Meltdown Monday
INTERESTING STUFF – 11 July 2020

Me and Oregon's Death With Dignity Act and The Alex and Ronni Show

[See below for the latest Alex and Ronni Show in which we chatter on about cats, hospice, medical workers, the virus, New York subways, a little bit of Trump, New Yorkers' attitude. Early in the video I mention that if we had not divorced, we would now have been married 65 years. Uh, that would be 55 years. So much for my on-the-spot math skills.]

* * *

Death With Dignity Act (DWDA) is the formal name of the law that allows terminally ill Oregon adults to end their lives by administering to themselves a dose of lethal medication.

My doctors refer to this as Medical Aid in Dying (MAID) which I much prefer to the state's name.

On Wednesday this week, I spent 15 or 20 minutes with the physician who manages this program at the medical center where I have been treated for cancer and COPD for the past three years.

We had spoken at length some weeks ago, so I was familiar with the law, with the details of how it works and what happens when a patient takes the drug.

This time, the doctor went over the legal requirements again, asked me the formal, verbal questions the state requires, and then emailed an official form entitled, “Request for Medication To End My Life in a Humane and Dignified Manner.”

You can see that document online here (pdf).

For such a monumental decision, it's not much of a form. Just a few declarations on my part and the signatures of two witnesses.

None of this is new to me. I've written about MAID in general over the years in these pages. I've known since years before my cancer diagnosis that I prefer this way of death to lingering beyond the time when I can enjoy daily life and/or care for myself.

Still, when I printed out the form on Wednesday and read through it on not just an ephemeral screen of pixels but solid paper, I felt a mild chill on the back of my neck and down my spine. I got light-headed for a minute or so.

A goodly part of me says that it is one thing to die on the universe's time frame and quite another to choose one's own time. Some call that suicide and they are not wrong.

That charge, however, doesn't resonate with me. The facile response is, “Hey, it's my life” but many of the world's religions condemn suicide, and the restraints against it are ancient. They can't be ignored by any thinking person, even someone like me who at best is agnostic but much closer to atheist.

Which doesn't mean I don't take seriously the many admonitions against suicide from learned people through the millennia. For a large part of my life, suicide was so taboo in American culture that relatives often hid the truth when a family member took his or her life.

Life is precious and as I mentioned a few days ago, I am so sad to be leaving Earth. But I am also a realist and I have made this choice. I expect to be comfortable with it when the time comes, but nothing says I can't change my mind if it comes to that.

In October 2018, when I had just been told there was no more useful treatment for my cancer, I wrote this about being terminally ill:

”For as long as I can remember, I have been curious about dying. When I have explained myself through the years, I've said that I want to be awake, lucid, not drugged or in pain because I want to experience the event of dying as clearly as possible. It is the last great mystery of life and I don't want to miss it.”

But now a monkey wrench has been thrown into the plan. If/when I use the MAID drugs, I will go into a coma within a few minutes. It is unlikely in that state that I will experience dying in the way I anticipated. Damn.

Roseanne Roseannadanna was right, “It's always something.”

* * *

Here's this week's episode of The Alex and Ronni Show.

You can check out Alex's online talk show here.

Comments

I had that same lightheaded feeling as I sat down with a funeral director to pre-arrange my send off. I can't imagine what it must be like to pre-arrange an end to life. My state's (NY) "Die with dignity" laws are sketchy but I would like to think I would have that option when the time came.

I continue to admire your incredible curiosity with all of life. I shall hold in my heart, that when you're down to your last few heartbeats, you will be one who, just knowing the pills are in your nightstand drawer will be enough, but not needed. And, like a movie I saw, Rumor of Angels, your "soul leaves the body like a school boy jumping out of the school room door with great joy and abandon.”

As I am sure you know, many get the prescription but never use it. They feel empowered by having it there in case it gets too impossible to go on; and sometimes that lets them go on and have a natural end. I don't consider it suicide as such. It's just choosing the time when the end is inevitable.

It's great to have options and to feel like you have some control, if not over everything, over the most important things. Also, I must say I so enjoyed the Alex and Ronni show today!

I hope your death is peaceful and easy, Ronni. I've experienced something similar doing my Advanced Care Directives workshop. When I started, 20 years ago, I was relatively glib about it. Now, at 68, I find it makes me feel uncomfortable; I'm talking about *me* now, not my parents.

In my thinking, my life inhabits my body for now. I think of the life force, my consciousness, as energy, and when life leaves my body (as it inevitably must) it will continue as it did before my birth, or perhaps as something else entirely. That's out of my hands.

On the other hand, I believe that my experiences in this life inform me in some way and that by leaving too soon I may miss or fail a lesson. It gets kind of jumbly. I don't know.

I've been following you almost 16 years now, and I believe you'll do the right thing.

From my perspective, after a lifetime of health care free at the point of use (and just as well since I would be dead long ago without it), the idea that someone in your position should have to spend so much time just getting the basic drugs you need to keep going is offensive. I can think of no other words, or at least nothing acceptable in polite society...

