Death & the Doctor : Dr. Jack Kevorkian Has Long Taken an Interest in the Dying. But Did He Go Too Far in Assisting a Suicide?

He was a bright young doctor at a time when America was just beginning its post-World War II ascent, and Jack Kevorkian, University of Michigan Medical School Class of 1952, could have--should have--had it all.

But he had this nagging, inexplicable fascination with the dying and the dead, a personal obsession, really, one that was all the more peculiar because it first appeared during an optimistic era of limitless possibilities and unquestioning faith in the resiliency of American life.

Perhaps it was reinforced during his brief time as a U.S. Army doctor in Korea; certainly it was there during his residency at the University of Michigan Medical Center in the mid-1950s.

“I used to take what I called death rounds,” says Kevorkian, 62, his dark eyes flashing, remembering. “I would go around to all of the people (in the hospital) who were about to die and watch. I wanted to see at what point they could no longer be resuscitated.

“All the other doctors laughed at me.”

Today, however, some leading physicians shudder at the thought of Kevorkian, his “death rounds” and his role in a controversial case of what he calls medically assisted suicide--the death of a 54-year-old Alzheimer’s sufferer from Oregon.

Of Kevorkian’s “death rounds,” Dr. Charles McElwee, president of the Los Angeles County Medical Assn., observes: “I would never think of doing such a thing, that shows a morbid obsession with death.”

To be sure, Kevorkian denies his was obsessive behavior. He sees himself as a misunderstood, research pioneer. As a pathologist, after all, his professional work involved the study of death.

“I don’t like to watch someone die,” he insists. “It is a traumatic, wrenching experience.”

Yet through the years, his increasingly macabre, independent research and writing have always led him back to death.

There was his early plan, first proposed during his medical school days and shunned by his professors, to “harvest” organs from prison inmates.

There were his experiments in taking blood transfusions from corpses, a practice now unacceptable in American medicine.

Eventually, he would advocate giving death-row prisoners the right to commit suicide--with their organs then removed while comatose--rather than face execution.

He even wrote Op-Ed pieces in the Long Beach Press-Telegram supporting his ideas in the early 1980s, when he lived in Southern California.

But the more his colleagues laughed--or blanched--at his ideas, the more determined he appeared to become.

He seemed, as a Michigan prosecutor later said, “to revel in the role of outcast.”

Over the years, Kevorkian’s obsession would cost him dearly. On the fringes of medicine, he would become permanently unemployed in his mid-50s--rejected two years ago even for a job as a paramedic.

His only patients, he says, are acquaintances who stopped him in the street to ask his advice on minor ailments. He would complain that American medical journals refused to publish his ideas.

“I’m unemployable because of the controversy surrounding my work,” he says. “The only thing protecting me right now is my M.D. degree.”

By the onset of the 1990s, Kevorkian had retreated into a private world.

He took to comparing himself to Dr. Frankenstein--a misunderstood genius, he says.

“The medical society is stuck in the Dark Ages,” he would assert. “I’m sure if they could, they would burn me at the stake.”

A lifelong bachelor living off his savings in a tiny, ill-furnished, walk-up apartment in Royal Oak, Mich., not far from his boyhood home in Pontiac, he spent his solitary days in libraries, reading. His thoughts were increasingly dominated by the issue of suicide for the terminally ill.

And so when Janet Adkins came to him earlier this month, eager to end her life, eager to stop the suffering of Alzheimer’s disease before she became mentally incompetent, Kevorkian was ready.

He had already traveled the slippery ethical slope that leads from medicine to euthanasia. In his own mind, he was no longer a practicing pathologist.

Instead, he printed up new business cards. On them, he called himself an “obitiatrist,” with its root in the word “obituary”: a doctor of death. “The world’s first,” he says.

On June 4, Janet Adkins, a 54-year-old mother of three from Portland, Ore., climbed into the back of Kevorkian’s rusting old Volkswagen van in a rural Michigan park not far from here and allowed Kevorkian to connect her to his homemade “suicide machine.”

She then pushed a button three times to ensure the machine’s death-inducing drugs would course through her veins. “Thank you, thank you,” were her last words, her neck arched as she beamed up at Kevorkian’s face.

The next day, Kevorkian exploded into America’s consciousness.

Overnight, his role in Adkins’ “doctor-assisted” suicide had ignited an emotionally charged, nationwide debate over the right-to-die issue.

Again, as throughout his career, Kevorkian has been condemned by the medical community since Adkins’ death.

“What he did is like veterinary medicine,” insists Dr. John Finn, medical director of the Hospice of Southeastern Michigan in suburban Detroit, where some terminally ill patients have tried to seek out Kevorkian’s services. “When you take your pet to the vet, he puts the pet to sleep. I think human beings are more complicated than that.

“I think he should have his license revoked.”

Dr. Melvin Kirschner, co-chairman of the joint committee on medical ethics of the Los Angeles County Medical Assn. and the Los Angeles County Bar Assn., complains: “Kevorkian did this without any guidelines whatsoever. Physicians cannot just, willy-nilly, assist someone in killing themselves.”

