On Our Terms Many Readers Agree That The Process Of Death Should Not Be As Frightening As We Make It. Instead, Says Polly Mcmahon, It Should Be A Celebration Of Life, One That Can Evoke Both Tears And Laughter.

Janette Knowles was 75 and suffering from Lou Gehrig’s disease. She wasn’t just prepared for death, she invited it.

She was, as her daughter Susan Miller, Cheney, recalls, “an alert, intelligent mind in a dead, painful body.”

But doctors at Knowles’ longtime home in Nebraska wouldn’t consider helping her die. Nor would those in Eastern Washington where two of her children lived. So Knowles went to Warren, Mich., and, with help from Dr. Jack Kevorkian, she died on March 24, 1997.

“My siblings and I consider it our final act of love for our wonderful mother to have been able to help her out of this life as she helped us into it,” says Miller, one of several readers who shared their views and experiences about death. Many of them had watched the recent PBS television series, “On Our Own Terms: Moyers on Dying.”

Miller’s mother could no longer swallow or speak. She got nutrition through a feeding tube attached to a bag she could barely lift. She had to use her hand to lift her head to see where to steer her walker. She didn’t have enough breath to blow out a candle.

“I’ve had enough,” she finally jotted in a note.

Miller regrets only that she and her sister weren’t with their mother when she died. Kevorkian’s lawyers advised them to be out of state.

“So we met Jack and his assistant, Janet, kissed Mom goodbye through our tears, Mom pinched my cheek, and we were gone into the night to meet a plane to take us back to Nebraska.”

The news beat them there. Public reaction, mostly scornful, was building before they landed.

“How sad, heartbroken and bewildered we were, but we all felt better knowing Mom was the one who ended her life, that she was out of pain and that we had been able to help her,” Miller says.

“Due to Mom’s decision, we were able to discuss all of her wishes. I was able to take care of her the last weekend of her life. I was able to rub her back, bathe her, feed her, dress her and caress her, which gave me the opportunity to memorize the feel of her skin, the shine in her eyes, the smell of her cheek when I kissed her.

“Everyone should be so lucky to be able to look death squarely in the eye without fear and to be able to treat it as another phase of the life process.”

It’s hard but rewarding to talk about death as a celebration, says Polly McMahon, chairwoman of the Gerontology Program at Spokane Falls Community College, which offers a class on death loss and grief.

“Some of the more interesting issues are the multi-cultural aspects of end-of-life care and often very, very funny stories. Always, always, tears and laughter are a part of such discussions,” said McMahon.

“We are not afraid to be born and to be alive as humans,” said Jack Poole, Nine Mile Falls. “Neither should we fear death, another process in that unknown continuum that we have come to call self or spirit. The process of death, I think, is as much a time for curiosity and wonder as the process of birth, and as much destined for further growth.”

For Kay Stoltz, Spokane, “Hospice is the most helpful organization to have around,” and it should be in place at all hospitals and nursing homes.

Still, when her grandmother died recently, Stoltz found Hospice’s effect limited by thin staffing and “archaic” insurance systems.

“One should have the option of dying at home with all the necessary accouterments,” Stoltz said. “There is a registered nurse on call, as well as counselors, but a nurse practitioner (at the least) or M.D. should be on the plan and allowed to make housecalls without doing it on the sly, so to speak, as has happened.”

She also had a fond word for primary caregivers:

“It has to be the hardest job in the world and I applaud anyone who can do it. Those I have known in the role do it lovingly and willingly, but it takes its toll and the well-meaning friends and relatives, for whatever reason, don’t give nearly enough support.”

Closure is vitally important in the case of a terminal illness, adds Victor E. Buksbazen, Spokane. “Family members, neighbors, co-workers and others who have had disagreements with the clients, sometimes lasting for years, can do a world of good by visiting, calling or writing and asking forgiveness.”

Even if that doesn’t achieve reconciliation, he said, it “can go a long way towards the restoration of peace to both parties.”

A few weeks before he died, Ruth Dixon’s husband, Harvey, asked her to take down some of his final thoughts.

He described an ordeal of misdiagnosis, treatments and tubes. He told her he’d made a deal with the physical therapist that if his pain could be ended he would do what it took to increase his mobility and strength. Then he added:

“But if no way is found to halt this continuous pain, I am going to do my damnedest to end it myself.”

He estimated $200,000 to $300,000 had been spent in six months trying to make him comfortable. More of the same lay ahead. Better to spend that money on “good nursing care and facilities for those who are healable,” he reasoned.

Maxine Jones had been an Army nurse in World War II and a teacher in California before retiring in 1977 and enrolling in a Hospice course in Missoula. She and her husband, who had been diagnosed with Alzheimer’s disease in 1989, both signed living wills in 1991.

In addition, they talked to their children and some grandchildren about their attitudes toward death. After he died five years ago, a memorial service was held in their son’s back yard and a group of children and grandchildren climbed Trapper Peak near Darby, Mont., to spread his ashes.

“I’m now soon 80 years old,” says the Spokane woman. “I live in a senior citizen apartment complex, very content and happy. My will is made, my requests made, my family well informed.”

Her doctors all have copies of her living will. Another is in her purse. Still she wonders: “Will my requests be respected?”

This sidebar appeared with the story: NEXT MONTH A new conversation

Bagpipes is a monthly feature that invites readers of the Perspective page to share their ideas about a selected topic such as the issues that surround death and dying.

This feature will return next month with a new name and an expanded opportunity for readers to comment.

We hope you’ll join the conversation. Be sure to check out the Perspective page on Sunday, Oct. 29.

A monthly discussion of regional concerns