Posted on 09/30/2007 10:01:27 AM PDT by wagglebee
Lovelle Svart woke up Friday knowing it was the day she would die.
There was much to do. Her family and closest friends would be gathering at 11 a.m. in her mother's apartment in the Southwest Portland assisted-living center where they both lived.
She directed trips to the grocery store and even called AAA to jump-start the dead battery of her 2006 Scion. She double-checked delivery of food platters from Fred Meyer: turkey sandwiches, strawberries and grapes, pretzels, almonds and sparkling water. There would be pink roses on the dining table and a boombox in the corner to play music, including the polka tunes she loved.
Lovelle made one last trip to "the bridge," a wooden footbridge in a nearby park where she had found quiet sanctuary the past few weeks as painful cancerous tumors spread from her lungs through her chest and her throat.
The consummate planner, she had choreographed the day. She wanted to leave time -- five or so hours -- for storytelling, polka dancing and private goodbyes. And at 4 p.m., she intended to drink a fatal dose of medication, allowed by Oregon law, that would end her life.
A smoker since age 19, Lovelle found out five years ago that she had inoperable lung cancer. Radiation and chemotherapy slowed the cancer's spread but could not stop it.
In June, Lovelle's doctor warned her that she was likely to die within six months, making her eligible for Oregon's unique, 10-year-old Death With Dignity Act.
What some call doctor-assisted suicide and others call physician aid-in-dying or hastened death is one of the most passionately argued issues in U.S. medicine and politics. Proponents frame the question in terms of personal choice, death with dignity and freedom from pain. Opponents say assisted suicide violates the Hippocratic tradition of "First, do no harm" and undermines the doctor-patient relationship by turning physicians from healers into accomplices of death.
Far more people ask for a lethal prescription than actually use the drug. Either their symptoms overwhelm them before they make a final decision, or they find other ways to control those symptoms, including pain.
Lovelle was determined to keep control, if possible, of when and how she died.
On July 1, she filled out and signed a one-page form titled, "REQUEST FOR MEDICATION TO END MY LIFE IN A HUMANE AND DIGNIFIED MANNER." By signing, she agreed that she knew the expected result -- death -- and was aware of alternatives, such as hospice care.
By law, she also had to make two oral requests at least 15 days apart. Her doctor wrote the prescription for a lethal dose of barbiturate in late July, and she had it filled Aug. 7. She kept the orange bottle of clear liquid in a plastic grocery bag on a stack of towels in her bedroom closet -- "hidden in plain sight," as she put it.
She was still unsure whether she would take the drug, but said she took comfort in knowing it was there.
Once she knew she had less than six months to live, Lovelle also decided to try to start a more open public discussion of dying. During the past three months, mostly through a series of online video diaries for The Oregonian, she shared publicly the experience of facing death.
Lovelle, 62, has "touched a chord" by chronicling her "deeply intimate struggle with mortality," said Dr. Susan Tolle, director of the Center for Ethics in Health Care at Oregon Health & Science University.
"People are following closely," Tolle said Friday. "They want to know what happens to her.
"Lovelle has become their friend."
Friday morning, Lovelle stuck a yellow note on the door of her mother's apartment: "Please Do NOT Disturb. Unless Urgent. Thank you."
She wore a blue sweat suit over a "Cancer Fighter" T-shirt.
Lovelle delighted in Friday's blustery weather and a forecast that included possible thunder and lightning about the time she planned to die. "Oh, the woo-woo crowd will have a blast with that," she said.
After AAA jump-started her car, she left the engine running to recharge the battery, returned to her apartment and set the kitchen timer for 10 minutes to remind her.
When a friend later expressed shock that Lovelle had spent part of the last morning of her life dealing with a dead car battery, Lovelle explained:
"The car goes to my sister. I didn't want it to be dead."
In the living room, her family and friends sat and told stories and jokes, sometimes with political references. Sometimes they laughed a bit too loudly, out of nervousness at the occasion. Twice, Lovelle came out of the bedroom where she was having private meetings to say, "No politics!"
A bit later, Lovelle and George Eighmey, head of Compassion & Choices of Oregon, an advocacy group that works with most of the Oregonians who end their lives under the Death With Dignity Act, danced a brief but rousing polka.
By midafternoon, the studiously punctual Lovelle was falling behind her schedule. No one complained.
But a little before 4 p.m., she decided it was time to make her final preparations. First, she had to take the two pre-medication pills -- to calm her stomach and control vomiting. They were hard to swallow, given the tumors in her neck, but she got them down with water.
