When it came time to die, she greeted it with open arms. She had been waiting. Paid her dues.
And as far as she was concerned, death was late.
“I had a dream or a vision,” my mother said.
She had called me in October 2018 just as she woke. Her conscious mind not yet ready to process what she experienced.
“A little fat man, I think Henry VIII, came and asked me if I was ready. I told him `no’.”
I paused, surprised. She had been talking about her death since my dad’s death in 2007. She told me then that she was ready to die, too, that my dad had the right idea. Grief-stricken, I told her she didn’t get to do that. She promised me 10 years. She gave me 12. Her plan was to die of a heart attack while eating breakfast; more specifically while eating a piece of bacon.
Later that day, she would deny her vision, swearing it was a dream and nothing more.
I wondered, in her death, did the little fat man come to greet her?
The English language does not have the words to describe or do honor to the complexities of our emotions. Our language cannot do justice to the experience of watching someone you love wither away into nothingness. And the feeling, when the magnitude of everything strikes you. You, too, want to wither away.
Months earlier, my whole body had recoiled when she asked.
“Do you want to go with me to my appointments with MAID (Medical Assistance in Dying)?”
I wanted to throw up or run. Probably both; but I couldn't, I was driving.
“I thought it would be good for you. Help with your work. Maybe you could write about it for The New Yorker?”
“What about as emotional support?” I asked, hoping she would realize that she needed it. But knowing she would swat it away, like an annoying fly.
“That, too,” she said with a lack of enthusiasm. A few moments later she reminded me it wouldn't be long now.
When she learned she had stomach cancer, she surrendered. Stage 3 cancer, with a large tumor in her stomach. Without treatment she would have three to six months left. She understood that cancer of the stomach is an extremely painful condition and that most people die fairly quickly. She decided she did not want surgery or chemotherapy. She didn’t want to have to recover from anything.
She was already weak and tired. She had lived her life. There was nothing she felt she needed to accomplish, do or see. She was content with the life she had lived. For her, it was time.
After her diagnosis, she struggled to eat, saying she wasn’t hungry. When she did eat, she felt great discomfort. A woman who her whole life had wanted to be thin. In two months she lost over 20 pounds. She was frail and skeletal. She refused intravenous support.
She wanted the “little black pill,” as she called it. Later it would be known as the potion. She set out on a mission to get it. And my mother was tenacious. When she decided she wanted something, she got it.
The case manager asked, “Is she able to make a decision about ending her life?” I did my best to reassure the case manager that my mother was of sound mind.
Of course I sometimes questioned her sanity. I did not share this. Part of me hoped that they would find my mother incompetent and deny her the medication. Part of me scolded myself for such thoughts, for being selfish, and for wanting my mother to suffer. But I didn’t want her to suffer, I just didn’t want her to die so soon.
The first appointment was with a doctor to get my mother into the healthcare system. When the doctor asked her where she was, she replied, “Like I give a shit.”
The doctor laughed uncomfortably and did her best to ask leading questions to help establish that my mom, in fact, was not suffering from any mental defect and had an understanding of time and place. I watched the doctor’s face as she felt my mother’s stomach. Her eyes widened, and she briefly held her breath. The tumor was that big, inhabiting half of my mother’s stomach. My mother told the doctor that she was not suicidal but wanted the choice to die when her cancer became too much; when she could no longer handle the pain.
The second appointment was with the same doctor, who this time was serving as a representative of MAID. This appointment was to assess if my mom was of sound mind and could make the decision to end her life. When the doctor entered the tiny room, with me, my mother and the case manager, my mother’s eyes lit up and she said, “When you asked me where I was earlier, I should have asked, are you lost?” Everyone laughed. My mother put on her Southern charm and talked about the research she had done and shared her knowledge about her condition and decision. This time, she said, “I want to die by suicide when I can no longer live with cancer. When the pain is too much.”
During the appointment, they talked about the ceremonies and rituals people created on their last day. The food, the atmosphere. It sounded delightful. A celebration of life. They talked about most people taking the potion with alcohol. She always liked Grand Marnier. Kalua was too sweet. Maybe vodka. In the end, she chose gin.
My mom wanted none of that. She didn’t want her family there. Why make a spectacle out of her death? She just wanted to go. She didn’t see why people made their last day a celebration. She did not want to celebrate her life. Her childhood plagued with trauma. Her adult years consumed with addiction, depression, and anxiety. Life was not worth celebrating for her. Death promised relief, an end to the pain that had manifested itself as cancer.
It is a mixed mess of emotions knowing someone’s death is just around the corner. That somewhere behind locked doors, death and my mother were negotiating her last day. She was forthcoming that on her next bad day, if she got her potion, she would take it.
The next appointment loomed ominously for everyone but her. She couldn’t wait. This was the day she would get her potion to kill herself. She was like a child excitedly waiting for her birthday.
The first chosen death day was her birthday, November 1. As the disease progressed, it was moved to Friday, September 13, a full moon. Witchy and poetic.
“I’m going to do it Friday,” she declared with confidence.
“The day before your daughter’s birthday?”
“Yeah, I’m done. There is nothing to live for. I have nothing.”
I asked if the pain was getting that bad.
“It’s not the pain. I just am done with life.” And the call ended.
These words grabbed me like giant boulders tied to my feet, rapidly dragging me to the bottom of the river. I was trying to catch my breath from the dirty river water that was assaulting my nasal passages and choking me.
