Choosing Not to Die Alone : Dying: To some of his patients, Dr. Jack Kevorkian was an “angel of death” who could ease the “pain of deciding whether to live or die,” one expert says.

On a glass-top table in the center of the family room, Catherine Andreyev’s medicines were sorted out in coffee cups. There were sleeping pills, Tylenol with codeine, barbiturates, tranquilizers, narcotics and a mug full of morphine patches.

“I fully expected to walk in there one morning and find the cups empty and Catherine dead,” recalls her neighbor, Diane Collins.

“Each sleeping pill was tiny, a grain of sand. You could pop 20 of them down in a gulp of Jell-O . . . . But, of course, that’s not what she did.”

Instead, Andreyev, who had cancer, persuaded two friends to drive her six hours from her suburban Pittsburgh home to a modest house outside Detroit for an appointment with Dr. Jack Kevorkian.

No one knows for certain why Andreyev made that choice. But Collins has an idea:

“I think Catherine was saying ‘I didn’t have enough time to make anything out of my life, so I’ll make something out of my death.’ ”

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Since June of 1990, Jack Kevorkian has helped 15 people “make something” of their deaths.

Although the numbers are too small to be statistically valid, some patterns are beginning to emerge. Eleven of the patients were women; all were ill, all were white, most middle-aged. In addition, most:

* Had months, even years of life ahead of them. They said it was not pain but their weariness with life that made them want to die.

* Were divorced, widowed or lifelong singles. Many had recently suffered the loss of a loved one.

* Seemed depressed or withdrawn to their family and friends.

Suicide experts recognize such themes. But what propelled these four men and 11 women to kill themselves? Why did they seek out a high-profile stranger at life’s most private and profound moment?

“It’s a paradox, but sometimes people who kill themselves are trying to connect with life by taking leave of life,” says sociologist Ronald Maris, who heads the Center for the Study of Suicide at the University of South Carolina.

Through the highly public exit offered by Kevorkian, some connections are assured: with the media, with a famous doctor, with a cause, even with history.

Kevorkian, who has been barred from practicing medicine in Michigan and faces license revocation in California as well, refused to discuss his patients’ motives in seeking him out.

“For some, choosing Dr. Kevorkian may be a way of finally--for the first time perhaps--creating a social contact . . .” says Janet Billson of the American Sociological Assn.

For the never-married Catherine Andreyev, who was a schoolteacher, friends say the need to be a part of something grander than her own modest life may well have been a factor in her decision to go to Michigan to die.

“In life, she was practically invisible,” says one longtime acquaintance. “There is no doubt that, because of Kevorkian, Catherine was larger in death than she ever was in life.”

Andreyev, like most of Kevorkian’s patients, lived alone.

“We know that people who are alone tend to commit suicide more often. Life seems to have less meaning,” says Faye Girsh, a San Diego psychologist and right-to-die advocate. “Living alone is harder . . . .”

And so is dying. Like most of Kevorkian’s patients, Andreyev had access to enough prescription medicines to kill herself without help. But, by all accounts, she never tried.

“People don’t like the prospect of sitting in their apartments alone, brewing a (lethal) cup of tea, possibly vomiting everything thing up and never being found until they are totally deteriorated,” says Girsh.

“If people had a choice of having a nice, kind doctor give them an injection and sit by their bedside until they die, wouldn’t that be better?”

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Marjorie Wantz, who was Kevorkian’s second patient, had seen the publicity surrounding Kevorkian’s first patient, Janet Adkins, and was excited by the attention her own death promised.

“How soon will (the media) be told?” she asked in a videotape Kevorkian made days before helping her die Oct. 23, 1991. “Will I get a full, complete autopsy? I want the whole thing.”

Wantz, 58, who had been involuntarily admitted to psychiatric hospitals twice during the year preceding her death, contacted Kevorkian after several failed suicide attempts at home.

One day, her husband, Bill, said she tried to shoot herself in the head but missed and shot a living-room chair instead. On another occasion, she sat for hours in an exhaust-filled garage but never lost consciousness.

“I just can’t seem to pull it off on my own,” Wantz complained to Kevorkian in the videotape.

According to the American Psychological Assn., most women who try to kill themselves botch the job.

Women attempt suicide three times more often than men do. But every year in the United States, more than 24,000 men succeed, compared to 6,000 women, according to the National Center for Health Statistics.

The promise of certainty from “a doctor who so far has not failed,” according to Hemlock Society founder Derek Humphrey, can be very seductive and also may play a role in Kevorkian’s popularity.

“With this doctor, if you want it, you get it,” agrees suicidologist Maris. “Kevorkian comes across as a very strong kind of guy with very little doubt about what he’s doing. He’ll give you what you ask for.”

The Kevorkian guarantee of success also may help relieve the ambivalence that tortures most people who contemplate suicide, says Dr. Joseph Richman, a New York psychologist and author of several books on suicide.

“For some, Dr. Kevorkian seems quite magical, a true angel of death . . . . By going to this man, they may be saying ‘I’ve put myself in this wonderful person’s hands and now I don’t have to go through any more of this pain of deciding whether to live or die.’ ”

For 47-year-old Elaine Goldbaum, who was suffering from multiple sclerosis, Kevorkian was an angelic guide to the afterlife.

