Right to Die

by Hazel McHaffie

  Naomi just nodded when I told her where I was going. No questions.

  Curtis was exactly what I needed: professional, unemotional.

  ‘I know you must be knackered, end of a long day, all these people loading their problems onto you…’ I began.

  ‘It’s my job. Don’t worry about me. I’ve got as long as you need. I’m glad you felt you could come.’

  ‘You’ve been very good, coming to see me, letting me warble on. I don’t want to take advantage.’

  ‘You’re not but, hey, I could use a cup of coffee, so how about I make us both one, and then I’m all yours.’

  In the end I just blurted it out: Mother, Naomi, the pressure. Reporting, not judging – I hope.

  ‘Difficult. You can see it from their point of view too.’ he said quietly.

  ‘The more I think about it, the more I think the whole thing’s so unfair.’

  ‘Uhhhuhh?’

  ‘Okay. Imagine I’m in a persistent vegetative state. I can’t say what I want. One of your cronies can decide to stop feeding me and let me die.’

  I paused; he nodded slowly.

  ‘Scenario two: I’m on a life support system but I can still communicate. I ask for it to be disconnected. They’d have to do it.’

  He pursed his lips at this.

  ‘Instead of that, here I am, able to say what I want, in line for suffering much more than someone who knows nothing, but because I don’t need life-sustaining treatment, nobody seems able to help me. Where’s the justice? Damned if I can find it.’

  He leaned back in his chair without taking his eyes from mine.

  ‘I sympathise. But very eminent philosophers and moral theologians have maintained that a person can’t consent to his own death.’

  ‘Why not? What about Ms B? She consented to her own death.’ Trumped!

  ‘Indeed she did. But causing death, deliberately, isn’t the same as allowing to die. In Ms B’s case, she was rejecting the prolongation of her life by artificial means. And the doctors were simply allowing the underlying pathology to run its natural course. They weren’t slamming potassium chloride into her.’

  ‘So if we get MND, we’re penalised because our underlying pathology takes so long to kill us. We need a serious road accident, or a sudden catastrophic stroke or heart attack to rescue us.’

  ‘I hope you’re not about to ask me to push you down the stairs!’ Curtis gave me a look of mock horror.

  ‘Like I say, you read too many novels, Doc! Between us we could hatch a few original plots, don’t you think?’

  He grinned back at me.

  ‘All I’m asking is to be spared that last bit. A swift painless end before I get to an advanced state where I can be starved to death or have my ventilator disconnected. Is that so unreasonable? The only viable alternative I can see is to cut my life even shorter and do the deed myself.’

  ‘Things like slippery slopes and landslides and dominoes flash through my brain at this point.’

  He softened the potential irritation with a grimace.

  ‘Philistine!’ I countered in the same vein.

  ‘What about the rights and interests of others – including your lovely wife?’

  ‘Which brings us full circle. If I had some reassurance about the end you could argue it would be in her interests because it would relieve the tension now. We could enjoy the present. I’d be more bearable to live with!’

  We sat for a long moment in silence – not uncomfortable.

  ‘If she knows you’re contemplating suicide, she must be horrendously stressed. Would it help for me to chat to her about all this?’ he offered. ‘Find out more about what she knows, what she fears, what she expects. With your knowledge, of course, building on what you’ve told me. You could both do without this additional stress.’

  ‘Which is exactly why I didn’t tell her until she forced me to. I’m not at that stage yet.’

  ‘But in fairness she doesn’t know when you will be.’

  ‘Point taken.’

  ‘If you prefer, you can tell her I’m here if she’d like to talk about it. No pressure. Or talk about it yourselves and see if you’d rather both meet with me, together.’

  ‘I’ll do that. Thanks for being a listening ear.’

  ‘You’re welcome. Any time. My advice for the time being is: try not to dwell too much on the future. You’re doing incredibly well. I read all your features in the papers; only wish I could express myself half as well. And I can’t wait to read the novel.’

