Tag Archives: assisted suicide

Six Degrees of Separation: What Are You Going Through to No Saints Around Here

I’ve become an occasional Six Degrees of Separation post-er, when the mood strikes me and/or I get a flash of inspiration. This month we began with What Are You Going Through, which I reviewed back in October 2020. (See Kate’s opening post.)

Between that, The Friend and A Feather on the Breath of God, Sigrid Nunez has quickly become one of my favourite contemporary authors. I have two more of her novels on the shelf to read soon, one from my birthday haul.

In What Are You Going Through, the narrator is called upon to help a terminally ill friend commit suicide. However, I summed up the message as “Curiosity about other lives fuels empathy,” and noted “a sort of slapstick joy early in this morbid adventure.”

 

#1 One of the stand-out books from my 2021 reading so far has been The Inevitable, which is about assisted dying. The case studies are wrenching but compassionately told. Katie Engelhart explores the nuances of situations, crafting expert portraits of suffering people and the medical professionals who seek to help them, and adding much in the way of valuable context.

 

#2 As the saying goes, if there’s one thing inevitable besides death, it’s taxes. And if you’re a U.S. citizen, you will remain accountable to the IRS until the day you die, no matter where you live. (Eritrea is the only other country that requires expatriates to fill in tax returns.) I’ve now gotten my U.S. tax forms down to a science, keeping a list of pointers and previous years’ forms as scanned files so that I just have to plug in the year’s numbers, put zeroes in all the important boxes (since I’ve already paid income tax in the UK), and send it off. A matter of an hour or two’s work, rewarded by a G&T.

But I distinctly remember the Junes when I would spend days muddling through byzantine IRS forms, so I am very grateful that an offer for this e-book arrived in my inbox via my blog contact form in 2017: U.S. Taxes for Worldly Americans by Olivier Wagner. It goes through each form, often line by line. Three cheers for actually helpful self-help guides!

 

#3 Another expat tip that I found extremely useful, small as it might seem, is that “quite” means something different in American vs. British English. To an American it’s a synonym for “very”; to the guarded Brits, it’s more like “rather.” I have the Julian Barnes essay collection Letters from London to thank for this vital scrap of etymological knowledge.

 

#4 Unsurprisingly, I have built up a small library of books about understanding the English and their ways. In the How to Be a Brit omnibus, collecting three short volumes from the 1940s–70s, George Mikes (a Hungarian immigrant) makes humorous observations that have, in general, aged well. His mini-essays on tea, weather and queuing struck me as particularly apt. I would draw a straight line from this through Bill Bryson’s Notes from a Small Island to the Very British Problems phenomenon.

 

#5 As I was preparing to fly to England for the first time for my study abroad year, one of the authors who most whetted my appetite for British travel was Susan Allen Toth, whose trilogy of UK-themed memoirs-with-recommendations began with My Love Affair with England – included in one of my Landmark Books in My Life posts. I’m rereading one of the other three now.

 

#6 Toth is a very underrated author, I feel. I’ve read most of her memoirs and have a short nonfiction work of hers on my pile for #NovNov. Her most recent book is No Saints Around Here: A Caregiver’s Days (2014), in which she chronicled the last 18 months of her husband James’s life, as she and an army of caregivers coped with his decline from Parkinson’s disease. Toth gets the tone just right: although she is honest, she is never melodramatic; although she often feels sorry for herself, she also recognizes how lucky she has been, not just to have done a good job of looking after James, but to have had him in her life at all.

 

I’ve gone full circle from one story of caregiving to another, via death, taxes and Englishness. The starting and ending books are reminders that you never fully know what another person is going through; all we can do is our best while cutting others some slack.

 


Where will your chain take you? Join us for #6Degrees of Separation! (Hosted on the first Saturday of each month by Kate W. of Books Are My Favourite and Best.) Next month’s starting point is our buddy read for week 4 of #NovNov, Ethan Frome by Edith Wharton.

Have you read any of my selections? Are you tempted by any you didn’t know before?

The Inevitable: Dispatches on the Right to Die by Katie Engelhart

Why, she wanted to know, was I so interested in the subject?

“Why isn’t everyone?” I asked.

The fact that I read a lot more books about death than the average person is something I attribute not to some morbid curiosity, but to pragmatism. As the title of Canadian reporter and documentary filmmaker Katie Engelhart’s book makes clear, this is the one subject none of us can avoid indefinitely, so why not learn about and understand it as much as possible? The Inevitable focuses on the controversial matter of assisted dying, also known as assisted suicide, euthanasia, or physician-assisted death. It’s a topic that’s already come up in my reading a couple of times this year: in the Dutch context of That One Patient by Ellen de Visser, and as a key part of the narrative in Darke Matter by Rick Gekoski.

Engelhart spends time with doctors and patients who are caught up in the assisted dying argument, chiefly in Western Europe and the United States. Ten states plus Washington, D.C. have assisted dying laws, sparked by Oregon’s Death with Dignity Act in 1994. In California, the author follows Dr. Lonny Shavelson for a month, observing all the meticulous regulations surrounded a physician-assisted death: patients with a terminal diagnosis and less than six months to live have to complete multiple forms, give many signatures, deliver oral testimony, and be able to drink the fatal concoction by themselves (whereas in other countries doctors can administer lethal injections). And if, when the time comes, a patient is too far gone to give spoken consent, the procedure is cancelled.

