By Meg Ringler
CW: Conversations around assisted suicide
The first time I take a Jello shot, I am 8. It’s unclear to me now if I knew it had alcohol in it, or simply thought it was Jello. I got drunk. By the time I get sober at 28, it will take many, many shots to get me drunk.
The first time I run a mile without stopping I am 26. Fourteen months later, I run the Chicago Marathon.
Tiny doses. Baby steps. Inoculation. You can build up a tolerance to anything.
Take a hit: At the start of 2020, I tell my therapist I would like to make some death plans. I explain that my grandparents are old and not terribly healthy, that Whiskey is healthy but getting quite old, that I’d like a game plan, because I feel like someone is going to die this year.
It is January. The virus hadn’t reached the U.S. yet, not that we know of. It doesn’t have a name. I am not thinking plague or pandemic or perpetual terror. It has been a long time since anyone significant in my life died, two decades since we lost my paternal grandfather, and he and I weren’t even close.
I can’t tell if she is amused or appalled by this request, can never really tell what she thinks of our sessions at all. I imagine my problems are silly compared to many she sees. Am I a break or an exhausting reminder that human brains can make a mess of anything? That I can’t tell makes her a good therapist, I think.
“You can’t…plan for death,” she finally says. I want to reply with snark, a joke about my living will disagreeing with her, but I get what she means.
“I know? But I’m worried about my sobriety when Whiskey dies.” We spend the next appointment talking through what I’ll need, from her, from Mike, from my support system.
think about how I will want him to die, if there is an option to choose. She has printed resources for me, both about pet grief, generally, and a local company who offers in-home euthanasia. I will want his ashes, not to keep but to spread in the ocean, his favorite place. I will read a Mary Oliver poem on the beach. I will take time off of work and need another dog almost immediately. I have a plan.
Many people die in 2020. None of them are mine. No one has a plan.
Take a hit: After her first three weeks of chemo and radiation, my grandmother is tired. She comes — we come — from hearty Polish stock. Two of her brothers played professional football. One of them was a professional boxer. Her younger sister once held the record for largest baby born in our local hospital — more than 14 pounds. My grandmother was once tall, with broad shoulders and strong arms. Now, she says I could knock her over with a feather. Her appetite has dwindled to nothing; she’s lucky to force down one meal and one vanilla Ensure shake each day. My grandfather calls.
“Can you get us some drugs?”
“I’m serious. Her doctor said marijuana could help with her appetite, but it’ll take us a month to get her a card. She needs to eat now.”
“I know you’re serious. Of course. Mike has a medical card and I have a caregiver card. I’m sure she doesn’t want to smoke it, but there are pills and tinctures.”
“Aw, that’s great Meagan. Thank you. I knew we could count on you.”
Two days later, my grandparents and mom come to our house for Thanksgiving. When I had found out my grandmother had no intentions of letting the tumor on her pancreas stop her from making dinner, I insisted she let me take over. Firm in my belief that no one really likes turkey, I make a six-pound brisket and sides, including the matzo soup my grandmother has been craving. We discovered Mike’s medical marijuana card had expired; he never used it. While it’s a game changer for many Parkinson’s patients, his symptoms are well-controlled with good old-fashioned big pharma drugs. But there are plenty of ways to get weed, and I find another avenue.
Though the trip to our house from theirs is less than an hour, all three are on edge when they arrive. My grandfather won’t stop telling my mom her pants are too long or pointing out when her bra strap slides down her arm. My grandmother’s exhaustion shows; she looks pale despite the makeup she’s applied, pink blush and a pearlescent mauve lip. Her voice is weak and scratchy. I pull out a stash of drugs: “Okay y’all, so our cards are expired and we’re getting them renewed, but in the meantime we have very low-dose pills or…this totally awesome pre-rolled joint you could smoke.”
