Mercy

CHAPTER 17

Julie had known about Very Much Alive before she contacted the organization. In fact, she was probably on their list of least favorite doctors. In disability rights circles, Very Much Alive was considered one of the most formidable. The group organized demonstrations, was active on the lecture circuit, wrote peer-reviewed papers for many respected journals, and engaged in constant battle online, in the media, and in the halls of Congress with organizations such as Humane Choices, which advocated for death with dignity.

VMA had some of the best counselors in the business, who were expert at convincing others to change their views, including several patients who had wanted to die and now were spokespeople for Very Much Alive. Their stories were displayed prominently on the organization’s website with pull quotes, videos, and essays explaining how they came to their change of heart. Hopeful that VMA could reach Sam, Julie had made the call.

Sam’s eyes narrowed into slits, his teeth clenched, and the veins on his neck bulged just as they had the day Julie stuck a needle in his chest.

“You should… have told me… she was coming.” Sam labored to get out the words.

Julie capped his tube with her palm to fill his throat up with air again.

“In fairness to Julie, I’m the one who suggested we keep my visit here a secret. From what she told me about your situation, I was fairly certain you would have refused to see me. At least now I can plead my case, and all it’s going to cost is a few minutes of your time.”

“Please, darling. Five minutes. Hear her out.”

Sam turned his head away from Julie. He would have gotten out of bed and left the room, if only he could.

“Julie told me about the accident,” Michelle said, “and I want you to know how truly sorry I am for what’s happened to you.”

“Not as sorry as I am,” Sam said.

Michelle cast her glance to the floor and nodded in agreement.

“What is it you want from me?” Sam asked.

“I’ll get right to it. My organization opposes physician-assisted suicide. We view it as a lethal form of discrimination against disabled people.”

“What you call lethal discrimination, I call mercy,” Sam said.

“With time, your thoughts and feelings may change. We’ve seen it with other people in circumstances similar to yours.”

Sam nodded to Julie in a way that told her to cap his tube.

“There are drugs you can take that can induce temporary paralysis,” he said. “Why don’t you try living like me for a while and see how you like it.”

Julie glanced at Michelle and had no trouble reading the woman’s thoughts. This was going to be an uphill battle all the way.

“There’s no question you’re suffering,” Michelle said. “But is it unbearable? Who is the judge?”

“On that point, I think I am,” Sam said flatly.

“No. Your physician would actually become the ultimate judge, because he or she would have to take the steps to bring about your death. Right now, you might not be in the best place to guide that thinking.”

This was one area where Julie had gone head on with groups like Very Much Alive. Suffering was considered to be part of the human condition, as groups opposed to mercy killing often argued. Medicine, Julie said in her speech, was nothing more than a manufactured way to alleviate a natural process. Her argument went that mercy killing, as a means to end suffering, should therefore be treated as viable medicine. In her seminars, Julie asked, was it fair to force people to exist, often in agony, just for the sake of existing?

Sam eyed Michelle skeptically. “Are you suggesting I’m not rational, or that my judgment is somehow impaired? Want to quiz me on American history? I’ll get a hundred. Guaranteed. Or better yet, I’ll quiz you.”

Michelle was well practiced at dealing with adversaries. “I’m sure you know our country’s history better than I do,” she said, a trace of a smile curving her full lips. “But that has no bearing on the fact that assisted suicide is not the answer.”

Michelle had an ethereal quality, something inherently light, almost fairylike. She had high cheekbones and a slightly angular face. From their conversations, Julie had learned that Michelle had been married twice, and was close to fifty, but she looked easily a decade younger. She radiated warmth, and Julie cast aside any doubts she’d had about this meeting. If anyone could open Sam’s mind to new possibilities, it was Michelle.

“Pardon me if I sound rude here, Michelle,” Sam said, “but I think that I know best if my life is worth living.”

Uh-oh, Julie thought. Here we go.

“I’m not saying you don’t,” Michelle answered. “We live in a society that values physical ability. It’s completely understandable how your injury not only robbed you of your mobility, but of your dignity as well.”

“Thanks for getting it.”

Sam had never been sarcastic with Julie before, but the injury had changed much about him.

“At first blush, assisted suicide might seem like a good thing to have available,” Michelle went on. “But dig deeper and you’ll see the problems.”

Julie shrank a little from the look Michelle gave her. She obviously knew all about Julie’s papers and lectures advocating passage of death with dignity laws nationwide.

“It’s fear of living a disabled life that makes you want to die,” Michelle said. “It’s fear of the indignity, of not being able to get out of bed, or use the toilet on your own. But this is new for you. Over time, you’ll learn that needing help is not undignified, and that death is a far worse choice than assistance. Depression can be treated, Sam, but there’s no known cure for a lethal prescription.”

“Is this what you do for a living?” Sam asked. “Try and keep quads alive?”

His breathing had turned ragged. Julie gave him a drink of water, then capped his tube so that he’d be able to continue antagonizing Michelle.

“Not exactly,” Michelle said. “What we believe is that legalization of assisted suicide and euthanasia will lead to policies that discriminate against the disabled, poor, and underinsured. We want to protect people from doctors who tell patients they have six months to live when the prognosis of a shortened life expectancy is often wrong. And once society authorizes assisted suicide for the terminally ill, it’s inevitable the scope will increase to include those who cannot self-administer lethal drugs.”

“Well, that would be me,” Sam said. “And you have yet to convince me that lethal drugs shouldn’t be allowed.”

