About two years ago I bought a euthanasia drug online from China. You can get it that way, or you can travel to Mexico or Peru and buy it over the counter from a vet. Apparently you just say you need to put down a sick horse and they’ll sell you as much as you want. Then you either drink it in your Lima hotel room, and let your family deal with the details of shipping your remains home, or you smuggle it back in your luggage for later use. I wasn’t intending to use mine straightaway, and I wasn’t fit to travel all the way to South America, so I chose the China option.
My Chinese drug comes in powdered form. I keep it in a vacuum-sealed bag in a safe and secret place, along with a suicide note. I wrote the note over a year ago, a few days before I was due to have brain surgery. I had melanoma in the part of my brain that controls the movement of my limbs on the right side—incurable, no guarantee that the cancer wouldn’t return after the surgery. By then I had deposits of melanoma elsewhere too, in my right lung, under the skin on my right arm, a big one just below my liver, another pressing on my urethra, which had necessitated the insertion in 2011 of a plastic stent to keep my right kidney functioning.
I had been first diagnosed in 2005, just before my fiftieth birthday, after a biopsy on a mole excised from the back of my right knee came back positive as a stage-four melanoma. Since then the progress of my disease had been mercifully slow. It was three years before it showed up in my pelvic lymph nodes and another couple of years before it began to spread to other parts of my body. I had two rounds of surgery, from which I recovered well, and in between I suffered no debilitating symptoms. In that time I managed to keep my illness a secret from all but my closest friends. Only my husband, Shin, knew the whole story, because he’d accompanied me to my regular scans and specialist appointments. But I had kept the details from our two teenage sons, trying, I suppose, to protect them from pain, because that was my job as their mother. Then, in late December 2014, a seizure left me temporarily helpless as a baby and I could no longer deny the obvious.
So we convened a family meeting in our home in inner-city Brisbane—Shin, our younger son, Dan, his girlfriend, Linda, our older son, Nat, and his wife, Asako, who dropped everything and flew home from Kyoto, where they’d been living for two years. Over the next few days, I took them through all the paperwork they’d need to access if the worst happened: my will, their Powers of Attorney, my bank accounts, tax, superannuation. It helped me to feel that I was putting my house in order, and I think it helped them because it made them feel useful. I even revealed my interest in euthanasia drugs and evasively said they were on my wish list for Christmas. I called it my Marilyn Monroe gift pack.
“If it was good enough for her, it’s good enough for me,” I said. “Even if I never use it, just knowing it’s there would give me a sense of control.”
And, to the extent that they didn’t object, I think they understood.
My suicide note was by way of an apology. “I’m sorry,” I wrote. “Please forgive me, but if I wake up from the surgery badly impaired, unable to walk, entirely dependent on other people to care for me, I’d prefer to end my own life.” I also repeated what I’d told them a hundred times to their faces: how much I loved them all, and how much joy they had brought me. Thank you, I told them. Talk to me when I’m gone, and I’ll be listening. I wasn’t sure that was true, but it was as metaphysical as I was ever going to get, and it did make a kind of sense at the time, given that I was already writing to the living from the point of view of the dead.
As it happened, I came through the surgery, not entirely unimpaired, but not too badly off. The tumour in my brain was successfully removed. My right foot will never fully recover its strength, so I limp, but I have normal movement in the rest of my right side. And, over a year after the operation, I’m still here. Nevertheless, my situation remains dire. There is no cure for melanoma. A few drugs are being trialled, with varying results. I’ve been involved in three drug trials, and I can’t say for certain whether any of them slowed the disease. All I do know is that, despite my oncologist’s best efforts, I eventually ran out of treatment options. It was then that I became certain I was coming to the end. I didn’t know when, or exactly how, I was going to die, but I knew I wasn’t going to make it much beyond my sixtieth birthday.
With my health deteriorating steadily, I started to focus on the question of suicide like never before. After all, in a first for me, I’d gone to the extent of breaking the law and risking prosecution, in order to obtain the means. My stash calls to me day and night, like an illicit lover. Let me take you away from all this, it whispers. My drug would go straight to the sleep centre of the brain in the time it takes to finish a sentence. What could be easier than to swallow a fatal dose and never wake up again? Surely that would be preferable to the alternative, which is a lingering and gruesome demise?
And yet I hesitate, because what appears to be a clear-cut solution is anything but. Firstly, there are the practicalities of my taking such a course of action. As the law stands in Australia, I would have to take my drug alone, so as not to implicate anyone else in my death. Even though suicide is not a crime, assisting a person to suicide is illegal and is punishable by a lengthy jail term. Secondly, there are the emotional repercussions for others should I do the deed, be it in a hotel room somewhere, or on a lonely bush track. I ask myself if I have the right to traumatise some hotel cleaner, or some bushwalker, unfortunate enough to discover my corpse. Of paramount concern to me are the repercussions for Shin and the boys of my taking my own life, for as much as I’ve tried to prepare them for the possibility that I might, I know the reality would shake them to the core. It worries me, for instance, that my death certificate would read “suicide” as cause of death, with everything that the term implies these days: mental angst, hopelessness, weakness, the lingering whiff of criminality—a far cry from, say, the Japanese tradition of seppuku, or suicide for honour’s sake. The fact that cancer was actually my killer would be lost to posterity, as would the fact that I am not, by any fair measure, mad.
Faced with all of these obstacles, I contemplate my bleak future with as much courage as I can muster. I’m lucky to have found an excellent palliative care specialist and an exceptional home nursing service, so, along with my family and friends, I have as much support as I could wish for. If I were, however, to express a wish to end my own life, none of that support would be legally available to me. I would be strictly on my own. Our laws, unlike those in countries such as Belgium and the Netherlands, continue to prohibit any form of assisted dying for people in my situation. It occurs to me to ask why. I wonder, for instance, if our laws reflect some deep aversion amongst medical professionals here towards the idea of relinquishing control of the dying process into the hands of the patient. I wonder if this aversion might stem from a more general belief in the medical profession that death represents a form of failure. And I wonder if this belief hasn’t seeped out into the wider world in the form of an aversion to the subject of death per se, as if the stark facts of mortality can be banished from our consciousness altogether.
Surely there couldn’t be a more futile exercise, for if cancer teaches you one thing, it is that we are dying in our droves, all the time. Just go into the oncology department of any major hospital and sit in the packed waiting room. All around you are people dying. See most of them on the street, and you’d never know it, but here they are lined up, waiting for the latest results of their scans, to discover if they’ve beaten the odds this month. It’s a shocking sight if you’re unused to it. I was as under-prepared as anyone could be. It was as if I had stumbled out of a land of make-believe into the realm of the real.
That is why I started writing this book. Things are not as they should be. For so many of us, death has become the unmentionable thing, a monstrous silence. But this is no help to the dying, who are probably lonelier now than they’ve ever been. At least that is how it feels to me.