After

by Nikki Gemmell

  Sue Walker – Adelaide SA

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  ‘Your mother’s choice. That’s it. To rail against that . . . does it disrespect her last act of self-determination?’

  Lorraine Meades – Bendigo VIC

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  ‘The politics are a bottomless swamp. If “oldies” were allowed to go peacefully – surrounded by loving family, entirely voluntarily, when it all became unbearable for them – then all hell would break loose. The reduced demand for old-age palliative care would cause massive unemployment. Surgeons would lose about half of their opportunities to do lucrative operations, funded by the taxpayer. Modern medicine started by keeping us alive when we had so many productive years ahead of us, and we were grateful for the chance to do all the things we wanted to do. Now medicine too often keeps us alive long after we have done all the things we want to achieve, and are dreading even one more day, more than ready to go.’

  Mike and Maddy – Mandurah WA

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  ‘We feel very sorry for both you and your mum . . . She obviously knew the whole ghastly draconian legal situation and kept you in ignorance for your own sake. We need politicians with the backbone to change the legislation concerning euthanasia. I also have fairies at the bottom of the garden . . . We are sorry you didn’t manage to pick up on your mother’s research – We think that her final moments were more than an act of empowerment. She was certainly taking control of her life and the way it ended in a dignified manner. She was a brave and resourceful person, who need not have been alone as she died. It is not illegal to be present as a person takes their life; only if you assist them in any way to die. But perhaps she doubted that family members or friends would love her enough to “let her go” and would make it simple for you all. So chin up girl! She is better off than living in unrelieved pain.’

  ‘Two Hillbillies from the West’ – WA

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  ‘My husband did the same thing. Long-term heart disease then the diagnosis of a very advanced cancer threw him into the willing arms of the medical fraternity who don’t know when to stop. No one ever suggested he do nothing; just live and spend time with those he loved. Overwhelmed with guilt at not recognising what he was planning, I eventually consulted with a psychologist who cautioned me to not judge, that given the right circumstance, we are all capable of suicide. His note still haunts me: “What a disgrace. You will find what remains of me in the canal. I cannot burden you with the impending mire.”

  ‘Empowerment, despair, selfishness? Some of each; unwittingly they pass their burden on to us. It took years to forgive him but I have. Hold your mum’s memory close to your heart; I have no doubt she did what she thought was best for everyone. I’ve several friends who have their end mapped out; they will not linger and I suspect there’s much of this that doesn’t reach the press . . . we reach our “use by date” and don’t want the indignity of long term illness.’

  Name withheld

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  ‘Nikki, you can’t blame yourself because your mother wanted to end her life in her way and a way in which she was in control. We would all like to have that power when the time comes.’

  Margaret Deacon – Gold Coast QLD

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  ‘I did want to offer my small insight into my mother’s attempt to kill herself, during her battle with cancer. She died in 2013, in a nursing home, she had given up, couldn’t walk or care for herself and just shut down and died. The cancer (in her brain) wasn’t the cause, she just decided she didn’t want to be here anymore. Her illness had been a long one.

  ‘Like you I have often thought about what I said, did etc. and tried to understand my mother’s years during her illness. I do remember that when she said to me that she was going to kill herself I didn’t believe her. Like your mother she took an overdose but my father found her and she was rushed to hospital. My abiding memory of this is how furious she was with my father and I that we didn’t let her die. She had had enough and everything that she valued was being taken away from her, most importantly her fierce independence. Now others were intruding upon her, others were making the decisions and she hated it. Strangely I understood why she wanted to die and I respected this, despite my devastation at that thought. I believe that the illness had taken everything, all decision making and dignity was gone, the only thing my mother had left was her ability to choose to die. I’m not sure if it is selfishness, love etc., as you ask. For me these are not questions I’ve needed to ask myself because as her carer, with a long illness, it was all too obvious – what else did she have control of?’

