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Catherine Davenport

Goodbye And All That
(with a wink and a nod to Joan and Lacy)‌

“The people in the world, and the objects in it, and the world as a whole, are not absolute things,
but on the contrary, are the phenomena of perception…” ~ Wallace Stevens

The Angel of Death by Edvard Munch
1. Enroll in Hospice

It is sometimes hard to see the endings of things. In January I attended the death of a friend with terminal cancer. She had opted for Death with Dignity, which is allowed under Washington State law. She called her cancer “Darth” after Darth Vader. She loved Star Wars, her friends, and her cat. She was angry and bitter towards almost everything and everyone else. Her whole life had been a series of betrayals and disappointments from childhood to almost-death. She was forty-one years old. Her cancer was incurable, and according to her genetic testing, would recur no matter what treatments she went through. So, she opted for no treatment. Darth was visible as a pink and purulent mass on the right side of her chest.

2. Talk with your prescribing physician about the life-ending medication.

She had jumped through all the legal and financial hoops to obtain permission from the state to die and for the medications themselves. Her anger and bitterness were tempered by the knowledge that she would exit this time space continuum on her terms and on the day of her choosing.

3. Where can you take (ingest) life-ending medicines?

I arrived at her apartment at ten a.m. on Death Day. She opened the door and led me upstairs to her apartment. It was to be her last trip down and up those stairs.

4. Who should be present at the time of death?

Ultimately there were twenty of us, former coworkers and friends crammed into the small apartment. She made herself comfortable on the bed and alternated between telling us how much she loved us and having her own last Festivus with its “airing of grievances” about people who had betrayed and disappointed her. She was an atheist. There was no discussion of spiritual matters, an afterlife, forgiveness. She was a friend to those of us gathered in the room. There was love. She walked around the room and embraced each of us individually, told us what we had meant to her. She cried. We cried. It was truer and more spiritual than any church service.

5. The Dying Process

Someone had placed incontinence pads on the bed, and she sat on them, propped up with pillows. She had pre-medicated herself, as instructed, with an antianxiety medication as well as an antinausea medicine. The life ending medications come in a small brown vial and are mixed with water or juice. They include lethal doses of Diazepam, Morphine, and Phenobarbital which eliminate pain and anxiety. In addition, lethal doses of Digoxin and Amitriptyline cause cardiac arrest for the comfortable and comatose Darth hostess. The mixture, the label warns, is extremely bitter and it is suggested that the patient have a popsicle or the proverbial spoonful of sugar to help the medicine go down. I don’t think this is quite what the Mary Poppins character had in mind, but the popsicle helped.

She knocked back The Cup of Death like a shot of bad tequila, ate a popsicle, considered a second popsicle but said no, she could feel her body shutting down. She lay back against the pillows. Her eyes opened and she fought back a wave of nausea, her body’s attempt to live on against her will. The rebellion failed, the nausea subsided, and she complained of feeling hot. Someone removed her socks and dropped them at the foot of the bed. Someone else turned on a fan. She did not open her eyes again. Her respiratory effort increased. The rate of her breathing slowed, speeded up, slowed, stopped a few times, but kept starting again. Breathing is a hard habit to break after forty-one years. It took three and a half hours for her to break the habit of breathing. Her heart, not wanting to be left alone, quit about the same time.

6. After Death Occurs

Who really knows? One of her socks that was lying at the foot of the bed where someone had dropped it, held the clear imprint of her foot, the narrow arch, the individual toes. Its crumpled twin next to it held visible evidence of her last steps in this world in the form of dirt and a few stray cat hairs. Perhaps that is all that can be known of the afterlife from this side of Death.

I have thought of her often since that day. Many people have opinions on the ethics of the process she chose. We have our opinions, our certainties over what we would or would not do in the face of a terminal illness. The last time I saw Dani, she was in her apartment, her body was riddled with “Darth”, and she was moving towards Death with a little fear, but no hesitation. A dog barked in the downstairs apartment. Cars drove through the slushy street outside. People left one by one. A few of them stayed on.

About the writer:
Catherine Davenport is an MFA student at Eastern Washington University. She has 28 years of experience as an RN. This piece is about the death of a friend with advanced cancer who chose Death With Dignity which is available in Washington State.

Image: The Angel of Death by Edvard Munch (1863-1944). Oil on board (frame cropped away). 22.8 x 30.5 inches. 1893. Public domain.

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