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At death’s window

INTERVIEW
Dr. Death's second thoughts
A jailhouse interview with assisted-suicide activist Jack Kevorkian.

-PLUS: Author Anne Lamott helps an old friend die.

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Anne Lamott is a novelist and essayist. Her latest book is "Plan B: Further Thoughts on Faith," recently released in paperback.

THE MAN I KILLED did not want to die, but he no longer felt he had much of a choice. He had gone from being tall and strapping, full of appetites and a brilliant manner of speech, to a skeleton, weak and full of messy needs.

He and his wife still loved each other very much, but he’d lost the ability to do the things he had most loved to share during their 30 years together: to cook and overeat, hike and travel. He had always been passionately literary, but he was losing the ability to read and write, which had defined his life. Both elegant and down-to-earth, with lifelong depression and a rich, crabby sense of humor, he was 60 when he was diagnosed with cancer.

One day he’d been like the rest of us, comically forgetful, trying to live as fully as he could while at the same time trying to slow it down, and attempting to get through it all without too much difficulty. Then, stomach pain, headaches and, like sudden bad weather on vacation, months to live.

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Everyone recommended that he contact a hospice provider to help with pain management, but this was not his way. He said that if it was just his body deserting him, maybe. But his mind? His ideas? His self?

Mel and Joanne (that’s what I’m going to call them) told me about it one night over dinner. Their grown kids wanted him to do chemo, but aggressive treatment might buy him six months, or maybe not, and he had decided against it. He wanted to feel as well as he could for as long as he could, savor his family and friends and the beauty of life, on his own terms, in the strange basket of sickness. And if the fear and suffering got too great? Well, they’d deal with that then.

That night was the closest I came to drinking in all the years I’d been sober, but somehow I didn’t. I believed that God would be close to us all no matter how things shook down, even though Mel was not a believer. And the next three months were sort of lovely, a mosaic of beauty, love and his body breaking down. He could no longer hike, and he wasn’t ever hungry. He was, by turns, depressed, fascinated, scared, fine, exhausted, sad, accepting, enraged, grateful and amazed at the love and support that surrounded him. If you have a body, you are entitled to the full range of feelings. It comes with the package.

At first, opiates diminished the pain without muddying his mind, which was as finely tuned as a melancholy thoroughbred’s. But then he began to space out a little more often, and he became terrified by the prospects. One day over lunch, I told him that if he ever experienced too much pain or diminishment, I would try to help him die on his own terms, if he wanted.

He was amazed, and so was I. I hadn’t particularly planned on offering this. I told him about the evening many years earlier when my brothers and I promised my father we would help him die if his brain cancer took him to a place that he could no longer endure. My father was relieved to the point of tears, but looking over the top of his Benjamin Franklins, he pointed at us sternly, and quoted Duke Ellington’s great song, “Do Nothing ‘Til You Hear From Me.”

We promised, but when he got to the point when we knew he would not want to be in that shape, he was no longer capable of making difficult decisions. Two months before he died, when he lay in a hospital bed in our one-room cabin in what amounted to a coma, my younger brother and I crushed up some barbiturates that his doctor had given him to help him sleep. But we couldn’t do it. We were too young.

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All of his old friends who were part of his final months said sternly that we must not play God, that nature must be allowed to take its course — and they were all atheists. So we did the best we could, and it sucked, and it was beautiful. But all the time I knew he had not wanted to end up in the shape he did.

I know if the tables had been turned, he would have helped me out.

So I offered to help Mel if he ever needed me. We talked about it briefly. What did I think death was like, he asked? I didn’t have a clue, but I’d heard an Eastern mystic say that it was like slipping out of a pair of shoes that had never fit very well. Then we moved on to what we were reading, and how our kids were. I knew for a fact, though, that Mel believed in assisted suicide. We had discussed a story in the paper once, about a local man who gave his wife an overdose, and then sealed her upper body in a plastic trash bag with duct tape. Then he had done this to himself, and they died holding hands. What love!

