By JoNel Aleccia MARCH 7,
2018
On the
last morning of their lives, Charlie and Francie Emerick held hands.
The
Portland, Ore., couple, married for 66 years and both terminally ill, died
together in their bed on April 20, 2017, after taking lethal doses of
medication obtained under the state’s Death With Dignity law.
Francie,
88, went first, within 15 minutes, a testament to the state of her badly
weakened heart. Charlie, 87, a respected ear, nose and throat physician, died
an hour later, ending a long struggle that included prostate cancer and
Parkinson’s disease diagnosed in 2012.
“They
had no regrets, no unfinished business,” said Sher Safran, 62, one of the
pair’s three grown daughters. “It felt like their time, and it meant so much to
know they were together.”
In the
two decades since Oregon became the first state to legalize medical
aid-in-dying, more than 1,300 people have
died there after obtaining lethal prescriptions. The Emericks were among
143 people to do so in 2017, and they appear to be the only couple to ever
take the drugs together, at the same time, officials said.
The
pair, early members of the 1980s-era Hemlock Society, had supported the choice for
years, and, when their illnesses worsened, they were grateful to have the
option for themselves, family members said.
“This
had always been their intention,” said daughter Jerilyn Marler, 66, who was the
couple’s primary caretaker in recent years. “If there was a way they could
manage their own deaths, they would do it.”
Before
they died, the Emericks agreed to allow Safran and her husband, Rob Safran, 62,
founders of the Share Wisdom TV Network, of Kirkland, Wash.,
to record their final days and hours. At first, the video was intended just for
family, but then Safran asked her parents for permission to share it publicly.
“I
think it can help change the way people think about dying,” she said.
The
result is “Living & Dying: A Love Story,” a
45-minute documentary that details the background of the Emericks’ final
decision and their resolve in carrying it out.
Shot
mostly with handheld smartphones, the video captures the intimate moments of
the couple’s preparations in their last week of life.
Charlie
Emerick was a former medical missionary in India and chief of ENT at a
Portland-area Kaiser Permanente hospital. (Kaiser Health News is not affiliated
with Kaiser Permanente.) He was diagnosed with Parkinson’s disease in 2012,
after dealing with symptoms of the disease for years. He suffered from prostate
cancer and heart problems and learned in early 2017 that he had six months or
less to live. In the documentary, he described his thoughts as he pondered
whether to use aid-in-dying.
“You keep going, Charlie, you’re going to get
worse and worse and worse,” he explained to Sher Safran, in a quavering voice.
“The other can’t be worse than this.”
Francie
Emerick, who handled marketing and public relations for the hospital in India,
appears vital and articulate in the video. Her daughters, however, say that her
energy was fleeting and that it masked years of decline following multiple
heart attacks and cancer.
In the
video, Francie acknowledged that she could have survived a bit longer than her
husband. But, she said, she didn’t want to.
“Charlie
and I have a rather unique relationship in that we have done and been so much
to each other for 70 years,” she said.
The
pair carefully followed the specifics of the law, which requires examinations
by two different doctors to determine a prognosis of six months or less to
live, multiple confirmations of intent and the ability of patients to ingest
the lethal drugs themselves. The process takes a minimum of 15 days.
“We do
want it to be legal,” Francie said.
The
video traces the arc of the couple’s lives. The Emericks met as college
students in Nebraska, married on April 4, 1951, and spent years in the 1960s as
medical missionaries in Miraj, India. Dr. Emerick’s career took them to
Southern California and then to Washington state, to India and ultimately to
Oregon, all while raising three girls. In 2004, they moved into an apartment in
a retirement community in Portland.
That’s
where the Emericks died on a cloudy Thursday last spring, six days after a
family celebration that included their children and grandchildren — and, at
Francie’s request, root beer floats. The gathering was happy, but bittersweet,
family members said.
“There
were moments that they expressed great sadness at the goodbye that was coming,”
Marler recalled.
The
Emericks sought help from Linda Jensen, a veteran team leader with End of Life
Choices Oregon, a nonprofit agency that supports people seeking to use the
state’s Death With Dignity law.
“They
were pretty well informed,” said Jensen, who has assisted with dozens of deaths
in 13 years. “What they wanted to understand was what a planned death really
looks like.”
The
video includes a meeting between Jensen and the Emericks two days before they
died. It would be nothing like dying on TV, she told them.
“You do
not lose control of your bowel or bladder. You do not gasp for breath,” she
explained. Instead, she said, they would simply go to sleep.
The
Emericks went over the plan: no breakfast, just pills to calm their stomachs at
9 a.m., followed by the lethal drugs an hour later.
Safran
and Marler appear calm and determined as they help finalize their parents’
arrangements.
“There
was a lot of grieving ahead of time because we knew it was coming,” Marler
said.
Some
members of the family disagreed with the couple’s decision, but the Emericks
were determined.
“You
two have never wavered?” Safran asked her mom.
“We
have not,” Francie replied.
The
video captured details of the final morning: Charlie saluting the camera
farewell as he’s wheeled down the hall, Safran’s tearful last hug from her
mother, Charlie and Francie clasping hands after they swallow the drugs.
“It
just takes such a huge amount of internal strength and self-knowing to face
that choice, to make that choice and then bring along all the people that love
you and are going to miss you,” Jensen said.
There
was no funeral after the deaths. The Emericks had donated their bodies for research
through a program at the Oregon Health & Science
University and any remains wouldn’t typically be returned for
two or three years, a spokeswoman said.
In the
interim, the video has become comforting and precious to the family, said
Safran.
“It’s
very lovely, just to hear their voices,” she said.
The
documentary also serves a larger purpose: helping others to understand how
aid-in-dying works, she said.
Carol
Knowles, 70, was a member of Francie Emerick’s book club. The Emericks didn’t
tell other residents about their plans. Knowles said she was surprised when
they died the same day — until she saw the documentary.
“I
thought it was brave and beautiful,” she said. “You could see the care with
which Charlie and Francie had made that decision.”
Another
member of the group expressed concern, however, saying her religion prohibited
any efforts to hasten death. Knowles said she plans to take the documentary to
the retirement center’s social worker before showing it more widely.
“We
want to do it in a way that will not scare them or make them feel
uncomfortable,” she said.
Stephen
Drake, research analyst for the disability rights group Not
Dead Yet,had serious reservations about making the video public. He
worried that presenting aid-in-dying in a positive light “changes the
expectations; this romanticizes the idea of not just suicide, but a double
suicide,” Drake said.
Safran
said she expects strong reactions — including criticism — for chronicling her
parents’ final days. But she said the documentary honors the Emericks’ belief
that, if possible, everyone should have a say in when and how they die.
“We
have a faith that says life is not to be worshipped,” Francie said. “It’s the
quality of life that counts.”
KHN’s coverage of these topics is supported by John A. Hartford Foundation andThe SCAN Foundation
JoNel Aleccia: jaleccia@kff.org, @JoNel_Aleccia
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