Razors pain you;
Rivers are damp;
Acids stain you;
And drugs cause cramp.
Guns aren’t lawful;
Gas smells awful;
You might as well live.
DEREK HUMPHRY MIGHT NOT AGREE, and if he has his way, no terminally ill patient who opts for suicide need face Parker’s quandary without competent help. In Final Exit, the explicit how-to manual that has become a dark-horse best-seller, Humphry provides instructions for taking one’s life with minimal pain and trouble—and for helping someone else to do the same. A former journalist who says he has helped three gravely ill relatives end their lives, the Britishborm Humphry, 61, overlooks no detail. Guns and ropes are out—too imprecise and messy. Barbiturates are more effective, but be sure to take Dramamine so the drugs will stay down. Don’t disconnect the phone—that sort of behavior may alert would-be rescuers—but do secure a plastic bag over your head, as a backup measure.
As chilling as it may seem, Final Exit has found a large audience: With almost 500,000 copies in print, it has climbed to the top of The New York Times best-seller list for hardcover advice books. It is also becoming part of the growing front-page debate about the right to die. On Nov. 5, voters in Washington State faced a “Death with Dignity” initiative that would allow physicians to give lethal injections to terminally ill patients who request such help. In September, Prometheus Books shipped Prescription: Medicide—The Goodness of Planned Death, by Dr. Jack Kevorkian. A Detroit pathologist, Kevorkian was questioned last month in connection with the deaths of two patients, one of whom reportedly used his “suicide machine.” And Humphry himself was touched by a more personal controversy last month when his ex-wife, Ann, 49, committed suicide. Ann, who had helped her own aging parents to die, had undergone a bitter divorce from Humphry in 1990, after she was diagnosed with cancer. She claimed that Humphry had urged her to kill herself; he, in turn, charged that she was “dogged by emotional problems.”
Hotly debated by medical ethicists, Humphry’s book has drawn fire for presenting specific information to a general audience; critics argue that it could fall into the hands of troubled teenagers or of those who are seriously depressed. A staunch civil libertarian, Humphry says that there is no evidence that the book has been misused. “To tell another person, ‘You must live’ or ‘You must die’ is abhorrent,’ ” he says. “We’re talking about the quality of human life. That must remain a decision of the individual.” He believes the explanation for his book’s success is straightforward: “People want to take control of their dying. My book is a sort of insurance that they could make their escape if they were suffering.”
Not surprisingly, Humphry’s most eloquent supporters are the dying patients to whom his book is addressed. In the following pages, several of the most outspoken explain why they are planning their own final exits.
Loma Walters: Security in a stash of pills
When doctors at Mesquite Community Hospital in Dallas told Loma Walters last March that she had malignant melanoma—and that the cancer had spread to her lymph nodes—her response was not to mourn for herself but to cry for her husband, Mike, 40. “He lost his father to cancer at 9 and his mother when he was 25,” she says. “He’s such a very, very nice and kind person. I couldn’t bear to have him go through this again.”
An exuberant woman of 49, the North Carolina—born Walters once spent her days designing hot-air balloons. Now she spends much of her time in a reclining chair in the cramped living room of her house in Dallas, surrounded by her two Shih-Tzus, four cats and a tank of tropical fish. Whenever she rises, it takes her a few moments to steady herself. “The thing I miss most is that I used to be graceful,” she says.
Like Mike, who works as a machinist, Walters saw both her parents die of cancer. “My father died in 1989, and I remember the first time I had to clean him up because he had lost control of his bodily functions,” she says. “He had been such a proud man. When you lose control, you lose your dignity.”
After she was told that her cancer was incurable, Walters attended a Hemlock Society meeting. “It wasn’t morbid at all,” she says. “Final Exit made me see that I’ve got a way out.” Yet she says that she has no intention of using her stash of pills unless she is overcome by pain. “I’m not giving up,” she says. “But everyone has the right to say they don’t want to continue.”
Knowing that she has the option, she says, gives her a sense of peace. “I’ve even gotten Mike to talk about it enough so we can make jokes,” she says. “When the time comes, I’d like to be able to kiss him and tell him how much I love him and then send him off to work, then take my pills and go into a very, very deep sleep. I’m not afraid at all. All I’m losing is this body, and I’ll be gaining an entire universe. I mean, I won’t have to pay to go on a cruise anymore.”
Ray Hoffman: After a good life, a good death
At 83, retired journalist Ray Hoffman is a wellspring of joie de vivre—and self-reliance. Barefoot, wearing a flouncy cotton dress, she bounces around a two-bedroom house in Fort Lauderdale that she shares with nine cats. “Before I go to bed, I take out my gun,” she says. “I parade around with it in front of all the windows. If there’s a prowler out there, I’m telling him, ‘You better see what I got, bub.’ ”
Hoffman professes a similar take-no-prisoners attitude toward the Grim Reaper. Last year a checkup revealed that the former three-pack-a-day smoker suffered from emphysema, arteriosclerosis, a leaking heart valve and leukemia. Although she now takes medications for most of her maladies, she doesn’t want doctors to use extreme measures to keep her alive. In particular, she says, she has no interest in being treated with the kind of highly toxic anticancer drugs that made her husband, Herbie, “green and sick” before he died in 1974. “Thank goodness for Derek Humphry,” says Hoffman, who says she’ll turn to Final Exit if and when she feels the need.
