Finally, I pushed the words out of my lungs with as much force as I could. “I’d like a prescription for the medication needed to end my life in accordance with the Death with Dignity Act.”
My words came out so fast, they ran together. I wasn’t even sure if I’d said the right thing, or if there was a transcript I was supposed to follow. It all sounded so stilted and forced.
The doctors looked at each other.
“I’m satisfied,” Dr. Paul said. “Send the paperwork. I’ll review the reports and if it meets criteria, I’ll sign as a witness.” He extended his hand toward me.
I grabbed it and we shook.
“It was lovely meeting you, Mrs. Falls,” he said. “You’re in good hands with Dr. Morales.”
“Thank you.” He left and I looked back at my doctor. “So…that’s it? You’ll prescribe me the medication?”
“That was only the first step.” He looked apologetic, but firm. “Next, I’ll arrange a session with a psychiatrist who will tell me if you’re capable of making this decision. If all goes well, you’ll return here in fifteen days to make a second request. If you still feel the same way, that is. Much can change in two weeks.”
“I’m not changing my mind,” I assured him.
Dr. Morales seemed unfazed. I liked that. I liked that he wasn’t invested one way or the other—it was truly my choice. “I’ll send a psychiatrist recommendation and write the scripts for the anti-seizure medication. Once you have those, you’re free to go home. Sound good?”
I nodded. “Yes. Thank you so much.”
With a polite smile, he left and I sagged into my pillow, tears springing to my eyes. After a miserable first few weeks in Vermont, things were finally starting to fall into place. I was closer to dying—an inevitability that both relieved and terrified me—but it was finally going to be on my terms.
Chapter Twenty-Four
Tuesday, July 15, 2014
* * *
“Do you want me to come in with you?” Kyle dropped down onto one side of the overstuffed couch in the psychiatrist’s waiting room then let out a loud yawn.
With how many doctors I’d dragged him to in the last few weeks only to be turned away, I didn’t blame him for being so tired. The constant disappointment was exhausting, but this weekend’s discussion with Dr. Morales felt like progress. It was our first yes, but Kyle saw it as just another hurry up and wait.
I shook my head. “No, I think it has to only be me.” I lowered myself gingerly next to him on the couch. I was feeling even more achy than usual, and my head throbbed. The last few days had put my body through the ringer.
He flipped open a magazine he’d grabbed from the end table. “Okay. I’ll be here if you change your mind.”
The inner office’s door opened and a middle-aged woman poked her head out. When she saw us, she smiled and opened the door wider. I pushed myself up to my feet and she stuck her hand out. “Mr. and Mrs. Falls? Hi, I’m Dr. Willow James.”
“Nice to meet you.” I shook her hand and smiled politely. “I’m Tessa, and this is my husband, Kyle.” Kyle stood and shook her hand next.
Dr. James pushed her hair behind her ears, an endearing move that looked almost vulnerable. I liked it, and I liked her. It’d only been a few seconds, but there was a softness to her that immediately made me feel safe. “Lovely to meet you both.” She gestured into her office. “Come on in, Tessa.”
After I entered her office, she closed the door behind me and waited for me to choose my seat out of the several arm chairs and couches available. I picked one of the smallest armchairs in the corner and then tucked my feet beneath me.
She seated herself in a similar chair across from me, a notepad and pen on her lap. “Dr. Morales gave me some information regarding your circumstances for being here, but I’d like to hear from you. This is your hour. We can talk about anything you’d like.”
“I’m not sure where to start...” The scarf on my head felt itchy. I pushed it back slightly, trying to adjust it, then, on a whim, decided to pull it off completely. I wanted her to see it. The scars, the fuzzy patches of hair, the way my skin flaked around the incision. “I have a tumor—glioblastoma—in my brain.” I ran a finger over my head to the spot above the cancer. “It’s terminal. Meds, radiation…I’ve tried it all, but instead of shrinking, it grew. I’ve got until November, maybe. I’m not entirely sure anymore. Every doctor has said something different.”
Dr. James exhaled slowly, and her eyes were frowning. I’d never seen someone who could frown with just their eyes, but she was and it was a more real display of emotion than I’d ever seen. A window into her heart that she’d willingly left open and encouraged me to look into. “I’m so sorry, Tessa. It’s incredibly unfair someone so young has to deal with this. May I ask, how old are you?”
“I’m twenty-eight. I’ll turn twenty-nine on the last day of September, if…” if I make it that long, I finished silently.
She seemed to understand my meaning. “Do you want to make it to your twenty-ninth birthday?”
If anyone else had asked me that, I’d be offended. But, there was no judgment in the way she spoke, an understanding that maybe I wouldn’t want to live like this and that was just fine. There was no rule that said I had to want to see my next birthday, but even as I realized she was giving me the freedom to say no, I only wanted to say yes. “I want to make it to all of them. Thirty, fifty…one hundred.”
She didn’t respond, prompting me to continue, forcing me to face the reality of my situation, something I tried to avoid thinking. That didn’t work out in my favor often. “I know the rest aren’t options, but I do want to make it to twenty-nine. Though, only if I can still be me.”
She cocked her head to the side. “What do you mean?”
