The Angel Of Death And The Elderly – Susan Varga

Writer Susan Varga’s, Heddy and Me, won international acclaim for its portrayal of Heddy, a character based on the author’s mother, whose flight from the Nazis in World War II led her to Australia with her two daughters. In her latest book, Headlong, Varga continues the exploration of her mother’s life and death through the lens of fiction. At The Sydney Institute on Tuesday 6 October 2009, using excerpts from her work, Susan Varga reflected on the poignant and vital themes of her book – suicide, old age and family.

THE ANGEL OF DEATH AND THE ELDERLY

SUSAN VARGA

The title of this talk, thanks to Gerard, is “The Angel of Death and the Elderly”. That got me thinking about angels. “The Angel of Death” has a somewhat sinister connotation – the angel who comes to take us all, the angel that will pay us one visit only and with only one result. And yet angels in other contexts are benign, light- filled, magical; they are marvellous other-worldly beings who come to help and guide us.

Why has this aura of light and air disappeared from the Angel of Death? We know from literature and history that death has often been seen as a relief; even a deliverance from “this vale of tears”. For many of the world’s religions it’s a welcome entry point to a better world. But in modern times we have pushed death into the farthest reach of our consciousness. It’s as if death were the Devil himself.

We have lost sight not only of death’s inevitability but of its naturalness, its benign function of release and ending. And as with birth, we have medicalised it almost beyond recognition to people from other times. The dominant aim of modern doctors is to hold death at bay as long as possible, and at any cost. And I mean cost at several levels – huge monetary cost, huge emotional and physical cost. The children of elderly parents are willing to pay these costs even when the actual benefit to their parents is dubious, even when the result is old people kept alive against their will.

But do we really want to make our own parents suffer more than they need to in the last years of their lives? It’s not what any of us would consciously wish for. Yet that’s what we do – and in four major ways:

• We throw the works at them in life-prolonging procedures, regardless of what kind of life will be the result, or the pain and suffering such procedures might inflict. (I think of Caroline Jones’ story of her ninety-plus year old father who unthinkingly agreed to a heart operation which caused him unbearable suffering in the “recovery” process and who died a few months later anyway.)
• Because of the pace and style of modern life we often have no alternative but to put our parents into less than excellent nursing homes to while away their last years bed-ridden, drug-addled and lonely.
• Because of our laws (and perhaps because of our own fear of death) we cannot seriously listen to them when they say they want their life to end, nor can we help them end it. While suicide in Australia has been legal since 1983, assisting suicide is not. Think about what a conundrum that is. In New South Wales you could face a maximum of ten years gaol for helping someone in a perfectly legal act. In other states and in the Northern Territory the penalty is more severe still. To me this speaks of how ambivalent and conflicted we are on the question of suicide.
• And lastly, we have made it extremely hard for old people to end their lives on their own. For some years now barbiturates, which allowed people to die in their own beds in peace, are no longer available. Large quantities of sleeping pills and anti-depressants more often than not do not work. An old person must be extraordinarily determined and extraordinarily courageous and savvy if they want to go at the time of their choosing. They have to be prepared to join Exit and perhaps go to a self- help workshop. Or they have to fly to Switzerland to get the help of Dignitas. Or take a trip to Mexico to buy Nembutal. Not only do they need enterprise and knowledge, they need money – these are mostly options for the wealthy or middle class. Sometimes if they still have the strength and physical agility – not to mention the guts – they will resort to more terrible but effective methods: throwing themselves out of a window, hanging themselves or stepping in front of a train.

My own mother, who fifteen years ago sat proudly in this same room listening to me address a similar audience on my first book Heddy and Me – which was about her – died almost seven years ago. She threw herself under a train. Grief stricken and depressed after the sudden loss of her husband, she lost all will to live. She actively began to seek death with the same determination as she had once sought life. After several unsuccessful attempts at more peaceful means, she connived to go in secret to the train station. Her last attempt got her what she most desperately desired – death.

