There were nights when I couldn’t sleep. No matter the urgency for rest. My thoughts ran relays around my job on the hospital AIDS unit, trying to come up with ways to ease the suffering of patients I’d be nursing the next day. Beyond the disruption of everything familiar in their lives, their physical indignities and pain, the barrage of concurrent diagnoses and increasingly poor health, what gripped me most powerfully was each person’s fear of death.

I’d climb out of bed and grope through the darkness of my apartment to heat a cup of milk, always half-hoping to see a glow of light shining through the frosted glass of the kitchen window. The two square panes above my stove faced across a narrow air shaft to the identical window of my neighbor’s kitchen. If the light was there, I knew my friend was awake too. Jim often sat in his kitchen late at night, listening to music or books on tape, sipping from a glass of good Burgundy, absorbing the stillness of the hour. His presence helped to calm me.

There is a mixed blessing in the isolation that comes with living in a city apartment building, habitats stacked atop one another similar to cages in a pet shop. I valued the privacy and independence that went with living alone. But for me these advantages wrestled with the need for the reassurance and comfort of companionship, particularly in those years. The AIDS epidemic, with its inevitable outcome at that time, made me think constantly about the experience of dying.

Jim and I met when he was a volunteer on the hospital unit where I worked. A man in his eighties, he had a smooth cap of pure white hair and a walrus mustache neatly trimmed. His posture was straight despite his eighty years. He wore dress shirts, crisp and scented of laundry soap. Lacking involvement in the world of medicine, Jim came to do whatever he could for individuals with AIDS and the rest of us impacted by the epidemic. He was an able listener. I held the image of the kindness in his eyes the time he asked, as I exited the room of someone very ill, “How is it going for you today?”

As neighbors, Jim and I kept track of each other, respectful of the lone-wolf quality that characterized each of us. We left notes under the other’s front door just down the carpeted hallway, books we wanted to share, slices of chocolate mousse cake from the bakery two blocks away. Every so often we cooked dinner for each other, eaten in our tiny kitchens, several courses whose sauces and preparation we exclaimed over. A man of orderly habits, Jim walked five miles every day in increments, left the building at precise times, carried his mail and a small bag of groceries up our building’s two staircases with his heart and lungs in easy rhythm.

Jim had one fear: the imposition of death coming upon him when he was unprepared. He had a
horror of being suddenly struck down in public, sprawled on a sidewalk, vulnerable and inelegant, gazed at by curious strangers, accosted by a foul-breathed do-gooder attempting resuscitation. He recoiled from the image of himself collapsed on the floor of a supermarket, helpless amidst shopping carts and the chaos of clerks shouting for an ambulance, while a stranger grappled at his neck to loosen his tie. Death would not come to Jim. He would come to death.

Jim had been a member of the Hemlock Society for much of his life. He owned a well-thumbed copy of Final Exit. He meditated daily. He practiced yoga every morning. He spoke of an other-worldly being, a guardian spirit, with whom he held conversations regularly. Jim talked of his some-day death with enormous peacefulness and assurance. He would meet death on his own terms, when the time was right for him.

When Jim died, our apartment building was no longer my home. I had retired from nursing two years earlier and moved to Alaska where I lived in a one-room cabin whose kitchen merged with the bedroom.

From a mutual friend I learned that Jim’s eyes had been giving him trouble. Jim was ninety by then, still strong, still walking close to five miles a day. For over a year his ability to see had been dimming, his eyes plagued by chronic irritation. An ophthalmologist offered eye drops to quell the inflammation somewhat, although he gently explained that Jim’s eyesight was unlikely to improve and, in fact, would probably continue to deteriorate. The drops would have to be administered every few hours.

Jim loved being alive. He believed that life itself was a miracle, a marvel of existence that he valued and respected, a gift he had been given for which he felt blessed and grateful.

I was told that when Jim returned home from the consultation about his eyes, he was smiling. He had waited for many years, he explained, to recognize the right time to carry out his plan.

For two weeks, Jim met daily in his apartment with a small gathering of his closest friends. They reminisced, cried and laughed a great deal, drank Manhattan cocktails in such large quantities that some later vowed never again to ingest the combination of whiskey and vermouth. Throughout those fourteen days, residents of Jim’s building reported hearing him singing as he went about whatever he was doing.

While taking one’s own life is not against the law in the United States, to help someone to die is illegal here. For a physician in this country to participate in ending a human life, complex issues and regulations are involved including the ruling that the recipient must be terminally ill.
When Jim’s friend phoned me and described how a week earlier he had arranged, at Jim’s request, to spend several hours in a distant section of the city, leaving Jim at home by himself, I understood
what had taken place. Jim was gone.

Everyone dies. I regard this inevitability—especially the prospect of my own death and the deaths of people I have known as well as the deaths that are to come—with unbearable grief, anger, and fear. Jim’s death is the only one that gives me absolute and continuous joy. I miss him. Oh my, do I miss him! But I am filled with a happiness that I never imagined associating with anyone’s death.

I look out from my Alaska cabin at the mountain range across a bay that was once the arm of a glacier. I think of the ease with which the natural world incorporates living and dying. I am struck anew by the freedom Jim chose for himself.

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