Minutes after the state legislature passed a bill to stop Dr. Jack Kevorkian from assisting any more suicides, Kevorkian let out a whoop: "Now, the stage is set for fun!"
"They don't realize the dumb mistake they've made," smirked the retired pathologist. "They'll be sorry . . . . ."
"Dr. Death" is having fun these days. The thrill of the crusade, the supreme satisfaction in "doing what's right," is nothing less than exhilarating, he said in recent interviews.
And if the anti-Kevorkian bill becomes law as expected, this self-appointed flag-bearer of the right-to-die movement says he will step up the pace of what he does best.
For 2 1/2 years, Jack Kevorkian has been thumbing his nose at the medical Establishment, the courts, and lately some feminists, by helping desperate people--all of them middle-aged women--end their lives.
From his first assisted suicide in 1990 to his most recent two weeks ago, Kevorkian so far has avoided prosecution. In this state, where Kevorkian has lived most of his 64 years, there are no laws against helping another commit suicide.
While he has enjoyed public support for his promises of an easy exit to the pain-wracked and pleading terminally ill, a detailed look at the six Kevorkian-assisted suicides since June, 1990, raises several unsettling questions:
* Were these pain-free, dignified deaths? The bodies of two women showed "bruising injury" at the sites of Kevorkian's repeated and unsuccessful attempts to insert IV needles. Four of the women died of carbon monoxide poisoning, which is known to cause severe headaches and intense nausea.
* Were the women competent to make this most final medical decision? One had been involuntarily admitted to psychiatric hospitals twice in the year before she died. Another suffered such severe memory loss that she was unable to sign her name or remember what she was talking about on the eve of her death.
* Were these merciful deaths or calculated steps toward what Kevorkian has described as "my long-range goal of terminal experimentation?"
Just who is Jack Kevorkian--student of death and lover of Bach--and why is he doing this? Is he a visionary, an angel of mercy? Or is he, as some critics claim, "a lunatic," "a serial mercy killer" with no love for women?
"Society is making me Dr. Death," he says. "Why can't they see? I'm Dr. Life!"
In an anonymous living room in a home near Detroit, 10 people gather in front of a video camera to discuss the planned deaths of two women.
The women themselves are here, as are their next of kin, a few friends and the man who has brought them together for this most unusual chat.
Jack Kevorkian, looking comfortable in an overstuffed easy chair, twirls his eyeglasses and inquires casually, "So, what do you want? Put it in plain English."
"I want to die," says Marjorie Wantz. "I've tried (to kill) myself three different times . . . tried everything, short of a gun. This time," she says and looks warmly at Kevorkian, "it will be done right."
This is "death counseling"--part of the Kevorkian protocol for prospective suicides. Patients must state their final wishes for Kevorkian's records.
His older sister Margo Janus handles the camera work as Kevorkian conducts freewheeling discussions with his patients and their families about their plans to die.
In anticipation of the doctor's first and, to date, only double assisted suicide, there are a lot more people involved in this session. "I'm doing two together because if I help one of you, the authorities will prevent me from doing the other," Kevorkian explains.
And, though it lasts for nearly two hours, the show's stars are almost drowned out by crowd noise and an overwound cuckoo clock.
There is talk of car-pooling to the site the next morning and a briefing by Kevorkian on what to expect from the media. "They'll make the 5 o'clock news," he assures the families.
Marjorie Wantz has a final spat with husband Bill over his last-minute doubts. "Maybe it's selfish of me to feel that way," Bill sniffs. "Right, selfish," Marjorie says.
Her suicide partner, Sherry Miller, contributes little to the discussion. Miller, who has multiple sclerosis, sits in her wheelchair, staring at the floor. When she does speak, it is in a small and somewhat garbled voice that few of the others seem to hear. "I just want out, out," she whispers at one point.
Sherry's brother says he hates to see her die but respects his sister's judgment. Still, he tells Kevorkian, " I could not put the needle in her arm. I could not put the pillow over her head . . . "
'Not All Easy Deaths'
" Euthanasia means easy death. I can assure you these were not all easy deaths," says Dr. L. J. Dragovic, the Oakland County medical examiner who has investigated the deaths of the six Michigan women.
"Poisoning by carbon monoxide in this fashion is not easy or quick. . . . It apparently took about 10 minutes or more. That is a horrendous, long process," Dragovic said of the four women who inhaled the gas.
"It was probably less humane than the cyanide poisoning used in Auschwitz," says Dragovic, who came to Oakland County from Detroit two years ago.
Kevorkian first used carbon monoxide in the October, 1991, death of Sherry Miller, a 43-year-old MS patient who had planned to die by lethal injection.
But Kevorkian, a pathologist by training, was unable to find a vein in Miller.
Dragovic's autopsy showed that "Kevorkian poked Mrs. Miller with needles four times--once on the back of the right hand and three more times inside her elbow. There was bruising there; he clearly hit a vein but could not establish the flow . . . so he resorted to the backup system of carbon monoxide.