After my mother’s death I felt I had an unclimbable mountain to climb. I was grief stricken, traumatised and bewildered. I wanted only to hide and lick my wounds and wondered if the joy of life would ever return to me. But I was also a writer. I knew that while my mother and I and my family and partner had gone through a very particular set of experiences, they were universal too – experiences of loss, grief, death, family conflict, difficult ethical choices.

Important, fascinating, painful stuff – the stuff of life – yet areas where most people don’t go. Who wants to read, or write, about old age or illness or suicide? Not sexy topics. And yet most people I knew were dealing with ageing and dying parents and so – suddenly and confrontingly – with their own mortality. Why was no one talking about it apart from the odd newspaper article?  Why were so few people writing about it?

But could I write about it? Something so raw and painful and personal. In the end I had no choice. There was nothing else I wanted to write about – the book I’d been working on suddenly seemed worse than irrelevant. And my job as a writer, I’d always thought, was to sift experience, share it, transform it, and offer any hard-won illuminations to others. For me, both writing and reading are roads to understanding. Without understanding – or at least trying to understand – there is not much point in life.

The result was the novel I’m here to talk to you about today – Headlong. I decided not to make it a memoir, although the core of the story is fairly close to life. I made it a novel because I desperately needed the sliver of objectivity that fiction could give me – and I also needed the creative freedom. Freed from the constraints of literal truth, I thought I had a greater chance to get at emotional truths. And given the delicacy and the taboo nature of the subject matter at many levels, fiction undeniably gave me more licence.

Writing a novel also allowed me to bring in themes I wanted to highlight that were not there in real life. For instance, I could invent a much younger brother living mostly overseas, who opposes the way his sister handles their mother’s wish to die; that gave me the chance to show the clash in values between family members that happens all the time out there in the community but did not necessarily happen – well not in that way – in our family. Rob the younger brother also gave me a young sympathetic male character that the story needed.

So like so many novelists, I’ve blended personal experience with observation, make-believe and symbol, narrative pace etc. If I have done my job well, the reader will never know which bits are “real” and which not. That’s why we writers might do many drafts – in my case 14 – to make it all look seamless. The craft is to suspend disbelief so that you will never know what exactly it is that makes you want to turn the page and read on.

But by now I want to give you a flavour of the book. This is from the very beginning of Headlong…..

There was an early sign of what was happening. You became afraid fo swimming. You, who had always loved the water. Swimming was your meditation, your yoga. You swam a strong smooth stroke.

Remember how you taught me to swim? Breaststroke of course – it was the only style I ever liked. It made me feel calm and secure. I have a memory of swimming towards you when I was small, reassured by the calm beauty of your working arms, the serene angle of your head. I’d swim into your arms.

“Little ducky,” you’d say.

“Big ducky,” I’d say.

You swam into old age. Still a strong smooth stroke. After Dad died, I took to the water. It seemed to help more than anything else. I encouraged you to swim, too.

“It’s too cold now,” you said. “Maybe when the summer comes.”

I found heated pool and spa near where you lived and took you to see it. You told the receptionist all about your husband’s death. She showed us the pool, which was first class. You cast a cursory glance at it.

“I’m afraid of the water now,” you said. “I don’t know why. What if something were to happen to me?”

You’d changed, and not just temporarily – irrevocably.

And this is when Gabor, Julia’s husband suffers a stroke:

The stroke felled Dad in the afternoon. The news didn’t reach me till seven o’clock that night. Gill and I drove to Sydney at speed. At the hospital I ran down the long linoleum corridors, trying to find the tiny emergency room they’d parked him in. The room was lit with a malevolent yellow light. It smelt of too many people and disinfectant.

“Speak to him, Kati,” Mum said as soon as she saw me. “Say something to him. Hold his hand, touch him.”

I took his hand which was warm and damp. “I’m here, Dad,” I said. “Itt vagyok. Szerttlek – I love you.”

“He can hear you,” Julia said. “Talk to him.”

“I’m here Dad. I came straightaway. I love you. I’m here, Dad.”

