Tasmanian Times

The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. No price is too high for the privilege of owning yourself. ~ Friedrich Nietzsche

The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. No price is too high for the privilege of owning yourself. ~ Friedrich Nietzsche

History

Death in Amsterdam

As Tasmania debates voluntary assisted dying law reform, Margaretta Pos tells a very personal story …

One spring day in Hobart, I was having dinner with my son and Goshwin, my Dutch half-brother, who was visiting us, when the telephone rang. My son answered it. “Grandpa!” he exclaimed, as he always did whenever my father called. Yes, we were together, and he passed the handset to Goshwin, who listened, then stiffened. “I’m coming back,” he said and gave me the phone.

My father – Hugo, as we all called him – had been living with cancer for two years but in recent weeks it had spread. He now had difficulty speaking and his voice was a whisper. “There’s no need to come,” he said. “We saw each other six months ago and we had a wonderful time.”

This was true: we’d gone to concerts, walked and talked and laughed along the canals of Amsterdam under the summer sun, and talked about Surinam, where he was born and where his family had lived for nearly 200 years. But I wanted to say goodbye. I took a week’s leave. The night before I left, Diego, the younger of my Dutch half-brothers, called. “I thought you should be prepared,” he said. “It’s going to be Friday at 9 pm.” I was stunned; I hadn’t appreciated the urgency. I would be witness to my father’s euthanasia.

Arriving on a Tuesday night at Schiphol Airport, I walked into the arms of Diego’s wife, Sacha. “It’s been postponed,” she said, “until Saturday. The doctor was too busy on Friday night. He’s giving flu shots to elderly people and couldn’t make it on Thursday night either. So it’s Saturday morning at ten.”

“Too busy?”

She nodded and we clutched each other, shaking with silent, hysterical laughter.

We went straight to Hugo’s house. After embracing me, he asked if I’d be staying for the cremation. I looked at him, then nodded dumbly. “Good,” he said. “It will be on the Thursday afterwards.” All I could think was that I would have to change my ticket and take another week’s leave.

I was staying with Diego and Sacha. Goshwin stayed with Hugo, helping him to shower, massaging his feet to help his circulation, fetching and carrying for Dietje – his mother, my stepmother. I came and went to fit in with their routine. Hugo was up and dressed every morning, reading newspapers as he always did, listening to radio broadcasts about the American presidential election between George W Bush and Al Gore, and watching the news on television. It was all so normal.

I wanted time to slow down, for Saturday not to come; yet the strain of waiting for it to be over was terrible. Hugo sensed it, telling me dryly, “I’m not going to be hanged!” But that’s how it felt, like an execution. Hugo, on the other hand, referred to it as “the departure”. The day before he died, though, he said quietly, as if to himself: “It’s been one day too long.”

A former High Court judge in The Hague, my father was opposed to capital punishment, but he was willing to pass a death sentence on himself. A secular Jew, he didn’t believe in God or an afterlife, although he had some sense of a universal consciousness, but I remembered him once saying that the only reason we sleep peacefully at night is that we know we will wake up in the morning. His had to be a brave death; he knew he wasn’t going to wake again.

Hugo had been adamant he wouldn’t undergo any radical treatment requiring hospitalisation. He did agree to a minor procedure shortly before he rang us in Hobart: the insertion of a small tube down his throat. If it had worked, it would have enabled him to swallow more easily. It failed.

Voluntary euthanasia was accepted practice in the Netherlands in the 1990s, under regulated tolerance rather than law: the judiciary and the medical profession had an agreement that no one would be prosecuted if procedural ethics and safeguards were followed. It wasn’t until April 2001 – five months after my father’s death – that a law permitting euthanasia and assisted suicide was passed by the Dutch parliament.

