Death with Dignity: The Right to Continue to Be the Person You’ve Always Been

By Nora Miller, a volunteer for Death with Dignity. This story first appeared at

www.DeathwithDignity.org

My husband Rick and I talked about Death with Dignity in general terms in 1996 when my mother died in pain and struggling for breath, and then again during the debates and publicity around the 1997 ballot initiative on Oregon’s law. We both agreed we’d prefer to control the conditions of our own deaths.

In early 1999 Rick developed a cough that wouldn’t go away. The diagnosis of metastatic terminal lung cancer in April left no room for doubt or hope for something less final. His first words were, “Now we are going to Alaska.” (Alas, we never made it.) His next words were, “I will be using the Oregon law.” We were fortunate our son and both our families supported his decision, with some regret and a few reservations, but without argument or complaint.

By mid-October, the doctor suggested it was time for hospice. We were able to keep Rick at home. Later that month, Rick made his first oral request under the Oregon Death with Dignity Act, followed by a written request, and the final verbal request in early November. Rick’s oncologist had never received a request before—with the law only two years old, everyone was new at it—but he was reasonable and sympathetic. He agreed Rick was of sound mind, not depressed, and definitely terminal. He wrote the prescription on a cold, rainy Friday in early November, and I drove across Portland to the only pharmacy willing to fill it at the time. Rick told me he thought he’d be a lot sicker when he’d be making the decision to use the prescription. He was, in fact, a lot sicker than he thought. He was having trouble with his voice and with swallowing. He often lost words or used them seemingly at random. He woke up with blinding headaches from a growing brain tumor. He couldn’t walk on his own. He’d become emaciated.

The day he made his decision had been a hard one: he was very tired and weak, and medications had deprived him of his emotional control. He was ready to go. I challenged his intention. I told him he could sleep on it, decide the next day. He was sure. He was calmer than he’d been in weeks, almost jovial, relieved. He needed the control and the ability to choose, and he needed to know that, in the end, we’d have joy and love in the midst of our sorrow. This was a last loving gift we gave each other. I wanted nothing more than to make that possible for him. I’ve never once regretted it.

I’ve often replayed those last weeks, recalling moments where I could’ve or should’ve done something differently. It’s taken me years to understand what I did was what Rick wanted, and to have done anything different would’ve made the process about me and not about him. It was his life and it was his death—he needed the right to decide how it would happen. To provide real dignity in dying, we must unconditionally respect the unique and inherent personhood of the person at the center of the process. Nobody’s Death with Dignity story will be the same as mine.

The dignity people seek in the dying process is unique to them. For some, it’s a time to reconnect with old friends and heal old wounds. Others need a few close friends who can help them address their fears and assess their options. For others still, it means focusing on the narrowing possibility of recovery, of beating the odds. But for every single person who is dying, Death with Dignity means having the right to continue to be the person they’ve always been. I’ll be forever grateful to my fellow Oregonians for making this possible for Rick. I just hope the remaining 47 states join Oregon, Washington, and Vermont and enact similar laws soon. (June 2013 / August 2015)

An Interview with a Funeral Director

Today I interviewed Amanda Vanston for the blog. Since the beginning of my thesis/book, I have been fascinated by people who choose to work in the funeral industry and what that experience is like for them.

My name is Amanda Vanston, I am 34 years old and a mother of two amazing kiddos. I am a licensed Funeral Director and Crematory Operator in the state of Texas. I have been in the funeral industry for almost 8 years.

DW: When did you realize you wanted to work in the funeral industry?

AV: This is "THE" question. It is even the standard greeting amongst Morticians... "Hello, my name is ______ and I work for _______. So, how did you get into this industry?" A significant amount of Morticians are born into this business, so it's an easy answer for them. Then there are the folks who choose this profession as a second career, usually after retiring from ministry or teaching. In my case, I can't claim either one of the above responses, so I am left with the awkward, "because, I wanted to" answer.