I couldn’t think of anything else to say. He looked at me with his one good eye – he still had the use of one arm and one eye. The eye looked angry, bewildered. He raised the arm and beat it back down on the bed in a gesture of frustration. The arm swung up again, then down, with surprising force.

“Édes jó kis apám – my good dear little father,” Mum said and stroked his head and calmed his arm. “Tell him to squeeze your hand to show you he knows you.”

“Squeeze my hand, Dad. It’s me. I love you.”

He squeezed my hand, once, twice.

“Good, Dad! Wonderful, Dad!’ Indeed, I was inordinately, hysterically pleased. “You’re doing well. Squeeze my hand again.”

“Édes jó kis apám – my dear good little father, my dear good little father,” Julia keened, as she would hundreds of times in the next thirty-six hours. She didn’t say much else to him. That one little phrase held everything: ‘Oh what has happened to us, how terribly I will miss you, how much I love you, you have been a good husband, yes you are dying, I cannot deny it, how I suffer for you, how terrible my life will be without you.’

“Édes jó kis apám, édes jó kis apám.”

And so it went on for many hours – the beating of his arm becoming less, his eye beginning to film – until he slipped quietly into unconsciousness. We held his hand and stroked him throughout. I don’t think I’d touched him so much in my whole life.

Another reason I decided to write Headlong is that being born at the end of 1943 I just precede the baby boomer generation, and I hoped that the book and its themes would speak to that generation. The baby boomers, now teetering on the outer reaches of middle age, have sought greater freedom and self-determination than any other generation before them. Now they are going through the ageing and death of their parents. They are also beginning to face the extraordinary fact that they too will die! From what we know of them they will not go passively into inadequate nursing homes and wait patiently for death. The whole tenor of their lives has been otherwise; they will want a better deal and they are already beginning to agitate for it. The membership of the euthanasia societies and of Exit International is not just made up of the very old or terminally ill. They are also ordinary middle-aged people who have witnessed the painful lingering death or a forced suicide of a loved one and are not prepared to countenance the loss of control and helplessness at the end of their own lives.

As these baby boomers begin to agitate for change – and a lot of them have good political skills and clout – it will make a very interesting time for politicians. So far –  with the one exception of the short-lived euthanasia legislation in the Northern Territory – there is no movement on this issue; each pro-euthanasia bill that has been put up since has failed. And yet consistently, in Australia and in other countries, around 75 to 80 per cent of the population favours euthanasia. That has been so for many years now. A few other countries – Holland, Belgium, Switzerland, some South American countries and Oregon and in Maine in the USA – have passed euthanasia  legislation with no perceptible increase in the number of elderly dying. Mostly people just want to know they can do something if need be; usually that knowledge calms them, makes them more positive about living – in the end they rarely take matters into their own hands. Yet in this country the politicians refuse to touch the issue.

Why is that? Fear of the religious right? Fear of controversy? In the too-hard basket? All of the above, combined with the modern world’s underlying horror of death and fear of even talking about it. It all makes for a powerful taboo. Look at the attempt, for example, to silence Dr Phillip Nitchke and Dr Fiona Stewart if they want to convey their thoughts by telephone or online, on a peaceful death to the thousands who look to them for help. There is a $10,000 fine for online communication and their book, The Peaceful Pill, is banned.

Death, and suicide in particular, are still lace curtain hush-hush territory. Like incest and child abuse once were, and even until recently, depression. Every now and again it hits the papers – we hear the desperate cry of an aged couple who have decided to go together or an agonised wife or husband who has had the courage to help a suffering spouse. The debate flares, people take sides, then it all dies down till the next time. But I predict that euthanasia, suicide, and assisted suicide will very soon become the next topics to come out of the closet. And not before time. We need to start talking, thinking and feeling. The welfare of the old and very ill are at stake -our old and ill – and this is an ageing population.