Despite growing public support for euthanasia, Australians shy away from the subject of death, and in Amsterdam I felt at sea with the rituals of saying farewell. People from my father’s wide circle of friends had been coming to the house for days to say goodbye. He said goodbye to others by telephone, among them my mother in Tasmania, but in his last 48 hours, he decided to see only the family. Meanwhile cards, messages and flowers continued to arrive.

It was necessary for a doctor who didn’t know my father to visit, to ensure he was capable of making a rational decision on his own. This doctor came late one afternoon. Goshwin, Diego, Sacha and I sat in a bedroom, leaving Hugo and Dietje with him in the sitting room. Time passed and eventually Goshwin slipped into the kitchen to get a bottle of wine. We sipped our drinks quietly but were startled by the sound of laughter and the clink of glasses. After a while, my stepmother came in to apologise: they had forgotten about us. The doctor was interested in Hugo’s Japanese woodblock prints and they had been talking about his art collection.

The day before he died, Hugo discussed family affairs and talked calmly about what had to be done in relation to his death. There were arrangements to be made. He wanted Mozart at the funeral service and a live performance by a Surinamer flautist he admired. He asked Diego to engage him: Diego called and left a message but there was no reply. Annoyed, Hugo took charge. He rang, got the flautist and discussed what he would play. And he asked Dietje if she had selected clothes for him to wear when he was dead. “You know I don’t like to be cold,” he said.

On his last night, Hugo decided to sort through a trunk in his bedroom and asked Goshwin, Diego and me to join him. He started giving each of us papers, letters and photos, with some for my son, but had barely skimmed the surface when Dietje called us for dinner. He had a taste of chicken soup – he could barely swallow and had been kept alive by a special fluid developed for astronauts, which he hated – and a sip of wine. Afterwards, he wanted to listen to Mozart. It was a clear night with a full moon. We drew back the curtains; he put on the hearing aid he wore when going to the theatre and lay back on the sofa. A farewell concert.

Saturday dawned. I knew what to wear to a funeral, but what do you wear to the death itself? Sacha was going to wear a miniskirt and tights. She has great legs and thought Hugo would like her attire. I decided to wear a skirt, too, but a long black one with a slit up one side, leopard-print patterned tights, a black cotton top and a sleeveless woollen jerkin in taupes and olives, which I knew Hugo liked. I always wear earrings and chose a pair of beautiful black pearls, which I had bought in Rarotonga a couple of years before with money he had sent for my birthday.

We arrived at the house at a quarter to nine. Hugo was sitting on the sofa in his pyjamas and dressing gown. He welcomed us and then asked me: “What earrings are you wearing?”

Hugo did most of the talking. He said he’d enjoyed the previous evening and had a good night. He’d read a book by an ancient Chinese writer; he’d listened to the news at 1 am, taken only one sleeping pill and slept well until 5 am. When he woke he had quite forgotten that it was to be his last morning. He had no regrets. He had no great thoughts. His mind was empty. He looked at us and laughed: “This is like waiting for Godot!”

Glancing around the room, he said that a small stone statue was looking at him. It was from our trip to Afghanistan in 1977. It was a Gandharan sculpture: a Buddha head with Greek influence. “A beauty,” he said. He asked me to pass it to him and, holding it, he told Dietje how amazed he had been to find such a wonderful museum in Kabul.

Then he went to the bathroom and shaved. Goshwin made us coffee while Hugo had a sip of apple juice, saying he’d had coffee earlier that morning. Precisely at 10 am the doorbell rang. Two doctors were there: one to administer injections, the other to ensure the protocols were observed.

It all happened swiftly. Hugo went into Dietje’s bedroom, lay down, and one by one we kissed him and he held us briefly. Dietje sat on the bed; Hugo turned on his side; she held his hands and the doctor gave him an injection. In the brief seconds before losing consciousness he spoke a few light-hearted words in a lilting tone, as if to reassure us.

We sat there, immobile, until the doctor picked up a second syringe, and looked at us for our assent. We nodded. The first injection put him to sleep; the second put him into a coma. I don’t know how long it was before the doctor held up another syringe, looked at us again, and again we nodded. The third injection stopped my father’s heart.

