She was in her bed when I arrived. Walking in, I gave her a long hug. The tears I was fighting back began to trickle down my face. I knew this was the beginning of the end.
“How long can you stay?” she asked with a trembling voice.
“I am not leaving until you leave, and I am in no hurry,” I replied. A relieved look crossed her face, now assured that I would stay with her until the end.
Only one month prior, I had gotten the call from my mom telling me she had been diagnosed with terminal cancer. Two weeks after that she was put into hospice care. I wanted to go down immediately, but she did not want to impose on my life and demurred when I suggested coming.
Within two weeks she had deteriorated so much she was unable to care for herself. She was not eating, was forgetting to take her meds, and was so doped up on morphine when she did take the drug that she could not think clearly or remember things. At that point I decided to come to her whether she wanted me or not. Clearly, it was the right decision. She was so appreciative that I would stay and take care of her. Sometimes people can’t ask for what they need the most—our presence. Even in dying, they don’t want to impose. Those people ironically are often the first to have offered care when it was needed by others in the past.
The next day the hospice nurse came and taught me how to dispense the medications, and a social worker came to provide me with counseling. Over the next several days my mother gave up more and more of her autonomy so that she had me answering the phone for her, meeting her friends, and preparing all of her meals. I got into a routine of taking naps when she did so I could be fully awake and present whenever she was awake.
I don’t remember ever really appreciating my mother prior to those last few weeks together. Until the last years of her life I wouldn’t even acknowledge Mother’s Day. I always said it was a ploy by Hallmark Cards to sell merchandise and that I would not celebrate Mother’s Day until there was a holiday for childless women too. Now I can see how unfeeling this spoiled rationale was for not honoring the mother I loved when I was able to do so.
I don’t remember realizing her generosity or support until then. I was too focused on her annoying idiosyncrasies. Her malapropisms. It wasn’t until one of her friends told me that mom was her Ruth Gordon that I got to see her histrionics and exuberance as something positive and fun.
I didn’t understand her level of acceptance of me and pride in me. At the end, all she wanted to do was have me sit at the foot of her bed so she could gaze on her beautiful daughter.
I did not appreciate her courage until she chose to die on her own terms even though she was afraid and wound up fighting for her life with all her strength. I asked her, “What’s the hurry? You are going to die in a few weeks anyway.”
Her response was, “I am in so much pain that every day is an eternity.”
It is terribly painful to let someone you love go, but in some cases it is an act of love. When assisted suicide is something your loved one wants and chooses after all hope for miracles are exhausted and all that is left is endless, unremitting pain, should this right to choose not be a personal one, regardless of what others might think?
I will be forever grateful I could be there for her. In living she taught me many things. In dying she taught me even more. As a childless woman, I wonder who would be there for me if I ever were in need of such help.
- Assisted Suicide - December 30, 2022
Many studies have identified the elements of a good death. The primary ones are: pain is adequately managed, advance directives are honored, the person is in a location of choice, comfortable and well cared for, and surrounded by chosen loved ones. Your mother had a very good death.
Advocates distinguish medical aid-in-dying (MAiD) or assisted death from suicide. MAiD is a treatment choice to avoid final suffering while dying. A patient has to be assessed to be dying within six months. MAiD is legal in all of Canada, ten US states, and some foreign countries. It is a carefully regulated practice where death is immediate. Some name it Death With Dignity. Death is immediate. Records show less than 5% of all deaths in any location where it is legal occur with such assistance.
Suicide is committed by healthy people suffering from psychological illness. It is committed alone and usually in a violent manner.
Switzerland is the only country that allows non-citizens who have a disease that is terminal to use the services of their provider organization, Dignitas. The process of accepting a patient is complex, carefully monitored, and expensive. A new book, “In Love” by Amy Bloom describes her husband’s choice to end his life at Dignitas rather than go through years of decline to death with Alzheimers.
Most countries, including Mexico, have legal protection for terminal sedation, a treatment for a patient whose end-of-life symptoms, especially pain and breathlessness, become unmanageable. The patient is sedated out of suffering and remains sedated, not eating or drinking, until death. It is also compassionate, seldom used, and prolongs dying by days.
While everyone stops eating and drinking before death, the only completely legal, available self-determined way to hasten death is to voluntarily stop eating and drinking (VSED). This is not an easy process, requires 24/7 care. It can take a few days up to two weeks to die, depending on the physical condition of the patient.
The poet Rudi wrote: “Life gives us two great gifts, love and death. Mostly they are passed on unopened.” You have opened both and kindly shared them with us. Thank you.