"That is pathetic," said the medical examiner, one of Kevorkian's harshest critics. "Mrs. Miller was quite determined about dying so she apparently said, 'OK, I'll wait' (as) Kevorkian affixed the gas canister to the bed with a screwdriver."
This was not the first time Kevorkian had run into problems helping a patient die.
He faced "bad veins" and several false starts with his first patient, Janet Adkins, whose husband first contacted Kevorkian by phone. Adkins' veins were "delicate and fragile--even slight movement caused the needle to penetrate through the wall of the vein," Kevorkian later reported in a research paper.
For Adkins, who suffered from Alzheimer's disease, it took five bruising attempts on her arms to start the lethal IV drip, according to the autopsy report.
Adkins was to die June 4, 1990, in the back of Kevorkian's 1968 Volkswagen camper, a site picked for its mobility. While setting up his suicide machine--the Mercitron--in the cramped van, Kevorkian turned to get a pair of pliers and knocked over a bottle of barbiturate solution, spilling more than half of it.
As he fretted over what to do, Kevorkian's two sisters, who have acted as his assistants but refuse to be interviewed, arrived at the Oakland County camp site with Adkins.
Kevorkian decided to drive back to his apartment for a new supply of barbiturate. His sisters and Adkins, still waiting to die, went along for the 2 1/2-hour round-trip ride.
It was noon before they returned to the park, where Adkins waited another two hours for Kevorkian to ready the machine.
"In contrast to my sister and me, Janet was calm and outwardly relaxed," wrote Kevorkian in his book. "With a nod from Janet, I turned on the ECG (electrocardiogram) and said 'Now.' Janet hit the Mercitron's switch . . . (and) said 'Thank you, thank you.' "
Kevorkian said, "Have a nice trip."
Five months later, Kevorkian lost his Michigan medical license because of Adkins' death. Lethal gas became the only option because, without his license, Kevorkian could no longer legally get the drugs for his Mercitron.
Days after her death, Adkins' husband Ronald said he believed the assisted suicide was a more dignified way to die.
"It's not a matter of how long you live, but the quality of life you live, and it was her life and her decision and she chose this way to go," he told his local TV station.
None of Kevorkian's six patients were "imminently terminal" and questions have been raised about their motivation for dying, especially for two whose mental competence has been at issue.
Janet Adkins was in the early stages of Alzheimer's disease when she died. Although she had played--and beaten--her son at tennis just days before she flew here to die, the athletic mother of three was inconsolable over her increasing memory loss.
"Can you imagine the pain of knowing you are going to lose your mind ?!" demands Kevorkian. "Even though from a physical standpoint, Janet was not imminently terminal, there is little doubt that mentally she was."
Yet, on the eve of her death, she needed her husband's help to sign her name to a suicide letter. And, at a farewell dinner with her husband and friends, she was uneasy, Kevorkian says, "at being unable to recall aspects of the topic under discussion. . . . "
Adkins' family has insisted she was fully aware of what she wanted to do and how she wanted to do it. (Since the first criminal charges were filed against Kevorkian after Adkins died, families have been advised by lawyers not to comment publicly on the deaths.)
Some relatives and friends of Sherry Miller and Susan Williams, both of whom were disabled by MS, have said they believed the women were severely depressed and that depression, more than intractable pain, drove them to suicide.
But the most controversial of the Kevorkian suicide candidates was Marjorie Wantz. Twice in the year before her death, the 58-year-old mother of two had been involuntarily admitted to psychiatric hospitals.
For years, she had complained of chronic, debilitating pelvic pain, which no doctor could explain. The autopsy found no sign of disease. And, Dragovic concluded, there had been "no active (disease) process for a long period of time."
"Don't tell me her pain wasn't real," argues Kevorkian. "I know it was. That is why I accepted her as a candidate."
Focused on the Dying
"My research," says Kevorkian, "has always been with dying people."
And it has, with few exceptions, always brought him trouble.
In the 1950s as a top medical student at the University of Michigan, Kevorkian conducted research among prisoners on Death Row, asking them whether they would donate their organs during executions.
That controversial survey proposed execution by lethal injection and harvesting organs under anesthesia before the prisoner died.
This innovative idea cost him his university residency but sent him to another training program at Pontiac (Mich.) General Hospital where he began another research project: blood transfusions from corpses to live volunteers.
He recalls the first such transfusion:
"An accident victim came in through the ER. She was dead on arrival so our team swung into action. A volunteer from the staff laid down on a stretcher beside another gurney with the deceased. I tried to puncture the jugular vein in the neck of the cadaver but I couldn't find the vein. Her neck was broken. So I just took this big needle and put it in the heart and began to withdraw the blood.
"We transferred more than half a pint into the volunteer and I said, 'How do you feel?' When she told me she had a strange taste in her mouth, that she felt quite dizzy, I almost fainted myself, I was so scared. This had never been done before. . . . As it turned out, the deceased had a fairly high alcohol level in her blood and the volunteer who got the blood was feeling the effects."