  ‘Well, thanks for that. And while we’re on the subject… I was wondering… if it’s not an imposition… would you be willing to read the first draft? I’m impressed by your ability to get to the kernel of things when you critique novels. You’d be ideal. If you could find the time.’

  ‘I’d be honoured.’

  ‘You’d get due acknowledgement, of course.’

  ‘No need for that.’

  ‘And a signed copy.’

  ‘Ahh, now you’re talking. An investment for a rainy day. An O’Neill first edition!’

  ‘Hmmm. Fat chance! And of course, even the signature presupposes I live beyond publication day.’

  He’s got something special, this guy. He isn’t just sticking to the rules without compassion. He’s agonising too. In the kindest way. I’m back to that again. *(For Ideas folder: kindness)

  But there really is a difference. I found this during my brief stay in hospital courtesy of Malcolm Inches. It’s possible to be seen promptly and politely, be correctly diagnosed and treated, without a scrap of kindness being shown. But in the midst of all the delays and mistakes and other administrative nightmares that clutter your day when you’ve nothing better to do than notice when the promised urinal doesn’t materialise, or the chicken korma you ordered yesterday becomes kedgeree today, or your favourite visitor misses three quarters of visiting time because the staff despatch you off to X-ray five minutes into the allotted hour – well, a single act of real kindness can soften the overall dissatisfaction.

  I guess natural kindness isn’t taught; it comes from within. What is kindness? – warmth, sensitivity, tact, communication? Curtis. But what does it cost him? He must go home at the end of the day drained to the dregs. Look at the load I dump on him, and I’m just one of hundreds. Maybe he’d last longer if he just stuck to the purely medical, technical things, left the emotional stuff for his family and friends.

  I must admit, sometimes he gets deeper into my psyche than I intend, or I daresay he bargained for. Then he has to deal with what he finds there, talk me back into a safer place. Like he did today – I realised afterwards, I came away from his surgery with the desire to hand him the novel stronger than my wish to end my life. Was that the result of his skill? Or my vacillating emotions? I hope Naomi will talk to him.

  She’d elected to go alone. Dr Curtis had been kind to her, too. Listening, confidentiality safe with him.

  ‘It’s his choice in the end,’ he’d said gently.

  ‘Now I’m confused. I thought you didn’t support the idea of suicide.’

  ‘I don’t. Although I have to confess, I can understand his reasoning. And from where he sits, I’m letting him down, forcing his hand.’

  ‘So, if you won’t do what he really wants, how is it his choice?’

  ‘Because he’s a competent patient able to make up his own mind. But time changes minds. Autonomy isn’t a static, absolute sort of thing. It’s a dynamic state. It can be affected by all sorts of things – illness being a major example. When we’re ill it’s not always possible to see the issues clearly, or to make the decision we’d make if we were in good health. Because of that, we doctors have to be very aware of the dangers of precipitate action.’

  ‘So you think Adam is diminished by his illness?’

  She’d stared at him in amazement.

  ‘I’m not sure.’

  ‘He’d have a fit if he knew you thought that! Seems to me he’s ruthlessly logical. Even though I
’m appalled by his conclusion, I can’t see a flaw in his argument. And that’s also what frightens me.’

  ‘In Adam’s case, I have to admit, he’s looking into things in enormous detail and depth. It’s no knee-jerk reaction. He’s impressive. He’s made me brush up on the legalities and ethical arguments too – which is no bad thing!’

  ‘But you still think his power to decide is impaired? I’m sorry, but I disagree. And it’s because I think he’s fully capable of arguing a case for killing himself, that I’m most afraid he’ll do it. Certainly I couldn’t persuade him out of it any more than I could argue his mother out of her position.’

  ‘What is her position?’

  She wrapped it up carefully. It wasn’t hers to tell.

  ‘And do you see Adam as just as immovable? In my experience, religious scruple is the position most resistant to reason and persuasion.’

  ‘Well, I certainly never win arguments when he’s thoroughly thought through the issues. And on this one, I get a distinct impression that he’s argued each tiny step with himself; there’s no way I could find a chink in his logic. Maybe some expert philosopher might better him, I certainly can’t.’

