A great man died a couple of weeks ago. Born in a small town in Nebraska in the 1920’s, he decided at age 8 he wanted to become a doctor to help and heal people. His parents were of modest means and not college-educated, so this ambition and love of learning was innate within him. He had paper routes and worked in the fields to save money for college and medical school. After serving in the navy in WWII he began his medical training. For over 40 years he practiced medicine, fulfilling his dream.
In the mid 1980’s his father died of Alzheimer’s disease after suffering from it from many years. Even then, Dad said he would not suffer the same fate. A couple of weeks ago at age 87, he decided that his loss of the ability to learn and his logical thinking had hit the tipping point, and he chose a rational suicide to prevent the onset of dementia. His son-in-law found him in the garden he loved so much where he shot himself.
He decided he wanted the family to share the 11 page suicide note he prepared well ahead of time to explain that there truly is such thing as a rational suicide. Here is some of the note he wrote:
I’m sorry it had to be this way, but it could have been no other way.
Consider it like a sudden heart attack when no good-bye can be said.
I wrote this suicide note some time ago and this has been a source of great anxiety for me. When I decided that this was the day a great calm came over me.
It’s the right thing to do.
Sorry, but there is no way I could have prepared you for this. I’ve tried in the following to explain my rationale and to explain it wasn’t a spur of moment decision.
It’s inconceivable to most that someone would choose to take their own life. It is usually a pathological state of mind and done on impulse. But it is possible to have a rational suicide. Mine is rational and long-considered and not impulsive. This is something I have to do to prevent far worse consequences.
I have long vowed to myself I would never allow myself to die the way my father died, demented and dehumanized. He had no knowledge of who he was, who I was, or where he was. He remained in a nursing home, curled in the bed in a fetal position, diapered for fecal and urinary incontinence, he couldn’t hear, he couldn’t see, he couldn’t speak and had only enough brain function to allow him to swallow. He had lost his “being.” There are things worse than death, and this is one of them; and it lasted 3 years.
I know what lies ahead for me and it is what has caused me to act now while I still have enough judgment to do so. I am advantaged by having no religious proscription or stigma attached to suicide. My secular humanism beliefs attach no stigma to suicide done for valid reasons. You may think this is premature, but it isn’t. Dementia is a slow, insidious but unrelenting process with one inevitable conclusion.
I am increasingly aware of this slowly progressing process. I’m becoming more and more dysfunctional. It’s harder and harder for me to function in unfamiliar situations and settings. The memory loss was bad enough when names couldn’t be recalled, now its words that are just out of reach in mid-sentence. I can no longer read and remember what I have read. Dementia has stolen the joy of learning from me. The ability to reason has been fairly intact until recently and I now notice some failure there also.
I can tolerate the usual infirmities of aging; the thing I can’t tolerate is the loss of cognitive function. I don’t want to wait too long and risk sinking into the abyss of advanced dementia, unable to make the inevitable decision to control my own destiny.
I am 87 years old, and death is no more than a few years away in any circumstance, and I don’t want to spend them demented. I don’t want to be a burden to my family or myself, and I don’t want the “long goodbye” of Alzheimer’s disease, because there is eventually no goodbye at all, just demented oblivion. It is time to go; I have reached the level of dementia I can tolerate.
I love you all. No one but me is responsible for what I am doing. There is no failure on anyone’s part not to have foreseen the sequence of events, and there I nothing you could have done about it, nor is there anything I would have wanted you to do.
I have led a good life. I fulfilled my ambition to study medicine and become a physician. I had an excellent wife- better than I deserved; I have two delightful daughters who make me proud to be their father; I have four grandchildren that have been a joy to their grandmother and me.
So instead of mourning my death, celebrate my release from dementia.
Goodbye. I hope you go with fond memories of me and forgive me my transgressions and the memories of my death. In any case, the poem says it all.
Your loving father, grandfather and father in law, DEM
'Reparation' by Franz Wright
The day’s coming
when I will no longer consider
my mere presence inexpiable.
I will place my hand in that flame
and feel nothing.
I will ask nobody’s forgiveness again.
Or I will just go
Among people no more-
I may writhe with
remorse in the night, but
the operation must be
No one must be asked to relinquish
A grievance that can’t be removed
without further destruction, it may be
it is lodged in who he is now
like a bullet in a brain
whose removal might only worsen its change.
The forgiveness! I know it
will be freely offered
or it won’t, and that is all-
and no one may bestow it
If it is to come
it will come of itself like a separate
a mystery, working
unseen as a wind causes still
leaves or water to move once again.
And hide me in the shadow of Your wings.
Let the heart be moved again.
-Poem by Franz Wright