There is a lot of argument and polemic in this area. Remember the debate raging around the academic Lisette Nigot, who killed herself simply because she was about to turn 80 and thought the time was right? There is lots of argument but not much fiction. Fiction deals with people and emotions, and it deals especially in empathy.  Headlong does not take a stand on euthanasia or suicide – that would be anathema for a novel – it just takes you to the heart of a situation and asks you to empathise, to feel for both Kati the daughter and her mother Julia, and to ask,  “If it was me, if  I were in this situation, what would I do?”

My strong belief is that people only change their position on something if they have been touched in their hearts and souls as well as their minds. Literature is a powerful medium through which we examine ourselves and our choices. We grow to love or hate the characters in a book, we care what will happen to them, we are invited in to witness, intimately, situations that are new to us and yet as we read on, so close and familiar:

When Julia wakes up in hospital she is very angry that she’s still alive. She is furious.

“I can’t believe I’m still here! This is the worst nightmare! I wanted so much to go. Let me go. Help me. You must help me!”

She clutches my hand, picks compulsively at my sleeve. “Help me!”

“Ssh, édesem – dearest. Ssh. It will be all right.”

“No. Never. I want to die.” Her eyes lock on mine, she retains my hand in a feverish grasp. “Kati, IT’S ALL I WANT.”

“Mum, please, you don’t know what you’re saying.”

“Yes I do. Don’t pretend to be a fool. Promise me you’ll help me. Promise me solemnly.”

“I can’t. You know I can’t.”

“You must.”

Help my mother die? It’s out of the question. She’s just old, ill grieving. Time and love and care are all she needs.

“Mum,” I say, “remember the War years, and since? You’ve never admitted defeat before. Never. Why now?”

“This is different,” she says, and turns her head away from me.

Interestingly, I noticed as I was finishing Headlong and as it was being published  that I was part of the zeitgeist. Other writers too were beginning to touch on previously taboo, won’t-sell topics. There has been Garner’s The Spare Room, about a friend dying of cancer, Gabrielle Carey’s memoir about her mother’s illness, Caroline Jones on the death of her very old and beloved father. But I think Headlong takes us one step further in asking two deep and deeply important questions: when, if at any point, are you allowed to say that life is not worth living? It looks squarely at suicide, such a threatening topic for the living. And it also asks: if someone you love truly does not want to live any more and is not clearly insane, what is your true filial duty? Do you have a duty as a daughter or son or wife to keep them alive at all cost or is your duty to listen to that deep desire and help in its achievement? Again, there are no answers in Headlong, just the experience of one family and how they negotiate  the emotional, moral and legal minefield they find themselves in.

If Headlong reads like a raw diary, like unmediated experience, it is meant to. I wanted to capture how these terrible dilemmas can come upon us headlong when there is no time to think rationally and behave perfectly and have your moral position all worked out. I wanted to retain the pain and confusion that illness, grief and death bring. Polemics and politics play no real part when it comes to the crunch. You are flying by the seat of your pants. Which is why some of our more thoughtful citizens join Euthanasia Societies and lobby for change. Or the more feisty of them join in self-help Exit groups to make their own pills. They have thought ahead. They want to be prepared.

Headlong is set in the time of September 11 and the refugee crisis induced by the Tampa sailing into Australian waters. I wanted this as a sub-theme not just because of my own involvement in these issues, but because I wanted to explore the often uneasy interplay between our public lives – careers or politics or causes – and the personal, intimate tragedies that engulf us. Even though Julia has herself been a refugee fleeing Hitler, she is resentful of Kati’s involvement in the refugee issue. All of her daughter’s attention should be, she thinks, on her and her flight from Life. But Kati clings to her refugee work because it gives her some other perspective: “She clings to the wider world so as not to drown in her own small one.”  It’s another tension between mother and daughter.

Kati’s first reaction when her mother talks of wanting to die and then makes her first attempt is the natural and ordinary one. Suicide cannot be countenanced. But as it becomes clear that Julia will not change, that she will try gain and again, until she succeeds, Kati is forced to re-examine…

For a couple of weeks after returning home, she does not talk about dying. But as the pattern of illness resumes she begins again. Almost every day she says, “I want to go, Kati! This is no life. You have to help me. I can’t do it on my own; I’ve tried. Promise me you’ll help me.”