  Wendy Bertrand-Clark – Traralgon VIC

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  ‘I know you will be sharing every daughter’s feelings of love/guilt etc. for so many years to come. The only comfort I can offer you is this. I am now seventy-three, and I would definitely choose the same path as your mother/my father, when push comes to shove. Because the older I get, the more I appreciate that my life is all – and I, and I alone, hold it in my hands. My life, my choice as to how I live it, or decide to end it.’

  Helen Brierty – Yandina, QLD

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  ‘You’ve reminded me that my wife Rachel and I need to be listening to not only our parents’ words but also to their subtext as they too wrestle with the loss of independence, the loss of control, the loss of dignity that comes with chronic pain and the aging process. We need to not allow ourselves to become frustrated by their reluctance to ask for our help so as not to be a burden on their children and families. We too have felt confused, hesitant, impotent and unsure of what to do; you’ve encouraged us to be up-front, to speak straight and without hesitancy to understand what they are actually feeling.’

  Paul Wappett – Melbourne VIC

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  ‘Pain has changed my mother, not just physically but mentally. She has become cranky and often cruel in her behaviour, especially towards my father and me. It is possibly a reaction to her pain although my children and even my father tell me that she was always critical of others. Perhaps, her terrible pain has altered her. Whether she will be able to heal completely will be something that we will have to wait to see.’

  Ruma Chakravarti – Adelaide SA

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  ‘Your story about the passing of your mum reminded me of the passing of my dad. He wanted to “do it” himself but needed my help as he could not leave the house. (He had joined the Euthanasia Society.) He collected the sleeping tablets; I provided the mortar and pestle from the Uni Lab and I bought his favourite bottle of Malt Scotch. I waited with dread at finding him dead with a plastic bag over his face (still gives me the creeps sixteen years later). Next day I turned up to find an empty bottle and a very drunk old man . . . this happened a further five times! He said he just couldn’t do it as he was afraid he would end up a vegetable if things went awry.’

  Name withheld

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  ‘If it’s any help – after two serious bouts of cancer/chemo/radiation and god awful pains – I contacted Exit International with the desire to end it. I looked on death as the end of pain – peace and escape. But my husband worked tirelessly at keeping me alive to a degree that was heroic. So I changed my mind. I had to live for someone else as he was not ready for a lonely life. My motto was “Someone or something to love. Something to do. Something to look forward to.” And that made it easy for me.’

  Lurline Frank

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  ‘You are not alone, and by sharing your story, you enable more people to come forward and share their stories; particularly, but not exclusively, women. After all, they are still the carers and nurturers in our society.’

  Irene Goldwasser – St Kilda VIC

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  ‘The whole euthanasia issue is not going to go away, but one has the impression many people in high places are trying to dampen it down. If more females were shaping our laws, I don’t think this would be the case. Women in general are the carers of the frail and dying. Men, in general, aren’t nearly as involved. I’m now a
n elderly person, and myself and female friends have found our husbands aren’t at all interested in discussing end of life arrangements. My husband says he doesn’t want to discuss it and to do whatever I want when the time comes.’

  Rosalie Barry – Tewantin QLD

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  ‘I too feel guilty about not listening more to a loved one in distress and worse, being too tied up in my own issues to notice. Even twenty-nine years after my beautiful twenty-five-year-old son committed suicide I still beat myself up over what I didn’t do and what I could have done if I had known more. I have learnt strategies to keep myself sane which has kept me going, and knowing our loved ones are no longer suffering helps. Your mum was a beautiful woman and deserved better from doctors. It’s almost as if they killed her. I’m so pleased you shared your heartbreaking story as it may well save a life by making people more aware of others in deep despair, and point them to where help is available.’

  Elaine Joseph – Gold Coast QLD

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  ‘I know how you feel. Yes, you will never recover from the loss; and perhaps a perverse sense, even, of abandonment/desertion; I felt that but I was much younger, twenty-eight. Hug your children.’

