’s subsequent pleas for leniency in which they underlined that the good doctor was merely carrying out the wishes of their loved one, said that the trial was not “about the political or moral correctness of euthanasia”.  Instead, it is reported, she said “it was about you, sir.  It was about lawlessness”.

Yeah, but what about that law?

As a very impressionable young woman, I spent a couple of my university summers working in a horizontal hotel. That’s what I call a hospital.  Specifically, I worked in an Extended Care Unit.  My job as a Nurse’s Aide required me to work with terminally sick and elderly people in the final years, days and hours before they check out.  I’ve seen the last flicker of the flame of a life extinguish, many times.

The Horizontal Hotel can be a lonely place.  Long-term residents have been ravaged by strokes, or Alzheimer’s, and there are patients with chronic and terminal diseases.  There are people who have become incapacitated to the point that they are incapable of managing even the most basic of human voluntary functions, like eating or drinking or being continent or speaking or recognizing their own children.  And as they become more and more ill and disconnected from the world, it gets harder and harder for their families to spend time with them.  It is just too painful.  In these places the boundary between living and dying can become very blurred.  A person may linger there, hovering, for days, weeks, even months.  It can be a very long death watch for a family.  So in the end, they are often alone when they die.

It’s not the way I want to go, being warehoused in an old folks home or a long term care facility while my body and my mind slowly shut down.  Or hanging by a thread to life, a respirator or intravenous fluids or antibiotics, all things man invented, only prolonging the inevitable and the natural.  I’ve been there, seen that, and it isn’t graceful or poetic or dignified.  It is not how I would want my family to remember me – a broken shell of a woman, a wife, a mother, a daughter, a sister.   A living corpse.

I wonder how many of those people that I took care of, some of whom were no longer living, by my definition, and instead were only being kept alive, would, if they had been given a choice while they were still capable of making it, have chosen for their life to come to an end with a sweet good-bye.

All I know is that I do not want to make my departure from life in the horizontal hotel, alone.  I don’t want to be kept alive, plumped up by force-feeding, turned every four hours like a rotisserie chicken, unconscious of the world around me, with the hope that maybe, one day, if I’m kept alive long enough, there might be a cure to what appears at the time to be an irreversible condition.  Or with the hope, by some divine intervention, that my death sentence will somehow be forgiven.  Or with the indecision and uncertainty that is inevitably brought to bear by conflicted parties, duking it out in a courtroom.  Or with the fear that if my wishes are granted, that the person who did the final good deed for me will end up serving time in prison.

It’s a shame that Dr. Kevorkian looks so eerily like the grim reaper.  He is not a good poster boy for euthanasia.  But, at some level, I believe he is a pioneer for the movement, and perhaps in five or ten or twenty years euthanasia will be considered a human right instead of an indictable offense in North America.  Hopefully that will happen before I am in my dotage or am diagnosed with some terminal, painful, debilitating disease or am a victim of a serious accident that leaves me with as much dignity and brain function and enjoyment of life as a cauliflower.

Then, we might look back and remember these days with shame, when people like Sue Rodriquez, a British Columbia woman who was ravaged by ALS, bravely, but fruitlessly, spend the few final days of their lives appealing to have their misery ended legally.  She fought the good fight, putting the last, precious moments of her life in the public eye so that her life and her death would have some greater meaning.  So that people who followed behind her would not have to make appearances in court rooms in their wheelchairs, barely able to still communicate, to ask a panel of strangers wearing black robes to allow her to end their life legally, by a doctor-injected overdose.  Sue Rodriguez had a young son, so she had a lot to live for.  But her crippling disease was making it impossible for her to be a mother to him, and her chronic pain and the terrifying sideslipping deterioration of all of her capabilities drove her to want to have her life ended, while she could still say good-bye.

In the end, her request was denied, but her life was ended anyway, with a doctor and a compassionate politician who had become her friends in the process, amongst others in her company.  Accomplished without video cameras, the participants in her death were never charged.

We will remember that we chose to perform this ultimate act of kindness and love for our aged and ailing pets, to hold them and stroke them and thank them for their years of companionship and affection, and shed our tears as they slip peacefully from this world to the big doggie park or cat condo in the sky, aided by a painless injection from an animal doctor.

It seems so ironic that we are unwilling or unable to offer the same kindness to humans.

I have elderly parents who have both taken me aside on separate occasions with concerns about dying in the conditions, that as a medical family, we know exist in hospitals.  I would like to think that they should be permitted to write their wishes in a living will.  Something that defines their line between what they consider to be quality life and the circumstances under which they wish to be allowed to die.  And under what circumstances they would like that process to be speeded.  Something that will hold up in court and be respected and legally administered by doctors, should the need arise, without them or their family having to go through the agony of battling a judicial system. Without anyone feeling that there will be blood on their hands for carrying out the last wishes of their loved ones.  Something that will speak for them if and when they are no longer able to speak for themselves.

I believe in the sanctity of life.  But I draw my line at the moral majority who seems so intent on insinuating itself into our bedrooms and onto our deathbeds.  I do not understand why a certain group’s religious convictions should have any impact on how or when my life comes to an end.  Nobody is forcing them to sign a living will, and no one is suggesting that we speed their death in any way.  Nobody is suggesting that anyone make a decision about quality of life, except the individual whose life it is anyway.  If they want to tough it out, to fight the good fight, that’s okay with me.  They may believe that it is a mortal sin to bring an end one’s own life.  But I am not worried about rotting in hell, I am worried about rotting here on earth.

So I am not suggesting that we undertake geritol generation genocide, or that anyone who is having a bad day gets given an overdose.  Instead I am advocating for the rights of adults, who make a decision at a time of sound mind, to have control over the management of their own life, and death, should they choose to take it.

I believe in the sweet good-bye – a circle of love, a gathering of a family, the closest of friends, who surround a departing soul with comfort and acceptance.  An opportunity for sick and suffering people to be released from their misery in the kindest, most humane, most dignified and most beautiful way possible under the circumstances.  An opportunity to soar above the pain and the fear and to exit from this world like a shooting star, leaving a trail of star dust and tears and happy memories to mark their passage.  I think that is better than a family feeling guilty for feeling relieved that the ordeal is finally over – the ordeal being watching a loved one die in slow increments, having sometimes lingered for a very long time in the twilight zone, that netherworld between life and death.   And living with the guilt that, at the end of such a day, their loved one may have died alone.

I would like to check out on my turf, on my terms, in the arms of my family, at the time and in the way that I choose that is right for me.  I would like to depart, not with criminal furtiveness, but with a sweet good-bye.

It is the kindest thing, to let go when there is no hope.  And I think there is a big groundswell of people out there who would like to see it made legal.  The angel of death, Dr. Kevorkian, maybe went a little too mainstream with his on-air efforts to bring the subject to the forefront.  But the reality is, it happens more than we think.  There are doctors out there who are willing to leave their actions open to misinterpretation, who will give that extra push of morphine.

Is it murder, or is it kindness?