“Right,” Michelle said. “At first glance, your argument makes sense. Who better to make this decision than the person suffering from the condition? There’s no question your perception of quality of life is going to have to change. But your brain is still sharp as ever, and technology has come a long way.

“You can still read, write, and share your ideas with others. You can still watch a baseball game, smell the fresh-cut spring grass, or taste a delicious meal. I’m not saying it’s going to be easy, but it is possible to find enjoyment in new things, or a new appreciation for what you already know. There’s a danger we all face if we allow the lives of disabled people to be viewed as not worth living.”

Sam scoffed. “So now I have to be the poster boy for everybody else?”

“Not at all,” Michelle said. “But I am asking you to give it more time. See if your perspective about quality of life changes. If you won’t do it for yourself, then do it for Julie.”

Julie set her hand on Sam’s shoulder. She had not thought she had a single tear left inside her, but that familiar lump came back to her throat as her eyes watered.

“Give it time,” Julie said. “Please, Sam, for us. Let’s give it more time. Let’s put our energy on living, not dying.”

Sam motioned for Julie to cap his tube. Once he could speak more easily, he stayed silent long enough for the mood in the room to turn even more uncomfortable.

“What’s your deal with this, Michelle?” Sam eventually asked. “Why do you care so much?” His voice had turned soft, and his eyes were heavy.

It was obvious to Julie that this conversation had taken an enormous physical and emotional toll on him. It had on her, as well.

“You ask a fair question of me,” Michelle said. “And it’s a story I think you may be able to relate to. Do you want to hear it?”

“Last I checked, I’m not going anywhere.”

Michelle strained to smile. “We have to go back in time a bit, to my first husband. I was thirty-nine. I’m fifty now. Happily remarried to a doctor who works at this hospital, in fact. But back then I was happily married to a man I met in college-a man I thought I’d be with forever.”

“I thought I’d be getting married to Julie and buying a new condo in Cambridge. Now I can’t wipe my own ass. Funny how life throws us curveballs like that.”

Michelle shrugged off Sam’s aggression. Her eyes misted with memories. “Our curveball was a brain tumor. A grade IV astrocytoma, to be specific. He tried all the treatments-chemo, radiation, even surgery. Nothing helped alleviate his symptoms or his suffering. He was dying in the most horrible way. Seizures, nausea, blinding headaches, memory loss like an Alzheimer’s patient. I didn’t know what it was like to watch someone I love suffer so much, but I can relate to Julie’s pain because the experience was utterly excruciating.”

“Then you should be able to understand why I want to die.”

“I did and I do,” Michelle said. “I understood so well, in fact, that I moved my husband and teenage son across the country to Oregon, where he could legally get the prescription you’re wanting. And he got it, and he died. This was completely against my upbringing, my religion, but he needed my help and support.”

Sam returned a grim smile, but Julie was glad to see any smile from him.

“You’re making my case just fine,” he said.

“But it wasn’t fine, Sam. We’re all going to die, no debating that. What I learned from my experience is that death can bring more problems if you do something to speed it up. My husband didn’t die of a brain tumor. He died from the pills he ingested, the pills I helped him obtain. I thought the burden was mine and mine alone, but it turned out my son, Andrew, felt like he had a hand in killing his father. He didn’t share his feeling with me until after his dad was gone, but later he expressed his guilt for not doing more to stop it from happening.

“Andrew wasn’t sleeping. Started drinking, smoking, his grades went from As to Ds. He sank into a depression. I tried everything. Pills. Doctors. We eventually moved out of Oregon and settled in Massachusetts to get as far from the place where his father died as possible. It didn’t help. He carried the guilt with him all the way across the country, and it followed him like a shadow.”

Michelle’s sadness was pronounced. “I knew when I got home and the house was quiet that something horrible had happened. I knew when I called Andrew’s name and he didn’t answer. I just knew.”

Michelle closed her reddened eyes and put a hand to her mouth, head lowered. She stayed that way until her composure returned.

“I found him hanging in his closet. He was gone. He took his own life. He took his life because I took his father’s. And that’s when I knew that it wasn’t just about my husband and his freedom of choice. It was about all the lives connected to him, including my son’s. So I changed my tune about death with dignity and I turned my focus, my full passion, to preserving life at all cost. Death is coming for us all, Sam. And if you push Julie hard enough, she may just crack. She may move you to Oregon, or Vermont, or some state where you can legally order your own death. And you’ll be gone, and Julie will live with that decision for the rest of her days.”

Sam eventually broke the lengthy silence that followed. “I’m sorry for your loss, Michelle. You have my deepest sympathy. You’ve given me a lot to think about.”

Michelle smiled. “Then I’ve done my job,” she said.

In the protracted silence that followed, Julie sensed that anything she chose to say would be wrong. Except for the words, “I’m sorry,” which Julie spoke in a soft voice, directed at Michelle.

Julie bent down and gave Sam a light peck on his forehead. As she lowered her head, Julie could see a few red dots marking the lower portion of Sam’s neck. She stood, kissed Sam’s lips, and said she loved him. Then she hugged him and hugged Michelle. For a moment the mood lightened.

Then, being the doctor she was, Julie shined her penlight on those skin abrasions. “Well, in addition to that prescription for Prozac, I’m going to get you another for an antihistamine,” she said.

Sam returned a puzzled look. “Why is that?”

“From the looks of it, you’re about to break out in hives.”

“Hives? Oh, crap. Well, I guess when it rains it pours,” he said.

Julie laughed because she could not stand to cry anymore.