  Suzanne Edgar – ACT

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  ‘You mentioned “selfishness” – a strategic observation because it links with “rejection”. During my twenty-eight years as a mental health practitioner, rejection was often cited as a feeling experienced by those left behind. When your mum died in those circumstances lots of kin would have felt let down – it’s an understandable emotion. They say we spend most of our lives trying to live up to our perception of parental expectations, so it cuts to the quick when Mum or Dad choose to leave this life alone.’

  Mike Fenton – South West of WA

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  ‘We all try to examine the historical events and how we might have done better and it isn’t easy. In my case the memory of my mother passing didn’t need examination, but I’m often conscious of the time I asked her, when I was angry at something now irrelevant, some six decades ago, “Do you love me?” She looked at me with a very sad face and a tear rolled out as she said, “Don’t you know?” Ashamed was I for the rest of my life.’

  George – South Fremantle

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  ‘I have just come back from Holland. My younger sister, Annelies, was at the final stage of cancer and had the opportunity to end her life with the help of a doctor. She was so happy! She did not yet suffer too much, she used marijuana to keep nausea at bay and it helped her sleep too. She was totally clear headed and very ready to leave this world. She had had a long and interesting life, with many people who loved her and felt inspired by her.

  ‘Your mother chose to die because she didn’t think her life gave her the dignity and independence she wanted, needed. Dying is not a decision you take lightly. What you tell us in your writing is that she planned it carefully, with as little impact or nasty surprises as possible.

  ‘Thank her for that. That she did not tell you, is, no doubt, because she loved you too much, knew you’d run into trouble if she did. Dying is a lonely act. Though we were with my sister (three close friends, two sisters) my sister still died all alone. But you should have seen her smile when she got her injection. She was so happy. No more pain, no more travelling slowly and painfully to an end of life in a way that negated her independence and enjoyment of a very good and rich life.

  ‘Annelies was a very intelligent and independent woman. Quality of life was most important. And so, when she heard that the cancer had come back and was spreading, she talked to her doctor. She’d known my sister for a long time and agreed to be the one to give Annelies her injection. Then Annelies had to go to an independent psychiatrist, who talked with her, checked that her illness was terminal and gave her his permission for the procedure. And then, when she was too tired to take care of herself, and decided she wanted to leave, she had to start the actual procedure, and made a phone call. An unknown doctor visited her to assess her health and suffering. That’s rather ironic, who can assess other people’s suffering? Yet, such are the rules and regulations. And so . . .

  ‘In Holland the procedure is not legal, but it is not prosecuted if the rules are followed.’

  Frieda van Aller – Port Douglas QLD

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  Receiving the deluge of reader letters helped me to understand, buoyed me; suddenly, I did not feel so alone. I wish Elayn had had a swell of voices around her – myriad voices of understanding and compassion – in her bleakest hours. She didn’t. It felt like she was unbearably isolated, and frightened, and floundering.

  One letter, in particular, tugged.

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  ‘Dear Nikki

  ‘Your words hit me right in the heart. You see, I’m on the other side of the page. I’m a woman, mother and doctor, and I’m planning to go to Switzerland next year to take the option of assisted suicide with Dignitas International.

  ‘I’m sixty-one, and have been suffering from a disabling, progressive and very painful form of arthritis for the last twenty-three years. Although I don’t know the details of your mum’s circumstances, I suspect that the major differences between us are that I’m a doctor, and I have enough money to access a service overseas which I believe should be available for all people who need it. I made the decision to end my life at the time of my choosing five years ago, after a very painful and unsuccessful operation. Since then I’ve spent every day wrestling with the terrible balance between when my pain became too much to bear, and when my children would be sufficiently launched into their lives that they could manage without me (I’m a sole parent). I was hoping to wait until sixty-five, but the continuing encroachment of greater disability and decreasing effectiveness of my pain management regime (I’ve been fortunate to have the help of a chronic pain clinic, and lucky to avoid abuse of my opiate medication, although it’s a daily temptation) has forced my hand.