Mel was sort of surprised that as a Christian I so staunchly agreed with him about assisted suicide: I believed that life was a kind of Earth school, so even though assisted suicide meant you were getting out early, before the term ended, you were going to be leaving anyway, so who said it wasn’t OK to take an incomplete in the course?

Nothing more was said until one day several months later when Mel and Joanne turned to me at dinner one night. “Annie,” she said. “We want to bring up your offer.” Oh my God, I thought — I had just been being nice. I couldn’t take someone’s life. I’m not at all that sort of girl. I’m usually more like a flight attendant — bringing people cool drinks, blotting spills.

“I won’t be me for much longer,” Mel said. I don’t remember what else was said. I asked if his doctor would prescribe barbiturates — when my father was dying, we had communicated with the Hemlock Society, and I knew exactly how many Seconal pills it took to kill a big person, how to crush them up and add them to applesauce, and how to feed the sick person toast and tea so that he wouldn’t throw up the pills.

They shook their heads. They hadn’t known their doctor long and felt too shy about asking. Shy!

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I didn’t know where to start. Usually with life, you start wherever you are, and you flail around for a while — now, you just nose around on the Internet, but this was more than a decade ago. You couldn’t go around asking any old doctor for a bottle of sleeping pills or painkillers; it just wasn’t done. So I did what you had to do in the old days, before computers: I talked to a number of trusted friends.

Through wily and underground ways, I came up with a prescription that would cover enough pills for a lethal dose. That night, Mel and I had a cryptic phone conversation. “I got it,” I said, like a spy, or a drug dealer.

A month later, Joanne called to see if I could come to their house the following night. Their best family friend would be with us. I should come around dinner time. They would have a simple meal for us: toast, tea and pudding for Mel.

He was in the kitchen when I arrived, very thin and weak, but still definitely Mel. His friend was there, teary, solemn and strangely friendly. Joanne had prepared soup for us, with bread and cheese. For the next couple of hours, he asked us to put certain albums on the stereo — Bach, Dylan, Leontyne Pryce. We shared our favorite stories. He was absolutely clear as a bell, brilliant as ever. Everybody cried a little, but not at the same time. The air smelled faintly of honey and laundry, and illness.

I remember coming upon a cat once, in tall grass on a hillside by the side of a fire road, barely alive. Its eyes were open, and you had to bend in close to see that it was still breathing. I almost picked it up and took it to my vet, but my instincts told me to leave it, that it would be so scary for it to leave the soft grasses on which it lay, and the smells of the sun and its own body in the weeds.

Everyone but Mel and I had wine. Mel had a Scotch. We ate in the kitchen. About 8, Mel looked at Joanne and said he was ready.

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The lighting was soft in the bedroom. He went into the bathroom, changed into worn, light-blue pajamas, and got in bed, wasted, sad, sweet and comfortable. Everyone stood around, or sat nearby. Joanne stretched out on her side of the bed.

I went into the kitchen and crushed the pills with a mortar and pestle, then stirred them into applesauce in a tiny Asian bowl.

He grimaced when I fed it to him, like a child swallowing medicine. Then he thanked us, told us how much he had loved his life, and how he wished he could live with us forever. But every person owes God a death, he said, paraphrasing Shakespeare, and everyone should be as lucky as he.

He told us about the presents he had left for each of us. Mine turned out to be a framed 8-by-10 photograph of Abraham Lincoln that he’d had on the wall in his study. It was the last picture of Lincoln taken before he was assassinated. There was a crack running across his forehead, from some flaw in the ancient camera. Mel wanted me to be guided in my work by the depth of sorrow and compassion in his eyes.

After a while, Mel looked around, half smiled and fell asleep. People got up to stretch, for wine or water, or to change albums. He breathed so quietly, for so long, that when he finally stopped, we all strained to hear the sound.

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