Some time later, the doctor said he was dead and we went into the sitting room. My stepmother produced a tray of hot, spicy meatballs from the oven and to my surprise I found I was ravenous. Shortly after, the doctors took their leave and I had to get out of the house, to get some fresh air and to cry alone. When I returned, the others were sitting with Hugo, and I joined them. We stayed there quietly until five o’clock, when two men arrived, as arranged, to take his body away.

First published in The Monthly, here. Used with permission.

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13 Comments

13 Comments

  1. Merk

    October 2, 2013 at 8:21 pm

    If it pleases the Editor, I would like to submit the following comment:

    Death has been around much, much longer than the man-made notion of ‘dignity’. There is presently a strong safeguard against citizens being killed by the legal, political, or medical classes. It’s called the ‘sanctity of life’. Legislate away the sanctity of life, and what else does civil society have to protect itself from the excesses of the State?

    Show me a perfect, incorruptible system of lawful killing, and you’ll have my support. I shan’t be holding my breath.

    http://www.themercury.com.au/news/opinion/saying-no-to-a-fatal-attraction/story-fnj4f64i-1226732044959

  2. Simon Warriner

    September 30, 2013 at 7:50 pm

    As someone who watched his father suffer with prostrate cancer that spread to his bones and was unable to deliver him the quick and dignified death he wished for I would say to Mr Trevor Cowell that in spite of your insurmountable ignorance, I do not wish my father’s pain on you.

    Pray you do not go that way, sport. We treat our pets better.

  3. Sue DeNim

    September 30, 2013 at 6:08 pm

    As is often the case I have no idea what TGC’s interjection is supposed to mean but if they can provide an example from a contemporary society with proper checks and balances of when this kind of legislation has gone seriously awry I would love to hear it.
    Otherwise I can think of no other reason why anyone in their right mind would have a problem with it.
    A very moving story and a timely reminder that these are people we are talking about not numbers and statistics in a system.

  4. Judith King

    September 30, 2013 at 1:40 pm

    #4 is insensitive to the core of a person’s right to voluntary euthanasia when life is no longer tenable. Hope you never have to face the situation in order to understand and show some empathy to others.

    #8&9 When someone you love suffers in the process of dying, there is another level of anguish beyond the grief of death. The anguish and regret related to helplessness that you could not do more, stays with you even after the grief subsides. The anguish can drive people to do desperate things and this is why voluntary euthanasia laws are so needed.

    #9 Penelope… your pain is raw still and in your writing. Even tho I don’t know you, please know the majority of the community care and believe your husband should have had the right to choose. Love and strength to you from our place! Thank you for speaking out as it is the only way we can pressure politicians to bring the changes needed.

    At some future time people will have the choice at the end of their lives and we must continue as advocates for that change. Hopefully it’s sorted before our time comes!

    #8 the doctor did the wrong thing by your mother and you. Compassion should have seen the doctor sit with your mum to at least look at other options to give pain relief. To walk away is unforgivable and the so called doctor should not be associated with caring for the dying if that is how they underperform!

    #6 is a perfect summary “Those who wish to censor the death of others seem largely the same people who wish to censor life.”

  5. Penelope Marshall

    September 30, 2013 at 11:55 am

    #8 Yes my husband was so desperate to choose his ending he pleaded with me to take him to his favourite climbing spot on the mountain and just drive home and leave him there with his last small oxygen bottle. The implications of doing that were way beyond my moral and ethical capabilities no matter how much I wanted him to die with dignity. What I witnessed as his actual death in reality was so undignified and exactly what he did not want, I still feel great regret. He was only 34.