I was an odd child, fascinated by the unknown...I still am. Death is the ultimate mystery. I knew, from a very young age, that I wanted to work with the dead. As I grew older, I thought I would find something in the medical profession, like my parents, and kind of pushed the idea of being a mortician to the side.

After some unsuccessful attempts at college, I came back home and became a caretaker for my grandfather. During one of our hospital visits, I wandered around and came upon the Pierce Chapel at Methodist Dallas. I had heard about Pierce Mortuary Schools in the past, and so later that week when we went home I began my research on how to enter the funeral industry. I found Dallas Institute of Funeral Service and studied the requirements for entry. It was expensive, time consuming and frankly, rather daunting for a 20 year old who had just failed her second attempt at College so, once again, the idea was put on the back burner.

About 6 months after the birth of my second child, I had a "Come to Jesus" meeting with my OB/Gyn that changed everything. I had become rather depressed. I had lost my biological father and both of my grandmothers, all of whom played a key role in my life. I didn't feel motivated to do anything productive and I was living an extremely unhealthy lifestyle. My Doctor sat me down and she said, "you have got to do something! You've got two children and, frankly, at this rate you won't live to see either one of them graduate." She questioned me about my interests, what would I want to do? What would make me happy? I answered, "I would love to work in the funeral industry." She answered, "Funny, my husband is a mortician." I saw it as a sign. That was it. Dr. P set me up with all of the info about Dallas Institute of Funeral Service and I went home that evening and announced to my parents that I would be attending Mortuary School.

DW: Where did you go to school?

AV:

Dallas Institute of Funeral Service

, formerly Pierce Mortuary College. It is an 18 month program and you receive an AAS.

DW: What was that experience like?

AV: I am not going to sugar coat it, the experience is intense. It is A LOT of information crammed into your mind day after day. We are required to take Anatomy, Pathology, Microbiology, Chemistry and Science of Embalming on top of typical business courses and labs. In order to graduate you must complete 10 embalming labs, 6 of which have to be autopsy cases. In order to become licensed and practice, you must pass a state law exam, a national board exam in both Sciences and Arts and serve an apprenticeship.

DW: What was your first job in the funeral industry?

AV: My first job was with a Mortuary Service. I went on removals, transported bodies and served as a provisional embalmer. I don't recommend the experience, especially if you have a family. Those are rough times, never knowing where or when you're going to be called and where on earth you'll be going. Admittedly, I didn't last too long. I was there about 6 months before I was offered a position with a prestigious funeral home in DFW and I jumped on the opportunity.

DW: What do you like about your job?

AV: Being a source of stability and comfort for grieving families. It's warms my heart every single time a family walks away giving me sincere thanks, a pat on the back or a big hug. You have these people come in to your life and they are HURTING. They are lost, even when I ask if they have experienced a death before. It is my job to be a guide, to give reassurance that I, personally, am taking care of their loved one so that they can focus on their grief.

DW: What is a common misconception about the work you do?

AV: There's always the generalization that we are all greedy and want to rob families by taking all of their money, inheritance, or insurance. That we will lie to make a sale, bend the laws, mark up our services or merchandise and or basically do anything to take advantage of a grieving widow or family member. I can't say that this type of funeral director doesn't exist, sadly there are a few bad apples in the bunch, but in most states (Texas included), we are governed by strict laws. It is not like we can pocket people's insurance checks and be on our merry way. We report to state and federal commissions. We are licensed individuals and, just like any other profession that requires a licensed individual, the consumer has every right to file a complaint with the state; we will be investigated, we will have to pay for our consequences. I do wish that our industry could dedicate more time to the public and make more of an effort to educate them on what their rights are as consumers, what they should expect from any funeral home, what it is that we offer and what is and is not required by law....

DW: Do people want to talk to you about your job? Are they curious? Or do people avoid the topic?