  ‘And I suspect I couldn’t either. Which is possibly why I’m guarded in what I commit to.’

  His honesty was impressive. But the ideas rankled.

  ‘At the end of the day, even if, technically, the philosophers could better him in an argument, would their case be any more defensible than his? It’s his life. If he thinks the quality of his life’s too awful… Well, I know what he’d say about somebody else deciding!’

  ‘And that would be…?’

  ‘He’d argue that only he – inside the illness looking out – is in any position to know what’s best – for him.’

  ‘So, you’ll go along with whatever he wants? No questions?’ He was gentle with it, more wondering aloud than removing the rug.

  ‘Well… No, but… Oh, I don’t know! It’s all so confusing.’

  ‘I know. I understand, believe me.’

  ‘So what do we do?’

  ‘I’m inclined to sit tight and not do anything overtly. Listen. Be there for him, let him know we sympathise and understand his dilemma. Do everything we can to make sure his quality of life is as good as we can possibly make it. My aim certainly is to walk alongside him. And I’m looking to see if his decision is indeed a sustained one. I want him to make the best choices he can make.’

  ‘What do you think is best?’

  ‘That’s always a dodgy question to answer. Lots of patients ask that. Sometimes it’s easier to blame someone else if things go wrong ...’

  ‘Oh, I’m not…’

  ‘No, I know you’re not. And nor is Adam. He’s looking for an ally.’

  ‘So, if he says life’s intolerable and you think he’s been saying that all along, then why…’ It sounded too impertinent to ask.

  ‘Why don’t I do something about it?’

  ‘Well, yes.’

  ‘It could be that later down the track we do have to re-visit that scenario. But at the moment, I think Adam’s just thinking through the options.’

  ‘Do you think… might he…?’

  ‘He’s got a lot of things to live for. He’s talking about events in the future. He’s totally into his novel. He’s looking forward to seeing it published. What he needs is options. I think the worst thing we can do right now, is force him into declaring a position his pride will make him stick to – just to show he’s nobody’s puppet.’

  ‘But what if he does decide what he wants but he’s physically unable to do what it takes? He’d be so frustrated. But I just don’t think I could…’

  Dr Curtis interrupted swiftly. ‘One thing he’s absolutely adamant about: he doesn’t want you to take responsibility for that. He’s made that crystal clear. I don’t think that’s breaching confidentiality.’

  ‘But…’

  ‘We’ll find a way. Whatever else, it won’t come to that.’

  9 OCTOBER—Feeling foul. Headache making computer work impossible.Rang Joel. Tried to explain. He probably thinks I’m losing the plot.

  10 OCTOBER—Fouler still. It’s an infection – virulent apparently. Hope it kills me off.

  16 OCTOBER—Another week wasted in my extravagantly wasteful life. I’ve just dragged myself to this machine, wrapped in blankets, yards of tissues, lozenges at the ready. Naomi’s gone to the shops; she’ll kill me if she finds me in here, against medical advice. But I need to jot this down. Things are getting out of proportion in my sick-bed.

  What if I had ended it all on Tuesday, the most hellish day in a whole row of fiendish days? I was too far gone to be even contemplating action, never mind performing it, but if I had, where would I be now?

  My mother believes my soul would have winged its way to its Maker. Or no, maybe not. Hers would, mine wouldn’t. Not if I committed the ultimate sin; ending my life by my own hand. Is that the unforgivable sin? I can’t remember the order in her league table. I rather suspect that’s the one that merits eternal torment.

  Jannine, a girl at work, tells anyone who’ll remain stationary long enough to listen, that if they put their trust in her God their bodies will moulder into dust, but one day a great trumpet will sound, and miraculously all those fragments of ash will assemble themselves, and a body looking the same but now gloriously immortal, will rise again and stomp the earth for all eternity. The devil in me always wants to ask: Will I still have the tiny scar on my right buttock?