In a letter Goldbaum wrote to Kevorkian before her death last Feb. 8, she said, “I am Jewish and have been raised to believe that suicide is a mortal sin . . . . Your assistance in medicide (Kevorkian’s term for physician-assisted suicide) will get me into heaven.”

Goldbaum’s condition was not terminal but her family said she was depressed by her progressive loss of muscle control. Still, Goldbaum was mobile enough to go out to have her hair done for her appointment with Kevorkian.

At the end, her neighbors say, she seemed in high spirits. “You’d never imagine she was getting all fixed up to die ,” says one.

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The typical suicide victim is a white, middle-aged male. Among those who sought Kevorkian’s help in dying, only two fit that description--Jack Miller, 53, and Jonathon Grenz, 44. Both men had spreading cancers.

Grenz, an Orange County real estate broker whose sister--a physician--accompanied him to Michigan, was mourning the loss of his mother as well as his own recent loss of speech to throat cancer, say friends.

Although Kevorkian and his lawyers insist physical pain drove most of his patients to their deaths, autopsies on the men and women revealed fewer than half were taking any medications for pain when they died.

Stanley Ball, 82 and suffering from terminal pancreatic cancer, had been to his own doctor 10 days before his Feb. 4 Kevorkian appointment. Although his doctor gave him a prescription for a powerful painkiller, Ball never filled it.

Instead, he dictated a letter to his daughter to be shared later with the press. “I’ve lived a great life,” he wrote, adding, “I want to end my life at the earliest opportunity.”

And although families and friends reported that depression and pain had driven their loved ones to Kevorkian, few were taking antidepressant drugs when they died.

Those who specialize in suicide say pain and depression often cause people to contemplate ending their lives. But, just as often, they say, treating either condition can eliminate the suicidal thoughts.

Yet, some of Kevorkian’s patients rejected help, according to interviews with friends, families and physicians.

Shortly before Mary Jean Biernat, 73, sought out Kevorkian, she told her sister-in-law, “Don’t pray for me. I can’t live with the pain. It’s impossible . . . .”

To her physician, though, Biernat was “stoical and non-complaining.” Dr. Ray Drasga, a cancer specialist, has a reputation for giving terminal patients the pain relief they need to be comfortable. But Biernat, Drasga says, didn’t mention pain as her major symptom.

Marcella Lawrence, a 67-year-old retired nurse, appeared at a news conference shortly before her death to defend Kevorkian’s work and to describe her pain for reporters:

“The pain I have, I just wish they (Kevorkian’s enemies) could have for one night. If I was up on the 13th floor, I think I’d jump.”

Lawrence added, however, “I refuse to go to any more doctors. All of the doctors seem to think I should continue to try this and try that, and I should go here and go there. I can’t, and I refuse to force myself anymore! I suffer too much!”

When asked what sent her to Kevorkian, a friend of Lawrence’s said, “You mean, why didn’t she jump off the roof instead? Well, she believed in doctors helping people. And also, maybe, she didn’t want to be remembered as some horrible mess on the sidewalk . . . .

“But when you write about her, could you say her death made a difference? That’s what she would’ve wanted.”

The following is a chronology of the 15 suicides assisted by Dr. Jack Kevorkian:

* June 4, 1990: Janet Adkins, 54, of Portland, Ore. Had Alzheimer’s disease.

* Oct. 23, 1991: Marjorie Wantz, 58, of Sodus, Mich. Had intractable pelvic pain; Sherry Miller, 43, of Roseville, Mich. Had multiple sclerosis.

* May 15, 1992: Susan Williams, 52, of Clawson, Mich. Was blind and had multiple sclerosis.

* Sept. 26, 1992: Lois Hawes, 52, of Warren, Mich. Had terminal lung cancer.

* Nov. 23, 1992: Catherine Andreyev, 45, of suburban Pittsburgh, Pa. Had breast cancer.

* Dec. 15, 1992: Marguerite Tate, 70, of Auburn Hills, Mich. Had Lou Gehrig’s disease; Marcella Lawrence, 67, of Mt. Clemens, Mich. Had heart disease, emphysema, and arthritis in her back. (Hours after the Tate and Lawrence deaths, Michigan Gov. John Engler temporarily banned assisted suicides, effective April 1.)

* Jan. 20, 1993: Jack Elmer Miller, 53, of Huron Township, Mich. Had bone cancer.

* Feb. 4, 1993: Stanley Ball, 82, of Leland, Mich. Had pancreatic cancer and jaundice and was blind; Mary Biernat, 73, of Crown Point, Ind. Had breast cancer that had spread to her chest.

* Feb. 8, 1993: Elaine Goldbaum, 47, of Southfield, Mich. Had multiple sclerosis.

* Feb. 15, 1993: Hugh Gale, 70, of Roseville, Mich. Had emphysema and congestive heart disease.

* Feb. 18, 1993: Jonathon David Grenz, 44, of Costa Mesa. Had throat cancer; Martha Ruwart, 40, Waterford Township, Mich. Had intestinal and ovarian cancer. (One week after the Grenz and Ruwart deaths, Michigan Gov. Engler signed a bill temporarily making it a felony to assist in a suicide, effective immediately.)