Yet this time, Kevorkian has also struck a responsive chord within the growing right-to-die movement, which is being fueled by the nation’s mounting distaste for medical technology that extends lives regardless of the suffering involved.

“If we are free people at all, then we must be free to choose the manner of our death,” argues Derek Humphry, executive director of the Hemlock Society, a Eugene, Ore.-based group that supports the idea of doctor-assisted suicide.

But even some of his supporters, such as Humphry, admit that Kevorkian is not the right man, not the right doctor, to try to set compassionate and safe guidelines for euthanasia in the future. He is too obsessed, too fanatical, in his interest in death and suicide, to offer direction for the nation. “He’s a strange bird,” acknowledges Humphry, who has met Kevorkian. “He’s a zealot.”

Indeed, after a recent hearing related to Adkins’ death, in which he both testified and acted as his own lawyer, Kevorkian’s angry, arrogant and often scatological dialogue with the court on the issues of suicide and euthanasia gave credence to those who have insisted the doctor isn’t the right man to play God.

At the hearing in Oakland County Circuit Court, in which a judge temporarily barred him from assisting in further suicides in Michigan, prosecutors suggested that Kevorkian wanted to become the “Domino’s of Death,” a deliverer of a quick, lethal new service to customers.

They said that Adkins just happened to be an exciting test case for him. That was a bit unfair; Kevorkian didn’t charge Adkins’ family for his work.

Those who have known Kevorkian professionally in the past, both in Michigan and Southern California, where he worked at several hospitals in the late 1970s and early 1980s, remember a different man, a good doctor who was an accomplished organist and painter.

“He’s a very brilliant man,” argues Dr. Fred Hodell, the former chief pathologist at Pacific Hospital in Long Beach, who hired Kevorkian as his assistant in 1981. “He was very friendly with people at the hospital, and I don’t remember him talking about suicide. At the time he was more interested in organ transplants.”

Hodell adds that Kevorkian left Pacific on good terms.

“He was quite a character, but he was very fair to work for, he kept his word, and he backed us up if there was a problem,” recalls Vince Hufanda, a medical technologist who worked for Kevorkian at Saratoga General Hospital in Detroit, where Kevorkian was director of the pathology lab in the early 1970s.

But those who knew Kevorkian acknowledge that he still always stuck out as being a bit odd, a bit of a loner. While working as a staff pathologist at the Beverly Hills Medical Center in Los Angeles in the early 1980s, Kevorkian would often sleep overnight in the hospital parking lot, in the same 1968 VW van in which Adkins later ended her life.

And his mind would latch onto gruesome tasks.

“What I remember most is that, in his spare time, he invented a contraption that would cut up prostate tissue in the lab, so you wouldn’t have to use a knife,” recalls Trudy Staler, a lab technician at Beverly Hills Medical Center.

In his work, Kevorkian remained restless, constantly on the move from one job to another.

Finally, he returned to Michigan and stopped working in his profession altogether; Pacific Hospital, which he left in 1982, was the last hospital in which he is known to have been employed.

He was thus free to concentrate on his real life’s work--death.

He remained largely out of sight until 1988, when he emerged in Los Angeles to make an outlandish offer to the Hemlock Society, a right-to-die group that was then backing a proposed ballot initiative for the legalization of physician-assisted suicide in California.

In a meeting with Humphry, the society’s executive director, Kevorkian offered to set up an illegal “suicide clinic” for the terminally ill in Los Angeles. It would draw public attention to the proposed suicide initiative, which ultimately failed to get on the ballot.

Kevorkian, Humphry says, claimed not to be worried that he might be prosecuted.

Humphry rejected Kevorkian’s offer. “The Hemlock Society is a law-abiding group” he says.

Kevorkian returned home to Michigan.

A year later, he surfaced again, this time to offer to assist in the suicide of David Rivlin, a Michigan quadriplegic who had gone to court in a nationally publicized case to win the right to die.

Again, Kevorkian was rebuffed, at least partly because he could not offer an easy means for physician-assisted suicide.

So after the Rivlin case, Kevorkian began work on his “suicide machine.” He put his gift for gadgeteering to use, and, from parts he picked up at flea markets and garage sales, Kevorkian quickly developed a device that would intravenously feed coma- and death-inducing drugs to a patient, after the victim had pushed the machine’s button.

Untested machine in hand, it wasn’t hard for Kevorkian to garner publicity.

Newspaper stories about his device last year, and an appearance on the “Donahue” television show, were enough to attract willing subjects--including Adkins.

Now, in the aftermath of her death, law enforcement officials are sifting through the evidence and are awaiting a final autopsy report to determine whether to bring charges against Kevorkian.

That may be difficult. As Kevorkian noted in his court hearing, assisting in a suicide is not a crime in Michigan.

Yet Kevorkian remains unrepentant and fully committed to his concept of “rational, planned death.” If he is cleared of all charges and the court order against him is lifted, Kevorkian says he plans to establish an “obitorium,” a suicide clinic.

And, above all, he remains convinced that he knows what is best for society, and that eventually, his ideas will prevail.

“All I’m trying to do,” says Kevorkian, “is condense the time between the birth of this idea, and its wide acceptance.”