Mike killed himself over the weekend. 54 years old – an AML (Acute Myelogenous Leukemia) patient of mine. Well, he wasn’t a patient of mine for very long – – just 3 days.
He was quite a cranky guy – with an opinion on absolutely everything. He was crusty and grumpy – but loveable. One of the very first things he ever said to me was, “I hope you aren’t going to be bringing any social worker into my house. I don’t want no fucking social workers here – they are useless.”
I never did bring that social worker in.
When I made my visit to Mike’s home on Friday – we had an odd conversation. Only odd in retrospect – because I’ve had this type of conversation with patients before. He looked at me and said, simply,
“How about assisted suicide?”
I said, “what about it?”
He replies, “Do you do it?”
I said, “No, Mike – I do not do it.”
He says, “Do you do it ‘off the books’ and just say that you don’t?”
I said, “Mike – I do not do it, period – on the books, or off.”
He replies, “I guess, there’s no money in it, huh?”
I said, “That, and it’s illegal, Mike.”
He says, “Illegal only because there is no money in it. Bet if there was money in it the drug companies would be lobbying for legislation to make it legal.”
I said, “You may have a point there – however, there are also huge ethical implications in it.”
He says, “Don’t talk to me about ethics. You’re a hospice nurse here to help me die – but you won’t kill me.”
We went on to a different topic. I explained all about the services our home hospice agency will be providing for him, now – and throughout the dying process, right up until the end.
“So,” he says, “Let me get this straight. I’m dying. I’ll be on this earth for about 4-6 weeks. In that time – I’m going to bleed from every oriffice possible – I’ll become immobile, weak and eventually non-responsive. You’ll be here to make sure my pain is in control…the nursing assistants will be here to make sure they have cleaned up my hemmorhaging and make sure I’m not lying in my own shit and piss? I’m bound to be miserable…in pain…incontinent and totally dependant upon really nice girls that I don’t know from Adam? And in the end – I die. Is that basically it?”
I thought and said, “I’ve never had anyone put it to me in quite those terms before, Mike – but yes, that is basically it. However, looking at it from a different perspective might help. Our job here is to help make this process as comfortable for you as possible and to make sure that you are able to die in your own home, surrounded by people who love and care for you. It’s better than the alternative, I think.”
He says, “Nursing home?”
I say, “Yes.”
He says, “That is hell. If you end up putting me in a Nursing Home – – not only will I die a miserable death, but I will haunt you for the rest of your fucking life.”
I said, “That’s a deal, Mike. I promise to do absolutely everything within my power to make sure you never go to a nursing home – as long as you promise to cooperate with me and don’t make it too difficult on the girls who come in here to care for you.”
He says, “I’ll see what I can do.”
I told him I had to go now – – off to my next patient. He smiled – reached out his hand to shake mine. I extended my hand to his – – and instead of shaking my hand – he kissed it. Then he smiled up at me and thanked me for being ‘real’ with him and not sugar coating it and not allowing him to be in denial about it. Then he told me not to make my scheduled visit on Sunday – he had plans to be out.
“Monday morning, then?”, I said.
He says, “Yes – but make sure to call first.”
I said I would.
And I did.
No one answered the phone. So I went to his house.
No one answered the door.
I went back out into my car and called his friend, Shelia.
She answered. I inquired.
She told me that on Sunday morning, Mike took 55 Oxycontin tablets – each of them 20 mg. Then he took 30 Morphine tablets – each of them 10 mg. He took them with 1/2 a bottle of Absolut. He died at approximately 11:30 Sunday morning. He did it his way. He didn’t want to die miserably – he wanted to die on his own terms.
I guess he really didn’t want me brining that fucking social worker into his home, after all.