Deathstyles of the rich and languorous

New York magazine has a long and disturbing essay ($$$ sorry I don’t have a gift link) by Evelyn Jouvenet (a pseudonym), about her mother’s medically-assisted death.

This is the beginning of it:

Do you know how many grams of Nembutal it takes to put an elephant to sleep?” asks the anesthesiologist from Pegasos, a voluntary-assisted-death organization in Switzerland, after an evaluative look at my mother.

We — my 74-year-old mother, my younger sister, and I — are sitting on a couch in the suite of a charming hotel near the center of Basel. Thin, contained, elegant, with a neat bob of white hair, Mom is at attention. The doctor seems at ease. As he tucks his hat under a red-and-gold Louis XV–style chair, he tells us that many people who avail themselves of Pegasos’s service, which costs more than $10,000, will sell their car or antique books to spend their last few nights at this hotel.

It is September 28, 2022, the day before my mother is scheduled to inject herself with 15 grams of Nembutal — enough to sedate three and a half elephants, the doctor says. She would not need to worry about waking up or being cremated alive. This was a relief to her, Mom says with a smile.

In June, my sister and I had learned, almost by accident, that she was seeking an assisted suicide. I was on the phone with Mom, listening to her complain about an annoying bureaucrat at the New York County Clerk’s Office, when she mentioned it. “I am putting in an application to Pegasos,” she said impassively, “so I was getting some documents for them.” I texted my sister while we were on the phone: “What the fuck? Why didn’t you tell me about Mom applying to die?” Three little dots. “Wait,” My sister wrote back. “What. What is she doing?”

Mom didn’t have cancer or Lou Gehrig’s disease or any of the illnesses that typically qualify you for assisted death. A cataract in her left eye had deteriorated, and though she had some foot pain and had gotten a pacemaker, all of which weighed on her, she was quite healthy for her age. She had completed a marathon just a few years before at 68.

But her long-term partner had been diagnosed with an incurable glioblastoma in February 2020 and had taken advantage of California’s “death with dignity” laws to die that May. Soon after, Mom left San Francisco, a city she hated for the 20 years she lived there, and moved back to her beloved New York. She bought an apartment near her childhood home on Fifth Avenue; reconnected with old friends; saw plays, art exhibits, and movies; ate good food; and traveled — and did not care about any of it. “Oh, I have nothing interesting to say,” she would say when I called, her voice animated only when she was describing a plan to smite anyone responsible for a grievance by writing a furious email or leaving an angry Yelp review. My mother had always been a flashlight of a person — shining a small but intense beam on things she wanted to explore — but now the radius had shrunk, the light weakened. She used to be curious about my husband’s hobbies, our children, my sister’s career, but those topics, like everything else, were now of only vague interest. She would come down to Virginia to see my family and go up to Connecticut to see my sister’s, but she wouldn’t play with the kids and didn’t seem to enjoy the trips, just expressed relief when they were over. In the last months of her life, the only thing that appeared to give her real joy was the hope that she would be ending it.

In the U.S., ten states allow physician-assisted death, which is available only to residents who are terminally ill with no more than six months to live. In Canada, the laws are more expansive, but citizens still need a diagnosis — if not a terminal condition, then an incurable one with intolerable suffering and an advanced state of decline. In Switzerland, where a foreigner can go to receive aid in dying, there are fewer restrictions on who is eligible. Pegasos is one of the only organizations that will help elderly people who have not been diagnosed with a terminal illness but who are tired of life. Its website notes that “old age is rarely kind” and that “for a person to be in the headspace of considering ending their lives, their quality of life must be qualitatively poor.”

My mother had pinned her hopes on this “tired of life” catchall. She had a three-pronged rationale, she told us over the phone: The world was going to hell, and she did not want to see more; she did not get joy out of the everyday pleasures of life or her relationships; and she did not want to face the degradations of aging.

It would be an understatement to say this is a fraught mother-daughter relationship:

After she told us about her application to Pegasos, I called her. “What would make you happy this summer, Mom?” I asked. I suggested a girls’ weekend with her, my sister, and me; she declined. Later, she tells my sister that part of the reason she has decided to kill herself is that my sister does not love her enough. In August, she sends me a final birthday card. On the front, it reads MAY ALL YOUR VENGEFUL WISHES COME TRUE. She has written on the inside, “Dear Pussycat, I think this is the best birthday wish ever. xxoo. Mommy.”

I can see it clearly — the special brand of narcissistic sadism she has perfected. Still, in my bountiful moments, I think perhaps she is consciously attempting a last act of parenting: doing me the favor of severing the connection that has defined much of my life and that I am too scared to break.

The mother, it turns out, is a lifelong libertarian, who appears to be more or less completely indifferent to the fact that her decision to check out of life like someone else might check out of less than satisfactory hotel is causing emotional devastation to the daughters she brought into the world.

I suspect that there’s much more going on here: the idea that a rich, physically healthy person surrounded by lots of friends and family can be psychologically healthy and still decide to kill herself because, at bottom, she’s bored with life, seems at least to me improbable. And of course we’re getting only one side of the story.

In any event I found the essay both fascinating and horrifying (“Jouvenet” is a fine writer), and I’m very interested in other peoples’ takes on both it, and the larger subject.