No Longer Worth Living?

Carolyn B Healy

I slid into the pew. It was a Tuesday night and I went alone. There were about twenty of us, an assortment of silver-haired elders with a smattering of younger people like me, one still dressed for the office, most more casually, as if they’d stopped in on the way to the grocery store. Each of us carefully avoided eye contact with the others.

In the back, a table was covered with tall stacks of pamphlets available for a small fee, “The Right to Die,” “Special Issues in Alzheimer’s Disease,” and other titles. The stacks were so high that it suggested a miscalculation – either another hundred or so people had been expected, or each of us was to grab multiple copies to pass out to our friends and neighbors. In either case, it made the evening seem like a failure before it even began.

The three speakers whispered together in the back of the room, watching the clock. At exactly seven-thirty, the tall lanky mid-forties man in jeans and a plaid shirt strode to the front, while his colleagues slipped into seats in the first row.

He discussed the founder, a British journalist who had assisted his wife, at her request, to end her suffering from bone cancer by brewing her coffee laced with deadly medications. When his career later brought him to the States, he and several others, including his second wife, founded the Society in 1980 in his garage in California, to bring the “hopelessly ill” news of their right to practice “self-deliverance” and of methods to achieve “hastened death.”

The next speaker was the stocky kindly-looking woman, gray-haired and dressed like Kathy Bates in Misery. Her voice was strong as she presented the public affairs angle. As she covered court rulings, right-to-die legislation and subsequent legal challenges, her outrage grew. She spoke against the restraints on people who simply wanted to determine their own time and manner of death, and the penalties for those who might assist them.

When she got to the part about famous snuff-meister Dr. Jack Kevorkian, the defrocked doctor who claimed to have assisted 120 people to die, her conviction that he was a martyr to the cause leaked out among her facts. The first death he helped accomplish was a fifty-four year old woman who had Alzheimer’s. His last was a lethal injection provided in 1999 to a fifty-two year old accountant with ALS, which led to his conviction for second degree murder.

I set the pamphlets down next to me to give me some distance from heroes who bring death to your door. I had a client once whose religion taught that bad spirits attach themselves to objects, and won’t go away until the objects are discarded, or better yet, destroyed. The issue that had brought her to counseling was guilt and anguish that had plagued her for months after the end of an illicit relationship. She proved her theory - all her symptoms evaporated as soon as she burned the notes and trinkets left over from her lover. If she was right, these pamphlets might sweep forces into my life I wouldn’t be able to control.

The third speaker, the calm man dressed in chinos and a buttoned-down shirt, outlined the practical assistance system. The wanting-to-die person, while still of sound mind and body, explains his reasons for wanting to end it all. If he passes muster, convincing them of his seriousness and emotional health, he is assigned a guide, a volunteer who promises to stick with him throughout the course of his illness, continuing to discuss the conditions of mind and body and intention. The Society becomes the last matchmaker you’d ever need.

Questions bombarded me. Who are these people, these guides? Survivors of a parent’s excruciating death by cancer? Anarchists looking for the cracks in the social order? Well-meaning humanitarians? Libertarians looking to kick government out of our personal business? Does it even matter what their motives are, as long as the person who wants to die gets to? Is wanting to die enough?

The lecturer, a serene man who wouldn’t worry you a bit if he sat next to you on the subway, laid out the long-recommended method of – well, since they refused to call it suicide– hastened death: a particular cocktail of medications that could easily be prescribed by a sympathetic doctor over time and stockpiled for the final day. They would then be crushed and mixed into applesauce which the individual could feed himself. If he could feed himself.

A newer method was gaining support as well, he explained, that involved helium and a plastic bag over the head, secured with rubber bands or panty hose. The hope was that this method would provide a reduced chance of unintended survival.

Had the woman sitting next to me sucked in her breath at that revelation, or was that me? There seemed to be too little air in the room, too little movement to account for twenty-some living creatures.

As one who has spent a career trying to stand between suicidal people and their permanent solutions to temporary problems, I had negotiated dozens of deals, even written them down so my client could sign them, “no harm contracts” they are called: “I won’t act on a suicidal impulse unless I call you/go to the ER/ call the hotline.” What an optimistic endeavor, to make rational agreements with people subject to irrational and overpowering impulses. I sometimes wondered if I helped keep people alive by tipping them off to how devastated I would be if they did kill themselves. Maybe the point is to know that someone cares that you are still here, that your counselor is awake at two a.m. hoping that you haven’t pulled the trigger.

But this, it began to dawn on me, was entirely different. These people had permanent problems, terminal ones. It also became clear to me that while the suicide decisions that I had tried so hard to prevent can teeter on thousands of precarious and temporary impulses, the decision necessary to a end a life as the Society laid it out is made day after day, over a period of time, and involves planning and long-lasting intention. And courage. And help.

My neighbor offered me a mint. I accepted. A few audience members spoke of their own situations – a spouse with a painful disease, a parent who had asked their help – most did not.

Meanwhile, across town, my mother sat, watched over by assisted care staff. She was at once no longer herself, yet unmistakably and indelibly who she had always been, in the moments when she would still surprise me with a joke or gaze at me with undiluted love. When on earth would her moment have been, when she would have thrown in the towel, declared her life no longer worth living? Should I have asked her that? We were certainly past it now, a relief of sorts.

She would have been, I told myself, of two minds: she would support the right of a person not to live out her days in dependency and diminishing faculties. But she was also one to let things run their natural course. She would survive as long as she could because life was good and she was part of it. Realizing that, I could breathe easier.

As I stood to go, I looked again at my neighbor and smiled.

“Good night, dear,” she said. She patted my hand and stepped into the cold night. I folded my handouts and followed.
CBH 07/23/08