I pulled on a loose string on the edge of the armchair. “I’d rather die now—able to talk and walk—than die paralyzed in a bed at twenty-nine. That’s why I’m here, why I moved to Vermont. To get the medication to end my life when that time comes.”
She didn’t look surprised, and I guessed Dr. Morales had already told her. “What made you decide this route? Have you researched other options?”
“I’ve spoken to more doctors in the last few months than I’ve spoken to in my entire life,” I admitted, a rueful smile pulling at my lips. “There’s no uncertainty in my diagnosis, even with other routes available. There’s also no question what it’ll be like in the end—paralysis, pain, blindness, seizures. I don’t want to go through that.”
She jotted something down on her notepad. “What about new medicines, clinical trials, experimental studies? Have you looked into those?”
I nodded, my stomach tightening. “There’s a clinical trial at a university in North Carolina with a lot of potential, but not in the time frame that’ll help me. The research is still in its infancy. Plus, most of the success they’ve seen were in earlier stages, and my tumor has progressed so quickly, I no longer fit the criteria.”
“What if they accepted you into the trial and it could extend your life? Have you tried to apply?”
I was beginning to think my first impressions of her were wrong. “I called and spoke to the lead clinician. He confirmed my tumor was too advanced. On the off-chance I was accepted, the treatment would most likely extend my life…but in a hospital bed. There would be hundreds of tests, strict procedures, constant monitoring. I’d never get to go out on my own terms, doing things I’ve always wanted to, with people I want to be with.”
She lifted one brow. “Even for a shot at life?”
My chest tightened, and I tried to exhale my irritation. I needed her to listen to me, not keep repeating the same question. “That would be the best-case scenario for someone without my tumor, my prognosis. I am dying, and that study—or any other—won’t change that. Hopefully, it’ll change things for the next person with a brain tumor.”
“Why not you?” Her face was completely blank, not a hint of emotion. Given that I already kne
w how expressive she could be, I wondered why she was hiding now—or what. “Why wouldn’t you try if it means you’d live a long and healthy life?”
My face twisted so hard, I worried it might freeze that way. Was she kidding? Did she not hear anything I’d said?
I mentally counted to five, pairing each second with a choice four-letter word I wanted to throw at her. Finally, I replied, “I don’t think you understand.”
“I do.” She didn’t miss a beat, and I let my gaze travel past her to her desk, wondering if I’d get a chance to steal and break the glass paperweight she had. I really had to stop soothing my emotions by breaking shit. Maybe tomorrow. “There is a trial that holds the tiniest bit of hope. It could extend or save your life, but you’re turning it down. You’re not even trying. Why?”
“I am trying!” The words shot out of me in a yell, my fists balled at my side. I was definitely going to break her damn paperweight now. “I am trying to spend my last months living... that’s the point of all of this. I’d maybe gain more time, but I’d lose the chance to live. I want to live.”
Dr. James carefully placed her pen on the notepad and stared at me.
Shit. I shouldn’t have yelled. Though, she didn’t seem surprised…or even upset. Therapy is a mine field, and my heart had stepped on each one until I detonated.
Christ, this woman was hard to read when she wanted to be. “I’m sorry,” I continued. “I don’t mean to yell. It’s just…I’m not giving up, or suicidal. I don’t want to die. I am dying. There’s a difference. I had to accept that fact to be able to find any happiness in my remaining days. I’m going to enjoy the time I have rather than spend it wishing for more.”
She placed her notepad on the table next to her then leaned forward, resting her elbows on her knees. “Tessa, if you’re serious about doing this, about ending your life, you need to know what you’re giving up. You need to decide it’s worth it to you anyway, find calm with that decision in your heart and mind.” Her eyes turned emotive again, and this time, I saw pride. She smiled, small and slow. “It sounds like you’ve done that.”
Relief seeped through my body as I realized how certain I was. For the first time, there was zero doubt in my mind about what I wanted. She was completely right—I’d done the work. The only things holding me back were other people’s judgements and feelings, but me? I knew what I wanted. This was the right choice. “You did that on purpose, didn’t you? Egging me on like that?”
She just smiled and cocked her head to the side.
I leaned back against the couch, my posture relaxing. “I’ve seen people die slowly…what it does to those left behind. I want to ease the suffering for my family as much as me. I want to be able to decide when it happens…how.”
“What if you can’t?” she asked, picking up her notepad again and jotting something down.
I frowned. “What do you mean?”
“What if the tumor’s growth accelerates and you pass before receiving the medication? Or, what if you’re not approved? What then?”
I swallowed at the thought. “There’s not much I could do then, is there?”
It was a question, but it also wasn’t. I had no idea how things would progress, nor did my doctors. They hadn’t expected the treatment not to work. They hadn’t expected six months to be too long of a prognosis. I hadn’t expected to be facing death before I turned thirty.
“There are people with terminal illnesses who end their lives other ways,” Dr. James said, her voice quieter now.
My eyes widened and I shook my head. “No. No way. I mean…yes, I know it’s an option, but not for me.”
“Why not?”
