Therese Kwiatkowski
Chicago, Illinois, USA

In my experience, the end of life is neither peaceful nor dignified. I wish I had been told that death is hard work for both the patient and the loved one.

I did not expect that losing my mother would be easy. I had read books about impending death and had asked hospice staff many questions. Still, when the time came, I was surprised by the ugliness of death and my inability to know what to do in the face of it.

My mom, 91, slipped into death over the course of several days. She had survived two strokes in five years and was already impaired, but the final cause of her death was non-specific and seemed to mirror the gradual shutdown of organs in old age, which I had read about in How We Die by Dr. Sherwin Nuland.

No food and no water for a week left my mom’s face and body skeletal. Unable to speak after her second stroke, her only means of communicating were by the lifting of a finger and her little smile. That communication eventually ceased as my mom lay in her bed at home, her eyes open and glazed and her breathing labored and raspy.

A devoted full-time caregiver begged to try to give my mother water and food. Kind hospice nurses said “no.” Food and water prolonged the inevitable, and they said my mom was not suffering. Morphine and other drugs were provided.

Frustrated and frightened, I had my mom moved to a hospice unit in a hospital so she could have the best round-the-clock care. The care was more of a vigil because there was no medical intervention to be done.

My mother died there two days later. I was glad to be at her side. But I wish I had been told the truth: that death is hard, not peaceful, and not dignified.

You Don’t Know Jack, an HBO movie about Dr. Jack Kervorkian and his crusade for the legalization of assisted suicide, puts end-of-life decisions in the spotlight. In interviews and in the movie, Kervorkian maintains that withholding food and water is inhumane, painful, and akin to Holocaust concentration camp practices. Kevorkian asks: Would not a quick injection be kinder? Wouldn’t it make sense for like-minded doctors to be certified and monitored in their efforts to hasten death in extreme cases?

Initially I believed that assisted suicide would not have been appropriate for my mother. I realize now that it would have been a viable option. Would it be so different than consenting to remove my brother from a breathing machine after doctors said he had no chance of survival after being hit by a car?

Maybe death is supposed to mirror birth as a painful, difficult process. I wish someone had made it clear that death is not so peaceful.