AV: I can honestly say it depends on the person. Some people cringe when I tell them my profession, some want to know every single detail. The majority of folks that I encounter are curious and want to know only as much as they can handle. It's almost a social experiment...how much can one person take of the knowledge that I am privy to before they cry "uncle." In truth, it is extremely rare to find someone outside of the industry that wants to know the gory details of the profession. Most are surprised at the drama that surrounds us as funeral directors. When I first began working at the funeral home, my mother couldn't wait for me to call her with the stories. She said it was like a soap opera and she couldn't be more right. Death is, literally, the ultimate soap opera...there is nothing calm or convenient about it.

DW: What is the most difficult thing you've had to do for your job?

AV: Everyone has a case that they don't want to deal with. Most directors would say babies or anything truly tragic. Others would say extremely high profile or high maintenance cases. The most difficult thing I ever had to do was extremely personal. In October of 2013 my ex-husband and father of my children was murdered. I couldn't do anything to save him in life, so I focused my attention on creating a very memorable and personal funeral that would honor everything that he was to me and our family. My colleagues would not let me do any of the prep work (embalming) so instead, I got to hand pick who I wanted to embalm. After that, I took over. I planned the service, ordered the flowers, polished the casket, called the minister, wrote the obituary, stayed up every night designing programs, creating videos, writing the eulogy etc. That was the easy part. The day of visitation, I came to work and fought my supervisor to let me dress, casket and cosmetize Roderick. No one thinks you can handle these situations when they are your own but truthfully, there is no way in hell I was going to let anyone else touch him. I was the star when it came to cosmetics and restorative art, and they were either going to let me do it and do it right, or they would have to deal with me standing over them criticizing every move. Needless to say I won the battle. I got the honor of preparing him for the viewing and the service. We had a "Full Service Cremation" which is where the body is embalmed, placed in a "rental" casket and is present for services, then cremated afterwards. I am a licensed crematory operator so I also got to be the one to cremate his body. I was there from beginning to end. That still wasn't the hardest part. The absolute most difficult thing I have ever done was place Roderick's ashes into their urns. It was utterly final. I stood in the prep room spooning cremated remains into little receptacles for the family and I didn't even realize that tears were streaming down my cheeks. My co-workers came to check on me and immediately took the task out of my hands, and while I thanked them...that was incredibly difficult as well. I never wanted to give up control and seeing the 7lb. sack of my first love's cremated remains made me painfully aware that I couldn't control squat when it comes to death.

Facing Fears

Yesterday, my

book

came out.

Yeah, yeah, yeah. We know, Pam. You've inundated Facebook and Twitter with posts and we're kind of over it.  

Well, folks, to be honest with you, so am I. As a self published author, I have to wear many hats, including marketer and publicist. I would really prefer to sit in front of a computer by myself and write, but now I have the responsibility to put myself out there. Putting myself out there involves conversing with people and reading in front of them. At one point in my life, the idea of standing in front of others and moving my lips scared the pants off of me. Not literally, of course, but it certainly felt that way. I felt naked and vulnerable, eyeing the room for the closest exit.

But not anymore!

Last night I spoke at the

Pine River Public Library

in lovely Bayfeld, Colorado. The event was slated to begin at four and there were about 5 people. Easy peasy lemon squeezy, I thought. But as I began to read, people crept in and the room began to fill. While Bayfield isn't known for its punctuality, it is known for its support. 

Dan Miller.  He's in the book.  

For those who know me, this picture right here is a rarity. I'm giving people hugs. It happened a lot last night. I deem the event "Hugapalooza 2015." It felt so wonderful to be back in my hometown with people I haven't seen in five years.

Here I'm chatting with an old friend and the lady to my right just showed up. I felt like such a celebrity!

Last night I learned that the library is having a local author book sale in December. I am sending them signed copies of my book (Yes, I decided to have it printed.) All proceeds will go to

Cate Harding

and her family. So, if you're in the area go buy one.