"It" would be in about an hour, she told her family. Time now to sit alone with her mom, Vi Svart, in her bedroom for the last time. The rest of the group sat in the living room, debating whether they wanted -- and whether Lovelle wanted them -- to be in the room with her at the end.
Lovelle's three siblings and her mother, despite deep misgivings about her decision to end her life, supported Lovelle in her choice.
"I feel so at peace," she said. "I've had such a good time. . . . And today has been so wonderful.
"I'm really ready to go. I'm ready."
About 4:30, Lovelle announced she wanted "a hugging line" -- one last hug for everybody. "You'll be first and last," she said, turning to her mom.
Lovelle stood in the center of the living room and embraced them one by one -- long hugs with tears and laughter.
Then one last cigarette break on her favorite sitting stone next to the parking lot. Afterward, Lovelle took the elevator up to the third-floor apartment and hung up her coat and hat.
"OK," she said to no one in particular. "I'm going to get into bed now."
In many ways, Lovelle fits the pattern of Oregonians who choose to end their lives under the Death With Dignity Act.
Like most, she had cancer. She was in her 60s. Well educated and insured. Not formally religious. White. Enrolled in hospice care.
And fiercely independent.
"I could be very gregarious -- and very private," she said. "Very much the partygoer -- and very much want to stay home and read."
She was chosen Miss Cafeteria at Crater Lake Lodge in the summer of 1963, and she has the lemon-yellow rayon dress to prove it. She left it hanging in a plastic dry-cleaning bag on her bathroom door.
She loved surfboarding and polka-dancing and both her first and last names, "because they are different, and I like things that are different."
And she liked, as she was the first to admit, being in control.
Lovelle decided it was more important to die by taking the lethal drug while she had a degree of control over her body than to wait for nature to take its course. But how to decide when?
Her symptoms -- shortness of breath, stomach distress, weakness and pain -- were intensifying. If she waited too long, she would be unable to drink and swallow the lethal drug on her cupboard shelf.
Lovelle sought a shifty window between life-worth-living and incapacity, "this tiny bit of freedom" when, for her last act, she could swallow a fatal potion in the company of family and friends. "That's when I want to go."
Last Sunday, after a painful, restless night, Lovelle decided it was almost time.
Swallowing was more painful than ever, like choking on broken glass or razor blades, she said. She had barely eaten in two weeks. She started taking morphine to dull her pain.
She told family and friends to come Friday.
Lovelle sat on the foot of the bed, while 10 others gathered around. A photograph of Lovelle as a curly-haired 5-year-old stood on one bedside table; on the other were a glass tumbler containing the liquid medication, which looked like water, along with a container of morphine and Lovelle's ever-present mug of Gatorade. On the wall above the head of the bed were five more family photographs.
With some help, Lovelle yanked off her shoes and socks and slipped partway under the covers.
Eighmey stood by her bedside. He has attended more than three dozen deaths of this kind.
"Is this what you really want?"
"Actually, I'd like to go on partying," Lovelle replied, laughing before turning serious. "But yes."
"If you do take it, you will die."
"Yes."
Ever the detail person, she reminded him that she wanted her glasses and watch removed, "after I fall asleep."
Eighmey warned her that the clear liquid would taste bitter. She needn't gulp it. She would have about a minute and a half to get it down.
Lovelle dipped her right pinky into the glass and tasted.
"Yuck," she said. "That's why I need the Gatorade."
Holding the glass, Eighmey asked her again to affirm that this was her wish.
Yes, she replied.
Someone asked, "Can we have another hugging line?"
One by one, they came to head of the bed for hugs and teary whispers.
"Sweet dreams."
"It's all right."
"I know."
"Thank you for being my big sister."
"All the church is praying for you."
Lovelle was sitting up in bed, three pillows propping her up.
She held the glass tumbler in her right hand, raised it to her lips and drank. It was 8 minutes after 5.
"Most godawful stuff I ever tasted in my life," she said, making a face before taking a sip of Gatorade and plain water.
She laid back and scrunched down under the covers, glasses still on to see her loved ones.
She reached for her mother, who leaned closer, then laid down next to Lovelle, stroking her hand.
"Are you OK, honey?"
"I'm fine, Mom."
"You're not sick?"
"No. I'm peaceful. It stopped raining, the sun's out. And I've had a wonderful day.
Her eyes closed.
"It's starting to hit me now."
For a while, no one moved or spoke, as Lovelle drifted into a coma. Then Lovelle's mom asked for a prayer. Others spoke up with prayers and memories, which prompted other stories. Lovelle's brother Larry read part of William Wordsworth's "Intimations of Immortality."
