Experiencing Death with Dignity

​Several years ago, my state, Colorado, passed a death-with-dignity law. It is now among a small but growing number of U.S. states which authorize very ill people to utilize medical aid in dying. The option is limited to those who are dying anyway but who wish to avoid a drawn-out, painful death by performing medically assisted suicide. The law requires two physicians to agree that that is in fact the case and for one, a Colorado-licensed doctor, to prescribe the required medications: two anti-nausea drugs and the “tea” itself.

Four-and-a-half years ago we had first met Nicole, not her real name. Forty-six years old at the time, she had been diagnosed three years before with multiple myeloma, a blood cancer which is incurable but treatable. The disease eats away bones from within and thereby causes painful fractures. Treatments at a renowned cancer clinic seemingly slowed down the myeloma but couldn’t prevent daily and nightly pain. She lived in a state, however, that didn’t permit its citizens to use medical marijuana for pain control. So, she was in our guest apartment in Colorado, a state which did. During the month or so she was with us, we became friends. Now, nearly five years later, she was a Colorado resident who had chosen, with our blessing, to die with dignity in our king-sized bed with a view to the Flat Irons, the Front Range of the Rocky Mountains.
           
After considerable searching, we found a doctor willing to prescribe the medications. He met with Nicole twice when she was revisiting us and was willing to go ahead as soon as she was. It turns out that 80% of those who get the medication never actually use it. Nicole would not be part of that statistic. A month ago, a friend drove her the 18 hours from her home state to our home in Boulder. It had been a rough journey, he said. She had thrown up several times from the pain that even the opioids she was taking couldn’t control. Once at our house—she arrived weak and tired on a Monday night—Nicole stayed in our bed except when helped to the nearby bathroom. The prescribing doctor would come midday on Wednesday, his usual day off. The medications were delivered Tuesday afternoon. Tuesday morning Nicole’s husband, 14-year-old daughter, and 24-year-old son arrived as did her best friend and a Lutheran pastor who had been working with her on her second book, which he planned to complete after her death. Her friends and family read, talked quietly, or sang to her, generally one at a time.

Around 11:30 a.m. Wednesday, she took the anti-nausea pills to keep her from throwing the death medication up. When the doctor arrived, he asked Nicole if she was ready to give up her pain. She said yes. Beforehand, he had explained to the rest of us in another room how the procedure would go. He then mixed the two liquids together in a glass with a straw. Despite its apparent bitterness, she would drink it down in less than the required 90 seconds. First, though, she said her thanks and goodbyes to the ten friends and family members present, an event videotaped, which later went viral on social media. (Nicole had been a much-loved and followed national spokesperson for the multiple-myeloma community.) She took the medication at 12:25 pm, became unconscious minutes later, and was pronounced dead at 1:35 after an hour plus of so-called agonal breathing. The doctor explained that she was for all intents and purposes already dead, but the body kept up some kind of reflexive breathing for a while thereafter. He also assured us that she had felt no pain.

Her death struck me as both totally natural and huge. About 15 minutes after she took the medication, a beam of sunlight came through the window and spot-lit her for a dozen seconds. I fancied that that was when her soul left her body and returned to its creator. After, the women washed her body in rose water and wrapped it in a sheet. Some of us sat for a while with what had been Nicole in a room that felt larger, higher, and brighter than I had remembered it. My wife felt as if the room were filled with angels.
           
​That’s how I experienced Nicole’s death with dignity as it eased her from the ravages of a relentless, unforgiving, ever-more-painful disease. May you rest in peace, dear friend.