Death Wish, Part 2

Let's talk about suicide. In Death Wish, Part 1, I explained that I have no great love of life; in fact, I'd just as soon be dead. But that's not the same as saying I want to kill myself. To the contrary, I accept and am grateful for the life my Higher Power has granted me. It's just that if my time is up, I'm more than ready to go. On the other hand, when my time is up, I'm going to do what I can to make it an easy exit. Specifically, if I find I am terminally ill, and things get painful and ugly, I'm going to opt for “self-deliverance."

Self-deliverance is the term preferred by Derek Humphry, author of the classic text, Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. Humphrey also founded the Hemlock Society, the original support group for supporters of self-deliverance. The Hemlock Society is no longer in existence, but Humphrey now runs the Euthanasia Research & Guidance Organization (ERGO). I ordered Final Exit directly from ERGO and received a signed copy along with some important supplementary information that I expect you won't get from Amazon.

I won't try to summarize the information in Final Exit. It is a quick and concise read, and includes information not only about how to accomplish the act, but also how to do it legally and with minimum negative impacts on our loved ones. I recommend reading it it if you are at all of a like mind about self-deliverance. (Biggest revalation: Self-deliverane is not something to be done alone. It's not illegal to observe someone commit suicide, so I will have a loved one with me if I ever do it.)

As to when I might consider doing the deed, let me quote Humphry:

Frequently I am asked if I will take my life when I have a terminal illness. My answer is: “I'll wait and see." If my dying is bearable, the pain well-managed, and my self-control and dignity are not damaged, then I shall hang on and die naturally. But if I am one of the unlucky few who suffer abysmally, then I shall make a quick exit.

So there you have it. I suspect my threshold for bearable pain and self-control may be lower than Humphry's, but in principle we are on the same wavelength. Humphry has stashed the barbiturates he will need for his exit; I've ordered helium tanks and a plastic hood. (A quiet death comes in five to ten minutes breathing an inert gas.)

As you know from Death Wish, Part 1, I do in fact have throat cancer. As I write this, I have completed one round of chemotherapy and I'm three weeks I into a seven-week, five-days-a-week course of radiation therapy. The chemotherapy was administered as a two-hour intraveneous (IV) drip of Cisplatin. I felt fine on the day it was administered, but the next day was the worst day of my life. I was stuffed full of anti-nausea and anti-vomiting drugs, so the nausea wasn't so bad in the usual sense, but my stomach sure didn't want anything in it. I also felt terribly weak, of course, but the main problem was a horrible feeling that terrible things were happening in my body. It was like every cell in my body was struggling for its life, which was exactly what was happening. In addition, I was wired and couldn't sleep. Worst of all, I had to be driven to the Stanford Cancer Center and back (a forty-minute trip each way) for the next two days for IV hydration, because the Cisplatin is particularly hard on the kidneys. What miserable car rides! Every day I felt a little better, but it was nine days before the chemo side-effects were completely gone. In the first few days, I dropped ten pounds because I couldn't eat. (I didn't lose my hair, though that was the least of my worries.)

So here's the first place where my death wish comes into play. I'm scheduled for another blast of chemo next week, and a final one at the end of my radiation therapy. I have a decision to make: Do I accept the chemo treatments, or not? One friend insists that I have to do it. In his view, I need to do everything the doctors recommend to fight the cancer this time; if I have a relapse, then I'm free to throw in the towel if I choose to. Another friend says it's my decision, and if I choose not to do it, she supports me. Interestingly, the latter friend is a cancer survivor herself, and she accepted a six-month chemo that was said to increase her survival chances by six per cent.

I asked my chemo doctor what happens if I refuse more chemo. He said the radiation is going to knock out the existing tumor, and the chemo is all about decreasing the odds of a relapse. The chemo, he estimates, may help my long-term survival odds by about ten per cent. My decision today is that I never again want to feel the way I felt last week, so screw the ten per cent. It's not like I want to live that much anyway.

Then there's the radiation. In the last few days, the skin on the back of my neck has begun to get itchy and bumpy, like the start of a sunburn. Over the remaining four weeks, that's going to get worse, and spread around my neck, lower face, shoulders, and possibly underarms. The same thing will go on inside my throat, so I've got a bad sore throat coming. In addition, I've started to develop mouth sores. I know it's going to get bad, because they've already prescribed me a big bottle of liquid Lidocaine and an even bigger bottle of Oxycodone. If it gets to the point where I can't get food down my throat, I get a feeding tube in my tummy, which I'll need for three or four months.

The big question, then, is how am I going to bear up under the radiation? Given my death wish, will I reach a point where I say “No more!" like I've already done with the chemo? But with the radiation, “No more" means stop the therapy and let the cancer kill me. Will I have the strength to see the radiation through, come what may? I think I will, but time will tell. Stay tuned for Death Wish, Part 3.

Lannie Rose
August 7, 2008