Other chapters consider specific cases that are not generally covered by current legislation but can drive people to seek assisted suicide: the ravages of old age, chronic degenerative illnesses, dementia, and severe mental illness. Each of these is given its own long chapter, like an extended magazine profile.

  • Meet Avril Henry, a former Exeter University professor in her eighties, now living alone with a failing body but no specific diagnosis that would qualify her for AD. Pain has long since outweighed pleasure in her life, so she illegally imports Nembutal from a veterinary supplier in Mexico and makes a careful plan for what will happen with her body, home, and possessions after she takes the drug in the bathtub.
  • Meet Maia Calloway, a 39-year-old former filmmaker confined to a wheelchair by multiple sclerosis. Her medicines cost $65,000 a year, not all covered by Medicare, and she can no longer rely on the patience of her boyfriend, who acts as her carer. She decides to raise the money to travel from Taos to a Swiss assisted dying clinic.
  • Meet Debra, a 65-year-old widow so rapidly declining with dementia that she knows she has to make her arrangements at once. She contacts the Final Exit Network, which gives advice and equipment (e.g. a nitrogen tank) that can make a death look unexplained or like a standard suicide.
  • Meet Adam, a 27-year-old in daily distress from OCD, anxiety, and depersonalization disorder. Though he’s lobbied for the inclusion of mental illness, he doesn’t qualify for AD under Canada’s laws. In 2017 he starts a Facebook livestream from a hotel room, intending to take poison off-screen. He loses his nerve this time, but is determined to try again.

These stories are so wrenching, but so compassionately told. Engelhart explores the nuances of each situation, crafting expert portraits of suffering people and the medical professionals who seek to help them, and adding much in the way of valuable context. Hers is a voice of reason and empathy. She mostly stays in the background, as befits a journalist, but occasionally emotional responses or skepticism come through – Exit International’s Philip Nitschke, vilified as a “Dr. Death” like Jack Kevorkian, is too much of a maverick for her.

And while her sympathy for the AD cause is evident, she also presents opposing arguments: from hospice doctors, from those afraid that the disabled will be pushed into assisted suicide to free up resources, from the family members of her subjects, and from those who have witnessed abuses of the system. There are those who frame this as a question of rights, and others who recognize a rare privilege; some who scorn the notion of escape, and others who speak of dignity and the kindness one would show a dying pet. The book is a vital contribution to an ongoing debate, with human stories at its heart.


With thanks to Atlantic Books for the free copy for review. The Inevitable was published in the UK on March 11th and is available from St. Martin’s Press in the USA.

Darke Matter by Rick Gekoski (Blog Tour Review)

Back in 2017, I enjoyed Rick Gekoski’s debut novel, Darke, in which curmudgeonly Dr. James Darke, a retired English teacher, literally seals himself off from the world after his wife Suzy’s death from cancer. I was pleasantly surprised to learn that a sequel was released last year – how appropriate to revisit themes of grief and isolation in 2020! – and right away was reminded of the delights of his grumpy, pompous first-person narration. As the second book opens, Darke is preparing to host his daughter Lucy with her partner Sam and son Rudy for Christmas and is in a Scrooge-like mood: “In my own home, I am blessedly safe from the canvassers, beggars and importuners spreading bubonically from house to house at Yuletide.”

Soon two things happen to shatter his peace: one is an invitation to join a poetry reading club hosted by a literary associate of his late wife – but he soon realizes it’s more of a support group for bereaved spouses. The second and much more serious interruption is a knock on the door from the police, who require more information about Suzy’s death. You see, early on in this book, Darke tells us himself that he gave Suzy a “soothing drink to carry her away,” and even in the face of others’ horror he maintains two seemingly contradictory facts: that he did not want for her to die, but that he did give her a fatal concoction to ease her terrible pain.

By coincidence, I was reading a nonfiction study of assisted dying, The Inevitable by Katie Engelhart, at the same time, and I’d also read That One Patient, a collection of interviews with Dutch medical professionals, some of whom have helped terminally ill patients to commit suicide, earlier this year. It was amusing, but also touching, to see Darke becoming an unwitting spokesman for this movement. He writes a manifesto headed “Easeful Death – Do you love your dog more than your wife?” and gets help disseminating it from a journalist acquaintance. Media attention follows and a scandal erupts.

One of the joys of this pair of novels is Darke’s fondness for literary allusions. In the previous book, these were mostly to Dante and Dickens. Here, the greatest debt is to Jonathan Swift: Darke has been reading Gulliver’s Travels to his grandson at bedtime, and decides to write a pastiche sequel to entertain the boy. Gradually, this turns into a coded story by which he can explain to Rudy what might happen to his grandfather. Will Captain Gulliver be found guilty of heresy? Will he have to flee to avoid jail?

Because we only ever experience Darke’s point of view, he is something of an unreliable narrator, and because he delivers the novel’s finale via his italicized Swiftian narrative, there is some uncertainty about what actually happens to our antihero. I didn’t enjoy this quite as much as the first book, but together they form a striking and witty character study. I especially appreciated how the sequel adds in a gentle note of controversy without allowing it to overtake the pleasures of the voice.

 

Darke Matter was first published in the UK by Constable in May 2020. The paperback edition came out on April 1st. My thanks to the publisher for the free copy for review.

I was happy to take part in the blog tour for Darke Matter. See below for details of where other reviews and features have appeared or will be appearing.