(One of his assistants in that experiment 25 years ago was a medical technician named Neal Nicol. Recently, Nicol assisted him again by providing his nearby Waterford Township home as the site for the the doctor's two latest assisted suicides. Kevorkian says "lease constraints" prevent him from using his own modest apartment.)
In the late 1970s and early 1980s, Kevorkian worked on and off as a pathologist at a number of Southern California hospitals, sometimes living in the VW van that would become famous as the site of Janet Adkins' death.
During a brief tenure at the Beverly Hills Medical Center, Kevorkian became known for his unusual "death rounds." He would rush to the bedsides of dying patients throughout the hospital to photograph their eyes to pinpoint the exact moment of death.
Since 1986, he has dedicated himself to what he calls his "long-range goal of terminal experimentation." After a visit to the Netherlands, where physician-assisted deaths are common, Kevorkian returned to Michigan to offer his services as a death counselor.
He advertised his new service in a series of classified ads in local newspapers: "DOCTOR CONSULTANT--for the terminally ill who wish to die w / dignity." But, he says, "I got exactly two calls. "
In March, 1989, the Society for the Right to Die issued a proclamation supporting physician-assisted suicide. "It was a milestone breakthrough for me," says Kevorkian.
He spent the next year telling anyone who would listen, on TV, the radio, in newspapers, in debates, that he and his Mercitron were ready.
After hundreds of letters and calls, he finally got the call from Ronald Adkins that would lead to the machine's first use.
'Most Dangerous Man'
"I'm not obsessed with death! I'm not and don't make it sound like I am!" Kevorkian implores a reporter. "What I'm doing is trying to snatch life back from death, to move this society along to the point where we don't waste lives, but use what there is left after death to save lives!"
But Oakland County Prosecuting Atty. Richard Thompson, who has filed three murder charges against Kevorkian, disagrees.
"Once you make the decision that some lives are not worth living and one man appoints himself to make that decision, that person--Dr. Kevorkian--becomes the most dangerous man in our society."
Thompson nearly lost his bid for reelection because of the tremendous support Kevorkian enjoys among the state's voters, polls indicate.
But medical colleagues as well as ethicists and feminists are troubled by Kevorkian's methods. University of Minnesota ethicist Arthur Caplan calls Kevorkian "a serial mercy killer" and says his cause is "immoral, unethical and very dangerous."
And, in the aftermath of the most recent assisted suicide, there is new criticism about whom Kevorkian chooses to help. Although he says he has "three or four men waiting," all of his patients to date have been women in their 40s and 50s.
New York feminist Irene Deitch charged last month that assisting their suicides represents "the ultimate violence against women." Experts say women attempt suicide four times as often as men do and are more likely to use drugs or lethal gas.
Lawyer-ethicist George Annas of Boston University's medical school finds a troubling pattern as well. "If someone is going around killing women, all about the same age, it's only the fact that he has an MD that lets him get away with it."
Jack Kevorkian grew up in Pontiac as a first-generation Armenian in a highly traditional and, he says, conservative family. His father had a small contracting business and his mother, an Armenian Orthodox, was deeply religious.
"She never pushed us. Nobody ever did," says Kevorkian. But he and his sisters Margo and Flora were outstanding students--"all champion spellers."
One of his most vivid memories is from his internship, the first time he saw how cancer could ravage the body.
"The patient was a helplessly immobile woman of middle age, her entire body jaundiced to an intense yellow-brown . . . .
"The poor wretch stared up at me . . . as though she were pleading for help and death at the same time. From that moment on, I was sure that doctor-assisted euthanasia and suicide are and always were ethical, no matter what anyone says or thinks."
His mother, Kevorkian says, wanted a more traditional life for her son. "She would've liked me to be in private practice in a nice office, with some money, with a family. More normal, you know."
Looking back, those are choices he sometimes wishes he'd made, especially the family. "I don't feel I'm a success really because I don't have any children. I never was able to, well, marry. To pull it off. The whole family thing."
Once, he says, he came very close, but "her family just wasn't suitable. I couldn't imagine being related to them."
So he lives alone in his two-room apartment above a statuary shop with gargoyles in the window. He has alienated the powers-that-be of his profession and cannot even get a job as a paramedic.
He entertains himself playing the music of his beloved Bach on the flute or on a small tabletop organ a friend loaned him.
He still frequents flea markets looking for toys whose small gears can be used to build future suicide machines.
He might resume oil painting, which he quit almost 30 years ago after mounting an exhibit called "Art Is Bunk."
The centerpiece of the Edvard Munch-ish show was a nightmarish depiction of "Genocide"--its frame painted in outdated blood from a blood bank. "That shook 'em up, I'll tell you," the doctor laughs.
He says he lives on $537 a month, which comes mostly from Social Security. He has received some donations from grateful families of his suicide patients but says he puts it all in a special account for future research.
He never charges patients. "I don't even charge for materials. To me that's money well-spent."
Kevorkian says he hasn't thought much about his own death. "I imagine I'll die from some disease. My father died of heart attack. My mother died of cancer."
What does Jack Kevorkian fear most?