I haven't commented much these last few months. I find it hard to know what to say as you describe this end stage in your life with such honesty. I hope when my time comes I can muster the half of it. On the other hand I'm not ready to go yet. I have a new grandson and want to see him further into the life he is just starting before it is my turn to leave.

Like others above I'm sure though that whatever happens you will be doing your utmost to make sure it is on your terms. My best wishes.

Stay around and comment some more...we need you...ellie

I'm not as close to dying as far as I know, but I'm otherwise with you re: every bit of this. Agnostic, although I certainly understand the appeal of the human storytelling aimed at taking away death. I've always wondered, always been intrigued by this final, inevitable passage toward which we are all steadfastly headed. My fears are not so much associated with the passage itself as with the prolonged incapacitation that might precede it. Like you, I feel sad about taking my leave of this place -- I feel myself saying goodbye with every glance -- and the everyday busy-ness of people on the street has a heightened poignance for me now. At the same time, life is many things in addition to being wonderful, and there are moments when knowing that there will be an end to it feels restful.

I just wiped out two paragraphs worth of jumbled writing, which, essentially, came down to this. It does not ring true with me that what you are contemplating is the same as suicide, though, as a woman with an inquiring mind, you would, and should give it serious contemplation. (every time the vet has come to "put down" a beloved animal, I have thought how much more compassionately we treat them at the end of life than ourselves. )

And, I will admit to wishing many times for many years, that this option were available where I live.
With love and great respect.

I’m not where you are but everything you said resonates as much as it is possible for me. You are an inspiration and an educator.

How is it possible to care so much for someone that I don't really know? I have not been following your blog for ages and ages--only maybe a couple of years--but I feel a real loss when I think of you as gone. I fully support choosing your time of death and hope I will have that choice when the time arrives for me. You are a dear person and a powerful guide for all of us who read your story.
Juliana Ellington

I don’t really think there is anything to experience. I would think even without coma inducing drugs, your own brain functions would put you in a coma minutes before actual death. So to me, you’re in a coma, either way.

My choice, if I could, would be to walk deep into a beautiful woods with a bottle of booze, a bag of pills and a warm blanket and just let nature take its course.

There’s a place in Japan, you can do just that, but I’d prefer this country or Canada.

Ronnie, please, please consider very carefully your decision. The medical powers-that-be are all smiles, but there's an agenda...from a really nasty place. Ronnie, what if the Bible is right?

Ah, Ronnie, my heart hurts for you! I'm sorry that you are at the place where you are seriously contemplating MAID...but at the same time, I am so glad you have that option! We love you and hold you in our thoughts, supporting you in whatever and whenever you decide is right for you! But we will miss you so much!

My Mom is 96, so maybe she can give me the great roadmap you have detailed, Ronni.
She spent her last 60 or so years being beyond healthy and NOW wants it all to end at 97.
Most of her friends have died. Her last boyfriend (at over 100) passed on. She's missing the 1940's now. I only hope I have your choices, Ronni. Washington state is different, but similar to Oregon. I first attempted suicide at 16, nearly 60 years ago. I think I still have the letter I sent home from Boise. Long story, but when I got up the next morning (surprising myself!) I still had to deal with the same problems. Like you Ronni, I look upon death as the last great adventure. Finally I will have some answers to all the theories. B

The thing is, we all have to die. With choice, we can select when and how. I can think of several good reasons for doing this.

Peace.

I'm a writer as well as a fallen away Catholic who's now walking a very personal spiritual path. I know you through your writing and have found you to be a shining and loving soul who continues to inspire and elevate all who come into contact with your wonderfully bright mind and open heart, qualities that will provide you the necessary light and compassion for whatever decision lies ahead. You continue to give much to the world through your writing, and we are in your debt. Thank you for sharing your life these many years with everyone, your generous spirit is deeply appreciated. Godspeed, Melanie Lee

I can only imagine that even after a decision, it must difficult to take this step, and that pain or other debilitating symptoms would be the deciding element.

It is good that you have the option; I wish it were available for my late stage Alzheimer's husband who could live for many more years with zero quality of life.

My favorite Woody Allen quote is "I don't mind dying, I just don't want to be there when it happens." You wanted to be there, so you are one up on Woody Allen : )

You remain consistently sane since your maiden TGB post when I instantly got hooked. You are clear-headed, a brilliant thinker, analyst, and writer and radiate purpose, joy, and integrity. You express rage far later than I would/could contain when triggered as with the recent “episode” on runarounds re: ur refills. Your hair looks fabulous — a gorgeous white, fluffy, flattering. Your smile and laughter are infectious. I love how you are.

Your blog today and some of the comments following gave me pause. I hadn’t thought until now how comforting it will be to have the means of relieving pain and angst in a drawer beside my bed. It certainly will make a difference to how I feel about the end of life. So thank you, and your readers, for that.
I also very much enjoyed the Alex and Ronni show. I loved the story of your Korean American care giver, and also the one regarding the NY subway. I was noticing yesterday that the shopping carts in one of our retail outlets are gleaming! Brings to mind how grungy they probably were before all this.
Love to you and all your followers!