“I couldn’t.” It was truly that simple. “Not to my family. To myself. What if my family got in legal trouble for it somehow? What if they blamed themselves? And, in the worst possible case scenario, what if I didn’t die from it at all? Or died slowly and in agony? There’s way too much risk. That kind of thing happens all the time. I literally have nightmares about it. I just can’t. I can’t. I know what I want to do.”
“That’s good to hear that you know what you want and you’re adamant about your decision.” She jotted down a few more notes. “Tell me about your family. Are they having a tough time with this? Surely they want you around as long as possible.”
“They do, but the only one opposed to how is my sister,” I explained. “And she doesn’t know what she’s asking.”
“What do you think she’s asking?”
“She’s asking for me not to die. Period.” I rubbed my right palm up and down my left arm, then switched hands to do the same thing on the opposite side. Soothing. Making it easier to talk about how little time I have left to feel my fingers brushing over my skin. “If she can’t have that, then she at least wants more time. It doesn’t seem to occur to her what that time will look like. When our mother was dying, Elly was so young. She doesn’t remember the pain and torment our mom was in, or what a hardship that was on our father…on me.”
Dr. James made a soft humming noise. “What would you do, then? If you didn’t get approved?”
I stared back at her. “Are you not approving me?”
She shook her head, sitting up straighter. “I don’t know the answer to that yet, and I’m not the final decision point. Either way—approved or not—there are external factors you can’t control. All you can control is how you respond to the uncontrollable.”
“I don’t know what I would do if…” I paused, looking up at the ceiling for an answer. “If I didn’t get approved…I’d probably look into alternative medicines or therapies, anything to stop the symptoms, or reduce my pain as much as possible.”
“And if that doesn’t work?” She was pushing again. Risky, considering the life of her paperweight was still on the line.
The thought of not only dying, but dying a slow and painful death, was terrifying. It overwhelmed me to think of what would happen, how it would feel, how long it could take....
I cleared my throat and fought back the impending panic. “If I have no options, then I have no options. I’ll die the same way people have always died, and life will continue on without me.”
We sat there quietly, letting the heaviness of the conversation catch up with us. She watched me, not in an uncomfortable way, but because we needed a moment of silence for my life, for my death…for me.
When we finally began talking again, we discussed what the next few months would look like, how I’d deal with it. Every fear poured out of me, letting down every wall I’d built up to protect the people around me from knowing how devastated I truly was. Here and now, I took care of me first. I bled my grief onto her office floor, and then I left it there.
The weight parked on my chest for months was gone. Whether she approved me or not, I had found a resounding assurance inside myself. There were no more doubts, no questions, and that certainty…it was everything.
I left her paperweight intact as a thank you.
Chapter Twenty-Five
Thursday, July 17, 2014
* * *
“I don’t understand why we need to discuss it now.” Kyle opened the car door for me and offered me his hand. “We already have the legal paperwork done—will, advanced directive, power of attorney. That’s more than enough.”
I stood with his help then stretched my neck from side to side as we walked up the porch steps and into the house.
“It feels so mechanical,” he continued. “I don’t like thinking about it.”
“I don’t either,” I reminded him while I pulled off my jacket. “But if I don’t tell you what I want now, when will I have another chance?”
He took my jacket from me and hung it in the coat closet. “There’s plenty of time.”
I nibbled on the edge of my lip. I hoped he was right, but I also knew he wasn’t based on the shooting pain radiating from my scalp to my neck. “Either way, I want you to know. Like for my book, my funeral—”
He waved his hands in fr
ont of his face, shaking his head. “I’m not talking about your funeral.”
“Good, because I don’t want one. If you need a small gathering at my burial, fine. But, I’d rather have a celebration before I die. With happiness. And dancing. Even if it’s just you and me—I want that to be my funeral.”
“You want to celebrate your death?” He looked incredulous, his brows lifted almost to his hairline. “Have you lost your goddamn mind?”
I rolled my eyes, heading for the couch. The dramatics on this one. “Not my death. My life.”
He scrunched his brows together and I wondered if I was pushing him too far. This entire topic was hard for him—I knew that. It was hard for me, too.
“I think we should plan a trip.” Kyle’s spontaneous admission surprised me.
“Yeah?” I perked a little at the idea, despite how zapped my energy levels were lately. “Where do you want to go?”
He joined me on the couch, lifted my legs into his lap, and rubbed my feet. “Better question is where do you want to go?”
I tilted my head, melting into the couch cushions thanks to his skilled massage. A groan escaped my lips, my eyes closing. Beast jumped on the couch and curled into the crook of my arm. “I want to go somewhere with water.”
Kyle laughed and I opened my eyes to see him pointing out the window at our view. “This isn’t enough water for you?”
“Nope.” I grinned, pushing up my chin. “I want excitement, energy—not gentle waves on a calm lake.”
“You’ve mentioned Niagara Falls before. We could take a boat under the falls, get completely wet.”
I wiggled my brows at him. “That’s what she said.”
He opened his mouth as if to respond, but then his face seemed to droop, and he shook his head.
“What?” I prompted. “I’m not funny anymore?”
“You’re always funny, Tessa.” He glanced sideways at me. “But I’m going to miss this. I’m going to miss how you make me laugh.”
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