I’ve done the calculus in my head before they arrive. I am 95% sure if I lit the joint and took a hit myself, I could get her in on it, too. My mom would likely join us. But though pot was never one of my drugs of choice, I can’t square my sobriety with it, even for a cause as good as this one. She chooses the capsule, but it’s mostly CBD and has no effect. She manages to eat more than I expected. I’m sure it’s an effort, but she wants to show her appreciation, so she eats the spinach salad, the matzo soup, half a slice of brisket, some cheesy potatoes and sweet potato pie.
The next day, we drive to their house to deliver a new tincture, one heavy on THC and specifically touting appetite enhancing qualities. She tries an increasing number of drops over the next few days, but notices the high before the hunger and stops. The Ensure will have to do.
Take a hit: I look for signs in essays or memoirs about illness. There are words and phrases people use: shell, wasting, lost memories, still in there, betrayed by the body, withered, trapped within. Sometimes it’s Alzheimer’s or AIDS or ALS, but often it’s Parkinson’s that has taken their loved one, even if they’re still alive. I’m drawn to them. Obsessed with them. These people have written about it, which means they have survived the loss. I’m reading them like textbooks, guidebooks, an instruction manual for the life I know and do not know is coming. No one dies from Parkinson’s. They die with it. Mike will not die from Parkinson’s. He will, someday, die with it.
Take a hit: When my grandmother sees the doctors two weeks after her last treatment, her appetite has started to return, though her strength and energy have not. They tell her they’re pleased with her bloodwork. Her antigen levels are decreasing and they’ll monitor them monthly. She calls to tell me right away.
“Are you busy?” she asks first, knowing I’m working. I tell her I’m not. It happens to be the truth, though I would have lied if it weren’t. I ask what they will do if her levels rise. With pancreatic cancer, it’s a when, not an if, but I can’t bring myself to say it. Studies estimate that patients progress from stage 1 — where she is — to stage 4 within a year, on average. The cancer in her body is aggressive and incurable, and the only one who seems to know that is me. I don’t want her to go through any more chemo and radiation, not when it takes so much from her. I want her to feel good in the time she has left.
“The doctor says if they start to go up again, maybe another round of chemo. It’s not gone or anything,” she tells me. I force myself to say something positive.
“Well, what a relief,” I say, hearing the hollowness in my voice and hoping she doesn’t notice.
That night, my mom texts me: Well we couldn’t have asked for a better Christmas gift!! She thinks we’re in the clear. I walk downstairs and into the living room, where Mike is sitting on our couch, explain that I think there’s something wrong with me of the psycho-socio-path variety. Why don’t I feel relieved by this news? Why can’t I let my mom hold onto this? I would ask the doctor what my prognosis looked like if I declined more chemo. I would want to know what my death would look like, when it might come. Maybe my grandmother doesn’t know to ask those questions. Maybe she doesn’t want to know. It wouldn’t change anything, after all.
“It might be better if you prepare your mom for the worst,” Mike says when I propose letting my mom keep her happy hope, as though it’s possible to prepare for your mother’s death.
Take a hit: Whiskey, my dog, sleeps soundly now, his muppety gray eyebrows overtaking his face as he tucks his nose into his paws. One month away from 14, he is nearly deaf. It means I can quietly rest my head next to his, my scent waking him up, his eyes happy before they’re even open. It means there are longer pauses between his breath. Pauses just long enough for me to think he’s gone.
When I arrive home from a run one cold Tuesday night — I run home from the office on Tuesdays, four hilly miles — Mike is standing outside, alone in the darkness. I see him from a dozen yards away and my heart stops, then quickens, then stops again. The only reason he would be outside, I think, is to tell me something before I go inside. To tell me that Whiskey has died. This is it. This is the moment I don’t know if I can live past. I close the gap within seconds.
“Where’s Whisk?” I ask, my voice level but breathy.
“Whiskey. What happened?”
“What are you asking me?”
“Is something wrong with Whiskey?”
“No? I just took him for a walk,” he responds, confused.
“I thought…I thought he was dead. I thought that’s why you’re out here.” He pulls me in for a hug. He is outside waiting for his son to help him take out the trash. Oh.
