Dying in Dignity No Longer an Option

Vivian Coyle cared for her husband herself, at home, without complaint. She talked frequently to God, at church and at home, praying for patience and strength. Both would come in miraculous ways.

Still, John Coyle’s death was slow and cruel. He’d been stricken with colon cancer, then Alzheimer’s disease. Finally, he languished for 32 days in the hospital before death officially came, when he was 83 years old. He and Vivian, the parents of four children, had been married 49 years.

Vivian Coyle told her family, her friends and her attorney that she wanted something else for herself. She had seen friends waste away too. She had seen bodies kept alive, in a strictly technical sense.

Vivian Coyle said she would welcome death when it called. Her life had been full; she loved nothing more. It was so-called heroic medical care that she feared most.

So she made out her will. She signed a durable power of attorney for health care. Her oldest daughter, Barbara Morgan, would act on her behalf. She wanted to die in peace, with dignity. A nursing home, she believed, would be akin to hell.

Vivian Coyle turned 81 last month.

When Barbara Morgan tells me about the wishes of her mother, the person whom she calls her best friend, tears fill her eyes. We are in the living room of Barbara’s Fullerton home now. We have talked several times on the phone before.

Barbara, the media specialist/computer coordinator at Nicolas Junior High School, hadn’t known where to turn. Her emotions were peeled raw, her mind in tight little knots.

These past two months, since her mother’s massive stroke, have been the longest of Barbara’s life. She tried-- Oh God, how they all tried --to carry out her mother’s will.

But something went wrong.

“We are basically stuck with what we feared to begin with,” Barbara says. “A body that has no quality of life whatsoever. This is the absolute opposite of anything my mother would have wanted. Who knows how long it can last?”

These words do not come easily to Barbara Morgan. They have taken weeks to form. They should never be interpreted as cold. I have witnessed Barbara’s anguished transformation myself. Despair, then hope, anger and fear. She seems resigned now.

“In retrospect, maybe the doctors did do the best that they could,” she says, and then her voice trails off.

“Watching my mother die, expecting her to die, the emotional ups and downs, it’s all been so hard. And you don’t want to lose your faith. You think maybe your prayers have been answered and the answer is no.

“There are so many people out there like my mother, like us. The other day at the nursing home, I talked to a man who always comes to visit his wife. He said, ‘This has been going on for 20 years.’ There’s a great amount of helplessness, a resignation that this is the best that it can be.”

Vivian Coyle, of course, tried to avoid such a fate. Her family knew, and approved of her plans--even if they wavered from time to time in carrying them out. Her stroke, which Barbara and her husband witnessed moments before they called 911, seemed to put everybody to the test.

Doctors initially went along with what Vivian Coyle would want. I saw the medical records that bear this out. No code are the euphemistic words. They mean no extraordinary measures to keep this patient alive.

Vivian Coyle was expected to die soon. But she did not.

For two weeks, her body tissues were merely hydrated through an I.V. This was to keep her more comfortable as she died. Then the hospital doctor, a man Vivian Coyle had not known, said he was uncomfortable in his role. He ordered a feeding tube inserted, a move that Barbara and her siblings fought.

The medical records show orders for insertion, crossed out and entered time and again. The family finally prevailed. The doctor then removed himself from the case.

Two more weeks passed. The family again fought against extraordinary measures to try and bring their mother around.

“My brothers and sister and I would say to each other, ‘If we save her, it’s only going to be for our own selfishness, not for her own good.’ That was the only thing that kept us going,” Barbara says.

But then one afternoon while Barbara was visiting her mother, crying to herself, talking in the hope that maybe her mother could hear, a nurse entered the room. Barbara told her how hard all of this was. She explained why the family was doing what they were, yet she wondered if some movements by her mother were a sign of hope, that maybe her mother did want to live.

By the next day, the nurse, without the attending physician’s knowledge, had called in a neurologist, who for the first time offered Barbara a degree of tangible hope. He said her mother may one day walk.

Barbara consulted with her siblings. The family agreed that their mother should be fed. Maybe it was a miracle, they thought. Maybe their mother was sending them a sign.

In hindsight, Barbara says now, she knows that was a mistake, that they were too emotionally overwrought to be making decisions about what was best. They were grasping at straws, interpreting movements in ways that they should not have done.

Now the same neurologist says that he may have been wrong about Vivian Coyle. Only he doesn’t use those exact words. All the other doctors and therapists who have seen Vivian Coyle now tell Barbara that they can offer no hope “at this time.”

“We weren’t in the least bit interested in causing trouble,” says Barbara. “We just wanted what is best for our mom.”

Now Barbara visits her mother every day in the nursing home where she has been moved. She has found her covered with liquid, with food caked down her front and smeared on her glasses and lying on soiled sheets.

“Now I think I just want her to be taken care of,” Barbara says. “To have the dignity of clean glasses, clean sheets. . . . My mom now--I don’t know--but I think she’s depressed. It’s the worst existence that anybody could imagine.”

Once again, Barbara Morgan loses her voice. She says she will continue her prayers.

“We had maybe a day or two left before she would have died,” Barbara says. “It would have been better for my mom had she been able to go. She would have been in a much happier place, where she deserves to be.”