Lovelle lay motionless but for the gentle rise and fall of her chest. Her heart slowed but didn't stop.
About an hour into the vigil, Lovelle's mom lit three white candles in cut-glass candlesticks in the living room. "She's still with us," she said.
Hours passed. Given what Lovelle's body had been through -- not only lung cancer but also open-heart surgery in 2004, Eighmey was surprised how long she was lingering. But not her family.
"I hate to say this," one said with a smile, "but this is just like her."
"A little spitfire," agreed another.
"Above average -- that's Lovelle."
"One last reminder that she's the one in control."
Jane O'Dell, a volunteer for Compassion & Choices, sat at Lovelle's bedside all evening, holding her right hand, monitoring her breathing and regularly checking the pulse in her wrist and neck.
About 10:30 p.m., more than five hours after she had taken the drug, O'Dell signaled that Lovelle's breathing had become shallower and more labored. Her pulse dropped, her skin turned pallid and her fingernails bluish. It was more than a minute between breaths.
Family and friends resumed their bedside vigil, and silence again fell over the dark room. Lovelle's chest stopped moving.
Eighmey leaned over at 10:42 p.m. and put his ear to her chest to listen for a heartbeat. He stepped back, shaking his head and spoke in a quiet voice.
"She's gone."
When my husband passed away a couple of months ago, God gave him all the dignity in the world. He wanted me to hold him, told me that he loved me and slipped into a coma for the next 6 days. We had time to get used to the fact that he was gone while still alive. It was perfect for him and our family.
Well, if I were in this situation, I wouldn't actively try to end my life (I think). But if my pain is such that the only way to control it is a dose which might end my life, so be it. I do realize that this decision isn't much different from the woman in the article, but it's different enough that I am comfortable with it, and my family would be comfortable with it too.
Am I the only one who sees this whole "party" as extremely self-centered? Command performance! Come and experience my death! Of course, don't we all want our loved ones with us as long as we can have them?
I don't know. I'm really struggling with what bothers me so much.
I am very sorry about your husband.
The reality is that all of us will eventually die and in many cases the conditions are unpleasant. However, this DOES NOT deprive a person of their dignity.
That’s good... hospice can be a wonderful thing. Or a horrible, evil, awful thing.
My husband and I made that choice when he was given a cancer life sentence. We did everything possible to keep him alive naturally until he went into a coma. No regrets.
We just turned it over to God, and He made all of the arrangements. Again no regrets.
Only if one thinks that know better than God.
It is the epitomy of hubris.
I understand they don’t actually TAKE the Hippocratic Oath any more.
When my husband was a spy for this country, he would have taken his own life in a heartbeat if it meant selling us out. When it was a matter of a terminal illness, he left that up to his maker. He is the HERO!
“Lovelle fits the mold of many FReepers. Her life belongs to her... and not the church, the state or the courts. It certainly doesn’t belong to the zealots here who would have her suffer in great pain so that their agenda can be fulfilled. It’s Lovelle call.”
It seems to me that the agenda is coming from the pro-euthanasia crowd. I wont criticize Lovelle; but, will criticize the Oregonian and the smarmy dog who wrote the article.
I would say that euthanazia represents nazi thinking and propaganda. Lebensunswerte leben. You bet.
Death with Dignity Act
Let’s think about the meaning of dignity. Does the publication of this article by her family detract from the dignity?
I think the problem is the last part of that 6 months is not much living. She knew she was getting close to the point where she had no control and couldn’t do anything. Nature would have to take its course in a few more weeks.
I once had a much different view of this, until I realized that I must face it. I visit friends in nursing homes, hear them beg, “get me out of here”, and have no power to do so. I know what they want, it is the dignity they are no longer allowed. I know, ahead of time, that I do not want to be trapped that way. I still function, to some degree. I can get out a few times a week, can still handle the basic life functions, reasonably well, but they get harder with each day.
I don’t dwell on dying, but some of the ways to do it sound better than others.
Don’t anyone panic, LOL, the seasons are changing, and the Red Shouldered Hawks will soon be hunting the hay fields, and I need a few more memories and pictures. I’ll be around for a while. Next year? I don’t have a clue. Don’t say what you will do, or not do, until you get there.
http://www.pbase.com/tsiya/root
http://photobucket.com/albums/v244/tsiya/
My prayers are with you!
Good for her.
Her doctor washed his hands after he wrote the prescription; the same way that archers washed theirs before they walked proudly among the swordsmen.
The dignity lies within the person dying, not in the uncomfortable spectacle that proceeds apace.
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