The Good Death: A Demonstration

SHE MODELED, FOR THE LIVING, HOW TO DIE WELL

Photo by Rafael Hoyos Weht on Unsplash

I’ve just finished an obituary of sorts for my friend Laurie, who died yesterday afternoon, slipping quietly into an ever-deeper sleep with those she loved best beside her. We should all, eventually, be so lucky.

The way you know you’re dead, in today’s senior living communities, is that your picture goes up on the hall table. Laurie and I laughed about that just last week, when I was saying I’d work hard at writing something elegant to go beside her photo. From somewhere in the ethersphere I am certain she’s getting the last laugh.

Elegance was easy to come by in this case. A decade ago Laurie had shepherded her physician husband through a descent into dementia, managing to keep him at home in their apartment until his own relatively gentle demise. They had raised two daughters and led a full, good life.

One daughter was extremely close to her mother, as was her wife, a particularly beloved daughter-in-law to Laurie.

So the first thing they did, en route to the Good Death, was to talk frankly and in detail about what exactly Laurie wanted. At 91 — precisely the age of this writer — Laurie enjoyed being with friends and family, walking her San Francisco neighborhood, reading and listening to music. She could still do most of these, but recent illnesses were imposing limitations. 

We talked, occasionally, of how she felt her quality of life had diminished. Because of my volunteer work with Medical Aid in Dying, which is legal in our state (and 9 others plus DC,) we talked a good bit about that option — which she said she would choose over any painful & debilitating end. 

A few weeks ago an intestinal issue sent Laurie to the hospital. Surgery would be required, the doctors said; and it would be a high-risk procedure.

No thanks, said Laurie, I think I’d rather go home to die in peace.

Which was exactly what she did. With a hospice bed positioned so she could look out at the distant mountains, a TV set she mostly kept turned off and flowers on the windowsills, she made herself comfortable. There was morphine for pain, but she had almost none.

There’s a name for this way to die: Voluntary Stopping Eating and Drinking (VSED.) The intestinal issue had spelled the end of her eating; stopping drink hastens the process. A popsicle-like swab was by her side to prevent any discomfort from thirst.

For a week, friends stopped by. We’d tell her how much she had meant to us; she’d return the sentiment — but nothing faux or flowery: “We really didn’t know each other that well,” she said to one visitor. “But I remember a funny thing you said not long ago . . .” 

Sometimes, as the days wore on, she would fall asleep mid-sentence. Nobody cared. 

Ten days after her return from the hospital Laurie’s sleep simply deepened and her heart and breathing stopped. Her two beloved daughters were holding her hands.