Take a hit: I know my grandmother has terminal cancer, and I cannot bring myself to feel it. I imagine giving her eulogy, the casket, what she might wear. I think about the funeral homes in my hometown, the grave plot picked out and paid for in the cemetery where her parents are buried. Nothing. Why is it that I am unable to stop the flood of anticipatory grief for a still healthy dog, but cannot find it for my grandmother with terminal cancer? Am I living in the present or compartmentalizing? Are those the same thing?
Take a hit: He has a gun, my mother tells me. My grandfather has purchased a .38 and keeps it in his nightstand. She overheard him telling the plumber.
“What can we do?” she asks.
“Don’t let yourself into the house while they’re asleep,” I say. I don’t ask the question running through my head: Did he buy it to commit suicide when my grandmother dies? I tell a friend I hope he’d pick a less messy option. He had once asked if I could get my hands on other
kinds of drugs, the kind that would let him end his life with hers. My friend notes that men are more likely to use a gun.
Take a hit: We fight about suicide, sometimes. One night in our bed, Mike says he thinks medically assisted suicide is an option people should have. I agree. He starts sentences he does not finish. If the Parkinson’s gets too bad. If someone is a burden.
I get up and walk downstairs, fall to my knees on the living room floor and wail. When I look up, he’s blurry through my tears, standing above me.
“Don’t you know?” I ask him. He doesn’t. He couldn’t. “My mother, when the depression got too bad, when she felt like she was a burden, she said we’d be better off without her. Better if she took all of the pills. Better if she never woke up. That is what loomed over me growing up. You can’t say that.”
He rubs my back.
The next time it comes up, assisted suicide, we are sitting on our porch. Maybe the daylight makes me more rational. Maybe it feels more thought experiment than plan, this conversation. He asks with equal measure sincerity and snark: “Isn’t it my body, my choice?” He’s not wrong.
“You have to talk to me, first,” I tell him. It’s decades away, I tell myself. I’m not having this conversation, not for real, not right now.
Take a hit: By Christmas, a few weeks after her last chemo treatment, my grandmother is feeling better. She looks better, too. In January, they send her for a PET scan and bloodwork to check the size of the tumor and the antigen levels in her body. The tumor remains unchanged. The antigen levels are the highest they’ve ever been. A few days later, they go in for an oncologist appointment. When they call me after, both of them on the line, they tell me she’s going to have a port placed and begin another round of chemo, this time stronger. I try to gently ask: Did the doctor talk to you about all of your options? Did they say what kind of side effects you can expect? Did he tell you how long you’ll be getting chemo? She doesn’t know, had not thought to ask. I try to gently say: I’m worried about you getting so sick again that you can’t eat. I’m worried that it’s not helping and you won’t have any quality of life. I’m worried.
We hang up. My grandfather calls back. He is angry, yelling at me that I should not be putting these ideas in her head, that it’s between them and the doctor, and I am way out of line. Finally, he yells: “Do you think she’s going to die?”
I reply, not yelling, but not calm, either: “Yes. She has terminal cancer.”
I tell him I have to go. I would support any decision I thought she was making freely, but none of this feels like it has been her choice to make. And there is nothing I can do about it.
Take a hit: Why do I think I should get a say in Mike’s end of life care, but want my grandmother’s choice to be hers alone?
You’d think I’d be high on all of this grief, but it hasn’t hit me.
On a Friday afternoon Peloton ride with Ally Love, I start to weep. I’m 30 minutes into a 45-minute Broadway ride, and “Seasons of Love” comes on. I ugly cry and pedal, ugly cry and pedal. She finishes with “Quiet Uptown” and I am beside myself, sobbing and heaving and pedaling and pedaling and pedaling, going nowhere at all.
About the Author
Meg Ringler is a writer living in Pittsburgh, PA with her husband, the world’s best dog, and the world’s worst cats. She is working on a collection of essays interrogating what it means to take care. Her work has previously appeared in Catapult, the Chicago Review of Books and no tokens. Find her on Twitter and Instagram at @Meg_Ringler.