For Hoffman, the balance of life has been “wonderful and exciting.” She was born in Philadelphia, where her father was a manager with Philadelphia Rapid Transit. After graduating from the University of Pennsylvania, she landed at the Philadelphia Record, writing sports. Marriage to Herbert Hoffman, a reporter at the Philadelphia Inquirer, came in 1930, and the two went on to work at papers including the New York Post. They traveled widely and never stopped long enough to have kids. “We decided we’d wait until it was a good time, and we’re still waiting,” says Hoffman.
Since her diagnosis, Ray has been attending meetings of the Hemlock Society. She plans to take Humphry’s advice and ask a friend to be with her if she does orchestrate her own exit. “I’ll call her and tell her what I’m going to do. She’ll probably say, ‘No, don’t,’ ” says Ray. “Then I’ll say, ‘F—- you. I’ll do it alone.
For Hoffman, the prospect of a “good death” is immensely reassuring. “I don’t have to worry about friends collecting money to pay the hospital,” she says. “My death is going to be calm and pleasant and even beautiful.”
Ryland Jones: Waiting for the knock at the door
As much as he loves life, 36-year-old Ryland Jones knows that the time will come when he will want to end his. Since learning that he had AIDS last year, he has lost more than 50 lbs. Weak and hollow-eyed, he is dwarfed by the chair in which he sits in his San Francisco apartment. At some point, he says, “I’ll hear a knock at the door, and I’ll know.”
Jones has planned his exit meticulously: When the hour comes, he says, he will take the marble mortar and pestle that he keeps by his bed and head into the Sierra Nevada Mountains or perhaps to a Pacific beach. A few friends will watch as he grinds up a mixture of narcotics and barbiturates. (Since AIDS may have robbed him o( his sight by then, he has memorized the bottles by touch.) He will uncork a Cabernet to make the powder act more quickly. After a toast, he says, he’ll simply go to sleep.
Until that moment, however, he intends to “focus on the blissful moments,” as he puts it. For him, they include “being with friends, watching a good movie—just [savoring] the rapture of being alive.” And there’s a lot left to do before the knock comes. “I feel a sense of urgency,” says Jones, who until last year worked in the personnel department at an IBM office in San Francisco. A right-to-die activist, he campaigned for the Washington State measure that would allow physicians to help terminal patients commit suicide. “It’s the ultimate individual liberty,” he says.
Born in San Jose, Calif.—where his mother, Ida, was a nurse and his father. Dean, a welder—Ryland was raised as a Roman Catholic. In his teens, he became a fundamentalist Christian; in 1970 he joined the Jehovah’s Witnesses. Although he knew he was gay, he says, “I did without sex. I thought if I ignored it Jesus would make it right.”
In 1980 Jones moved to San Francisco, where he slowly started having affairs with men. A year or two later, his friends began to succumb to AIDS; forced to confront death, he decided that, if he became hopelessly ill, “I would insist on the freedom to choose suicide.”
Now, he says, he has an odd sense of anticipation about death. While lie no longer believes in heaven, he expects to enter “a dimension that is bliss, completeness.” In the meantime, he hears a kind of siren call. “The closer we get to death, the more compelling it is,” he says. “The dying process has a ring to it, like a hell almost. When it was a new ring, it was unsettling to me.” Now, he says, “it’s becoming more and more; pleasant.”
Larry Martin: Facing the final choice
Larry Martin lives the life of a woodsman in his house on a river bluff near Portland, Oreg. A red and gray Ford pickup is parked in his driveway, and six ducks—his beloved pets—live in a pen nearby. Tall and strong from years of backpacking, Martin, 44, looks hale and hearty. As it happens, however, he is locked in battle with cancer. At this point, he says, “My only cure is chemotherapy. If that doesn’t work, nothing will.”
When Martin, a paramedic who also owns a computer software and consulting business, was rushed to the hospital with acute abdominal pain in July 1989, physicians discovered he had colon cancer. In Martin’s case, it took hold quickly. Although he was given nine months of chemotherapy, the cancer returned. When he underwent surgery last June, tumors were found throughout his abdomen. “My doctor said, ‘I would guess you’ve got three months to a year,’ ” Martin remembers.
In the days that followed, he says, “I was real depressed.” He has since worked hard to come to terms with his situation. Visiting a grief counselor has been helpful; so has spending as much time as possible with girlfriend Jacki Dickinson. A California-born Army veteran with degrees from Texas A&M and Indiana University, he has volunteered with community groups including the Girl Scouts and the local fire squad, and he has friends all over the country. “I have a very good support system,” he says.
Martin has thought a great deal about the way he wants his life to end. “I called the Hemlock Society in August,” he says. “I don’t want to drag the family through weeks of having to agonize over when I’m going to die. If I need [Final Exit], I’ll use it. If I don’t, I won’t.’ ”
These days, Martin is trying to make ever minute count. “I’m enjoying my life as much as I can, regardless of the length,” he says. When all else fails, he visits his ducks. “They help me keep my sanity,” he says, with a laugh. “If I don’t feel grounded, all I have to do is look at them—ducks are real grounded.”
MEG GRANT in Miami SUSAN HAUSER in Portland. BARBARA WEGHER in Dallas, DIRK MATHISON in San Francisco