  The Jehovah’s Witnesses who doggedly ring my doorbell once every two months to try to save me from my heathenish ways, tell me unequivocally that death’s the end for me. There’s no such thing as an immortal soul, they reckon. To be fair to them, when I looked it up, as per their instructions, I couldn’t find a single mention of any such thing in the Bible. They also informed me, without the slightest hint of irony, that only 144,000 people out of all these generations since year zero will be saved and get to heavenly realms. And at this moment in my present unrepentant state, I am not one of them. Me, one of that miniscule elite? Hello?! So why they’re wasting precious time on a Saturday morning talking to me, I can’t quite fathom. Must be to get the ticks in the book of reckoning. That’s totally uncalled-for I know, and I confess to a begrudging admiration for their selfless determination and courage in the face of what must be one of the most thankless tasks in the world. But here in the privacy of this journal – well, any fool can see the numbers don’t add up.

  Rev. Castlemaine’s got a bigger picture of God. He’s a universalist. Comforts everybody with the thought that we’re all precious in the Creator’s sight and He wants to save us all. Being omnipotent, what He wants He gets. I warm to the Reverend’s version of Christianity just because it brings hope to the hopeless and makes God something I need Him to be. But I’m not persuaded he’s actually right – Castlemaine, I mean, not God.

  I wonder, has God got lots of compartments in the hereafter where he humours everybody and just makes sure the walls are high enough between them to preserve their illusions? If I die believing in nothing, is that what I get? If I end it all today, will I just be nothing for evermore? A void. Emptiness. Nothingness. Day after day, year after year, century after century. For ever and ever. Amen.

  Would that be so bad – if I didn’t know anything about it? The way I feel today I’d settle for nothingness. But normally?

  Rev. Castlemaine’s theory is most appealing. But it’s too cosy. The opium of the people. Brainwashing about judgement during my impressionable years deprived me of that solace.

  Eternal torment is bottom of my list.

  Bodily resurrection? Hmmmm. Fairer in principle, but I don’t care to think of Jannine strutting complacently along Queen Street with her inane smile and her squat but indestructible body, while I remain a pile of maggot droppings.

  Mother’s God seems too capricious, but I’d rather be judged by Him than by my mother. She’d cast me out into outer dark
ness and listen to the wailing and gnashing of teeth with a sort of smug self-righteousness that puts being right above other people’s welfare. Well, perhaps I might be her exception. I don’t know.

  Enough of this. Not exactly conducive to the sleep of the righteous.

  I can’t believe how weak this blessed infection has left me.

  17 OCTOBER—Why didn’t I refuse antibiotics? I could have. An opportunity missed. Just shows that you need to work out a strategy in advance.

  Why didn’t I use the opportunity of an aversion to food to start starving myself to death? After just three days of not eating I was positively skeletal. Ten days on I haven’t regained the pounds but I do have an appetite, I actually feel hungry. Another wasted opportunity. Would it have been so hard?

  I’m shocked by the lack of muscle power after only eight days of lying around in a heap. If I’m not ready to depart this life yet, I must make sure I keep up the exercises.

  18 OCTOBER—Jerry called in this afternoon, with his partner, Brenda. Said he was ‘just passing’. Nobody passes Montgomery Crescent!

  He gave me – would you believe it? – a bunch of green grapes in a plastic tub with the reduced sticker half peeled off and some awkward fragments of office gossip. Usual backbiting. Usual bullying. Nothing new. I appreciated his caring enough to give up the time but I was struggling to concentrate.

  Naomi took Brenda outside – she was ‘dying for a fag’. I couldn’t help make odious comparisons, watching them walking up and down. I think the caption is: if you must seek solace in extra helpings and silicone augmentation, swear an oath not to touch stretch fabric. I’m supposed to be growing more benevolent as I put life’s trivialities into the eternal perspective. Clearly I’ve not got to grips with the existential dimension.

  Evening Watched a sickening documentary tonight, about a teenage carer, devoted to his doubly-incontinent mother who’d been left brain-damaged by some violent intruder. He did everything for her, personal stuff, the lot. You’re supposed to be awed by his selflessness; I wanted to give him permission to toddle off and realise his own dreams. No point in two wrecked lives.