Listening to you with Alex. and the talk about your early marriage, with the cats, love your banter, I was asked by a friend yesterday how we met, (Michael and I, and the story, so I can share it on a holiday coming up like a Jewish Love Day) Michael doesn't want to talk about it, oh, well... How did you meet Alex?

I remember when I had my stroke and my heart did an afib I was asked about any instructions, forget what it is called. I told him my doctor had a copy. But with this covid I've had thoughts about my instructions that say no ventilator. When I wrote that I had no idea about covid and it is making me think as under the law that would apply if I get covid. Then who will care for my husband with dementia? Daughter has to work.

I wish I lived in a state with a choice on the when and how to be able to end our life. No one should have to live in pain, oblivion from dementia and no quality of life...bedridden, incontinent and almost like a vegetable. This is horrible to force that on people.

But alas, I’m in the Bible Belt and we will never have those options, so people are forced to take matters in their own hands. So unfair.

Ronni I hope it's alright to say that in the time I've known you, you've never looked lovelier. You absolutely glowed during the Alex & Ronni Show, which btw was a sweet, wistful watch.

(Though I admit your remark about this being the Apocalypse was a jarring one--one can't help but truly wonder.)

Whenever I attend a funeral I always feel it's a shame the deceased isn't able to hear the way they've affected people or to share in the stories that so often make people laugh. It might be the first time in many, many years that some people have reconnected and I feel the combination of the shared experiences is a gift.

Although it's undoubtedly cruel that you've been faced with so many painful health issues, (I shudder at the idea of having teeth implants) I feel you're fortunate to "hear" the affection with which you're held, the appreciation people have for your honesty, the pleasure you've given others, especially when you refuse to conform to the "old person" stereotype and to know so many people will miss reading your daily posts.

If and when you do decide to "take your medicine" you can do so knowing that all the people who've come to know you will remember you and miss you.

I was curious about having a child, the product of two human beings. Then came the curiosity of how a child is born. So, along the same lines, I am curious about the death process. Just want it to be quick and painless and, please God, not drawn out.

I wish we had MAID in place. It would be very comforting to know I could pull the plug anytime.

PS You look gorgeous in the video.

Re the Alex and Ronni show: if that hospice you are working with is smart, they'll ask you to record a chat about what it is like to enter hospice. People have so many misconceptions about this wonderful service -- and you are so good at dispelling them. Be well.

I think having options makes for a more satisfying outcomes in life.

So, preparing an option such as you are, is a premptive strike against not having an option you could have had had you needed or wanted it .

And, being the wise and smart anad clever person you are, you are thinking ahead.

You may or may not want or need the option, but this way you won't have to be regreting at the end "why didn't I plan ahead for this?"

Enjoy life all you can while you can.

My dad used MAID last summer in California. He was 85 and had pancreatic cancer. While I don't know what he felt physically, I do know that he was fully conscious and mentally aware, until he fell asleep. If he was frightened, he didn't say so. He was resolute that he was ready to say goodbye.

The first medication he took was a powerful sedative that would put him to sleep within 20 minutes, essentially in a coma, as you say. The second drug, taken 20 minutes later, stopped his heart, which in turn stopped his breathing. Apparently this can be painful. Being comatose prevents the patient from feeling any pain.

Dad's last half hour appeared to be peaceful. We were listening to his favorite music and he was comfortable in his recliner. He shared final comments and hugs with each of us, he looked out on his beloved garden, and then he closed his eyes. He seemed to fall asleep, that's all. The attending physician checked his heartbeat and respiration and told us when Dad had ceased to be alive. I like to think he simply cast away his physical ties to this earth when he died. I hope your passing is as peaceful for you and your loved ones. Ronni.

Not to worry Ronni - I believe you will know when the time is right just as my friend did. Lung Cancer spreading. She told me months before she felt she would know when the time was right and sure enough she did. I was with her the day before she asked to die. Her toenails were painted brilliant red and when I admired them her smile was brilliant too. I hope I will have mine done too.
take care my dear,
bb

Shabbos and Yontiff, huh? How lovely! Ours have always been given Hebrew names w/ whatever we named them after the shelters!

This conversation more than most made me sad .. happy .. comforted. You and Alex have such a dear relationship .. or so it mostly seems. And had I stayed married to my first spouse, we'd have celebrated 51 this past Jan. We are still friends.

As I contemplate my own mortality .. and the option to make that decision .. I read of your thinking and actions and I cry .. about you .. and think about what my spouse, friends, and yes, cats, have thought what the impact would be on them. And yet, why do we prolong our lives for others? Ok.. wait.. I know that.

Life .. death .. all complicated. And I know we are not to put in links.. I will suggest that others read this superb article from the Sun. print New York Times - "Boom Time for Death Planning" by Jennifer Miller. I'm curious if any among us have tried the tool - "Cake" - they mentioned to plan it all out and have it carefully recorded. I have my obit and plans provided and the play list if anyone wants to have a memorial gathering of some sort. (I said please don't call it a 'life celebration' - I'd really prefer to be mourned!)

So.. listening to you and Alex and contemplating more .. well...thank you both.

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