  6. Pete Godfrey

    September 30, 2013 at 11:05 am

    Thankyou for sharing your story Margaretta. Like others have said we don’t let our beloved pets or injured wild animals suffer. My mother also died in a palliative care ward, I sat there talking and being with her for the last 10 days of her life.
    She said she was ready to go and wanted to die. She had a good life and just wanted the suffering to end.
    What a brave and beautiful soul.
    She asked the doctor while I was there if he would just give her a needle to end it all, poor fellow just looked at his shoes and spun on his heels and walked off.
    I had to explain the ramifications for him and then went to thank him and explain that we understood how he couldn’t do that.
    It depends on what our view of death is I suppose, for those who feel it is just pushing up daisies and endless nothingness then death may be a horrifying thought. Others are obviously not perturbed by a natural event in all of our lives.

  7. Philip Lowe

    September 30, 2013 at 3:31 am

    Memorable piece.I held my breath while reading it.
    All our days are numbered.If we all would treat every day as if it were our last?

  8. john hayward

    September 30, 2013 at 12:52 am

    I’m trying to imagine an impulse to deny Hugo the right to depart from his suffering at his own choosing. I can’t believe that those who would deny him are acting out of concern with protecting a patient from exploitation, any more than I believe that the stop the boat crowd is deeply concerned with preventing drownings.

    Those who wish to censor the death of others seem largely the same people who wish to censor life.

    John Hayward

  9. Bonni Hall

    September 29, 2013 at 11:41 pm

    #4. I suppose,in your view, sending young men off to war knowing full well that will not all return, is not subscribing to a death? The previous three comments, and the article itself, thank you, all of you.

  10. TGC

    September 29, 2013 at 9:45 pm

    It is so easy to describe difficult deaths: where is the human right to ask someone to subscribe to a death?

  11. Joan Emberg

    September 29, 2013 at 6:36 pm

    I have hot tears. Judith is right when she says voluntary euthanasia is a human right. To criminalize it is obscenely inhumane.

  12. Judith King

    September 29, 2013 at 1:44 pm

    Thank you Margaretta so much for sharing your experience.

    My parents both organised so called ‘voluntary euthanasia’ in Melbourne that consisted of subcutaneous morphine injections. It took days as their frail bodies shut down. They went in and out of coma. It was awful to watch as different organs started to fail. Their skin and tissues gradually shut down as their blood pressure dropped from ongoing dehydration so the morphine absorption slowed dramatically.

    I was given the ‘role’ by each parent to keep asking staff to administer morphine as often as possible. Some nurses with religious views were unwilling to give the medication and we had to make several calls to the oncology (cancer) specialists to keep Mum and years later, Dad at a basic level of comfort.

    Palliative care basically gives a lesser option to this level of ‘voluntary euthanasia’ in Australia at present. It is unacceptable that people endure this protracted type of unnecessary suffering in the last stages of life. As often said…you would be charged with cruelty if you made a dog suffer in this way…so why do we continue to allow it to happen to people we love.

    As a health professional I have seen health staff and family members become desperate about their loved one’s suffering. Some have tried Tontine pillow therapy to help end the struggle. Other people avoid the hospital trap to shoot themselves, jump from bridges, hang themselves or take an ill informed variety of drugs to depart their suffering. One family made up poisoned soup to give their mother in hospital!

    It’s time for everyone to have Hugo’s choice available to us, should we need it. Some people manage to have a peaceful death in hospital and at home. Some don’t and need to be able to choose an efficient voluntary euthanasia.

    We need a legal option available so that a dignified QUICK death is possible for those unable to find relief through palliation.

    Please write to your MP’s to express your views on this matter asking for our human rights to be respected with all having the right to make their own decision on how to exit life and have a peaceful death.

  13. Penelope Marshall

    September 29, 2013 at 12:19 pm

    This is dying with dignity. If you have ever watched a loved one die in pain you would understand its importance. Twice in my young life have I sat by and watched the two closest people in my life suffer through terminal illness to death and wish I could have given them a choice. My father and my young husband, its cruel and sad for them as well, you can see it in their pleading eyes and feel it in your heart.

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