I could feel the slow burn of anger caught in my chest. The sadness that clutched and dug its claws into my heart. I wanted to yell at her, call her selfish, call her heartless. Tell her how much I hurt. How much I love her. How much I need her. I wanted to hear she loves me. I knew this would not happen, she had locked away her heart years ago, too much pain for one person to bear.
She called right back. I gathered my emotions like tidying up before a visitor.
“I think I’ll invite your sister up next week and then do it. But don’t say anything. I am not sure yet.”
“I’d like to see you, too, before you go.” I sounded like a timid child asking for something I knew I wouldn’t get. With defiance in her voice: “I said I was thinking about it. That’s all I have. Bye.” Sometimes, she was like talking to a robot.
When you know someone you love is going to die, it is like knowing a devastating storm is coming. You board up your house and hide in the safest place. You sit and wait in anticipation. Each passing minute it becomes more and more difficult to breathe.
The MAID case manager pointed out that all people who decide to engage in medically assisted death/suicide are pioneers; the staff, the doctors, the patients, their families. She again discussed the beautiful ceremonies people held to celebrate their lives. I wondered if my mom did not feel she had a life to celebrate. Or that she would feel let down by the people who did or did not show up.
My mom decided she would not go to the pharmacy or have the potion mailed to her. Instead she volunteered me to pick it up. I tried to explain the complex emotions for me in picking up the prescription. No, she had it set in her mind. I would pick it up on Friday and bring it to her on Saturday.
It’s a bittersweet thing, going to pick up the drug that will kill your mother, but also being able to see her one more time. She had been unwavering in not letting me or my sister schedule a visit with her. Even after I told her I wanted to see her before she died. She kept saying she was not making any plans.
I did not sleep well the night before I had to go to the pharmacy. I had a dream that I decided to try just a bit of potion to see what would happen. The anxiety of knowing for an entire day of work, I would have in my bag the drugs to end her life was frightening. I would be responsible for these drugs. Drugs I did not want to have on me. I felt like a criminal.
The pharmacist spoke to me like I would be with my mother when she took her potion. I did not correct her. She asked if I could update her on how long it took my mom to fall asleep and then die. When I later asked my mom if her boyfriend could collect the data, she protested, saying that the request was morbid and gross. I tried to explain they need to collect data to help future patients. My mom decided the pharmacist must be working on her Ph.D. and needed the data, which she refused to provide.
The pharmacist went over everything with me. No food four to five hours before. Not a problem for my mom. Before taking the potion, my mom was to take the two stomach medicines to stop nausea about 30 minutes, preferably an hour, in advance.
The potion is a mix of four lethal drugs. Most people mixed with alcohol, as it clumps with water. The pharmacist pointed out it has a bitter taste and many people drank something citrusy to help with the taste. She said it would be best if my mom could finish the drink in one minute. No sipping. Straight drinking. She said, for this reason, people only mix the 2 ounces of powder with 2 ounces of liquid to make sure they get it down. The powder came in an 8-ounce brown glass bottle because the powder, once mixed, tended to stick to plastics.
My mom was delighted that I picked it up and drove it to her. My mom, my daughter and I visited for the afternoon. Just like every time I saw her, she was thinner, frailer, weaker. Vanishing, sinking, disappearing. As she lay there talking with me, I couldn't help but wonder if this was the bikini-ready, heroin-chic body she had dreamt of in her adolescence. Potion in hand. The game of Russian roulette had begun. She liked the power and feeling of control that having the potion gave her. In a situation where she felt she had no choice, no options, no control. The potion gave her all of that. My mother would sit in her power of choice. Leaving the rest of us to suffer in silent agony as we walked on broken shards of glass, waiting.
It’s a suffocating feeling when you know you are going to see someone for the last time before they die. It’s like being underwater. You can see the light, the surface above, but you can’t reach it. There is also peace in knowing death is near. Because you know it, you don’t have to worry about the unknown or not being able to say goodbye or make your peace or clear up unfinished business or tie up loose ends. But there are still loose ends and unfinished business. There are always emotions left at the door. Problems swept under the rug. There is always something. Looming death does not clear the slate, it adds to it.
I visited on Sunday, September 22. We talked. I built a Lego haunted cemetery. The irony is not lost on me. She was addicted to Legos. She was thrilled that I was building Legos with her. She was weak but talkative and alert. It reminded me of the days we sat and talked for hours. I missed those days. I said I'd visit the following Saturday if she was still here. She didn’t answer.
My daughter and I visited the weekend of the 28th. We rearranged her room. We moved her bed so she could look out the window or watch TV. She loved looking out the window, watching the weather roll in, the deer graze, the dogs play.
She was in a great deal of pain. She was curled up on her bed. She struggled to move. She refused help. She was tiny, delicate and fragile. As if with one touch she might crumble into nothing. I didn't offer to visit the following week. My heart was a billion tiny broken pieces inside. Outside, I smiled and talked and did my best to make her comfortable.
Monday, September 30, 2019
I was told that she called my daughter before her death, she paused for a moment, hearing my daughter’s voice and her fighting the tears that welled up and demanded to be released. For a split second, my mother contemplated her decision. Then the pain took hold and she succumbed to it. Going through with what she had set out to do, die.
That evening, she took her potion at 6:05, by 6:07 she went into a coma, and her breathing slowed down. She passed between 6:20 and 6:25. The time of death was called at 6:27.