  ‘My children have known of my decision since I made it five years ago. Last Christmas I told them that this would be my last full year, and that I planned to make it the best year for all of us since I first got sick. I’m going to access some of my superannuation funds, and do something special with each of them this year. My eldest and I are off to Africa next month. I know that whatever I do with them will result in more pain, but it will be worth it for the pleasure of giving us all special memories of this final year together.

  ‘Of course, every day I feel guilty for being such a coward and leaving them early. On the other hand, I want to leave them all a good inheritance, rather than spending the next twenty years using up the money that I’ve saved for them in supporting myself as my life continues to contract around me. I know they’ll miss me terribly, but they have watched me suffer for a long, long time, and understand my need to end that suffering. I still enjoy lots of things I do in life, but as I explained to my physiotherapist, those things are like icing on a shit-cake. The icing is great, but it’s still shit underneath – and the icing gets thinner every day.

  ‘I would dearly love to be able to carry out my wishes here in Australia with all my family around me, and as a doctor I would certainly be able to access the appropriate drugs. But what then? If my children were with me, they would be subject to investigation by the authorities. If I were alone, then someone would have the traumatic experience of finding my body, and the children would then have to identify me. I can’t subject people to this. It’s a travesty that in a free, secular country, people like your mother and I are proscribed from having control over the time and method of our passing. I don’t know if it helps you hearing my story, but perhaps it might give you some insight into how it feels on the other side.'

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  The letter was from Dr Helena Thompson (not her real name). I’ve never approached, in person, any of the thousands of my column readers who’ve written to me over the years. With Helena, for the first time, I take a leap of faith and get in touch with her. It’s like stepping –
fearfully – through a door I’ve never had a need to go through, and have never wanted to. Who knows what’s on the other side.

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  Life. A woman determined to extract every last bit of joy that she can out of her time on this earth. And she’s only got a year or so left.

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  Helena’s home is two hours away. Before setting out to visit a complete stranger I write her details on a slip of paper and leave it on my desk, for Andrew, in case I never return. Who says this reader is really a doctor? Even a woman? A Google search tells me such a doctor exists, but maybe it’s one of the nutter-haters who’s used her name to lure me. These are just some of the charming responses to my writing I’ve received on social media: ‘As if I’d trust an article written by something that bleeds for a week every month and doesn’t die.’ ‘I hope you die alone. Cold. Afraid.’ ‘An alpha male doesn’t care what women think.’ ‘I just want big tits and to be left the **** alone when I’ve blown.’ Yet I leap.

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  Helena lives in a house teetering on the edge of a bush gully in the shadow of a great mountain. I know instantly she’s what I’ve needed. Grief is a silent, secret, confounding world, and she knows it.

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  Like Elayn, vivacity defines her. Helena hoots with laughter, shines with raucous joy. Her voice is clear, expressive, intelligent. Her short grey hair is coloured in playful rainbow stripes. This is a woman who knows how to live, fearlessly. It’s in her clothes, voice; her open face with its roguish smile. She’s known the underbelly of life, which gives her great empathy. She now works in drug and alcohol dependency after doctoring in emergency care, psychiatry and prison healthcare. Her gift is compassion, and she knows that not all doctors have it.

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  Helena wants my story first up. Listening is her job and life. Understanding, processing, helping. ‘As a doctor, the most important thing is to share your humanity as a fellow human being – and to make people laugh. I’m old [she doesn’t seem it], and I think old age is a wonderful thing because if you allow yourself to keep learning it teaches you. You never stop learning. Terence, the Roman playwright, said, “I am human, and nothing of that which is human is alien to me.” As a doctor you must make every patient, no matter what they’re telling you, feel like they’re part of humanity. You mustn’t allow them to feel that what they’re telling you is weird or odd, whatever it may be. And that’s why being in pain is so helpful as a doctor, because you can share the understanding with your patients, and the desperate temptation to have more opiates every single day because they make you feel good. Taking drugs is a normal part of managing the huge gap between what we hope life is going to be, and what life is. It’s not criminal or evil, it’s normal. But then people get caught up, and it overtakes their world.’