I know my mother; she loves a bit of drama, but she doesn’t bullshit in matters of life or death. When it comes to the purest questions she’s a straight thinker – it’s yes or no and she sticks to her decisions. She has never, ever, broached suicide before in her long life. She has never been a depressive. So I know she’s serious – utterly so. It follows that I have to take her seriously and consider seriously my duties to her.

What am I to do? I know that what I’m facing here is not unusual. Around the country, around the world, every day, the old and ill are asking those close to them to help them die. What does a daughter, a son, a husband, a dear friend, do? What am I to do?

I know, vaguely, that although she has every legal right to kill herself, I have no legal right to help her. But I’m barely thinking at all. I’m grasping, grasping for tree branches in the torrent. I’m pure reaction. If I could, I’d pray to a heedless God to save us from this nightmare. Let me wake up tomorrow, God-who-doesn’t-exist, to a day when Julia will want to live again.

So I play for time. I change the subject. I promise we’ll talk about it a week from now, a month from now. Things will change, I tell her. Things must change, I tell myself, because I don’t know what the hell to do.

Much later, when Julia has died, and Kati begins to think and read and go over and over what has happened, she tries to get the whole question of suicide into perspective. Why do we so fear and abhor it? Can it be a legitimate option at least for some and in some circumstances?

Suicide as a form of political insubordination – that has echoes for me, and for my times. To say ‘Life is not worth living, I do not value it as the rest of you do,’ is the most subversive statement anyone can make. Followed by a willed removal of self, it’s a devastating rejection of those left behind.

I think of Camus’ famous dictum:

There is but one truly serious philosophical problem and that is suicide.          Judging whether life is or is not worth living amounts to answering the        fundamental questions of philosophy.

I suspect the temptation of suicide is universal and powerful. It can tempt anyone at any time as the logical answer to life’s unbearable difficulty. It’s just that for most people, the temptation lasts for an instant or an hour. But for a few of us it is so powerful that it eclipses the world.

This is from Virginia Woolf’s diaries, about her old friend and mother-figure, Violet Dickinson, who came to visit. At a mere fifty-seven, Violet was already thinking of death:

She [Violet] told me she had no wish to live.

“I’m very happy,” she said. “Oh yes, very happy. But why should I want to go         on living? What is there to live for?”

“Your friends?”

“My friends are all dead.”

“Ozzie?” [her brother].

“Oh, he’d do just as well without me. I would like to tidy things up and disappear.”

“But do you believe in immortality?”

“No. I don’t know that I do. Dust, ashes, I say.”

Most of us are not like Violet; we don’t want to confront our death till we have to. We indulge in a prolonged self-deceit of immortality. It’s a natural thing; if we were fully sentient of death’s swoops and lunges, its casual depredations, we’d be constantly glancing over our shoulders, peering around corners. A partial, intermittent consciousness insulates us from fear.

But once death finally insulates himself into our lives, we are forced to learn new skills – accommodating his lurking presence, facing the fear he brings, learning to live with his temptations.

I heard this somewhere: “It’s not as if there’s anything particularly rational about wanting to kill yourself, but nor is there anything particularly rational about wanting to live, either. You want to live because there are good social reasons to do so, and you want to die because there are good social reasons to do so.”

I think that’s true.

“Your mother was terribly depressed,” a friend of Julia’s said to me yesterday, implying that irrational depression was the only possible explanation for her death.

“True,” I said, “but she was also very consistent and logical about wanting to die.”

I was trying to explain that Julia reasoned herself into her death. She was in the grip of an unanswerable internal logic, a kind of suicidal vision. Suicides don’t give way to a blank despair that deprives them of all powers of thought. Death makes profound sense to them. Life’s meaninglessness has finally found its logical solution.

It’s the depressives, not the suicides, who may be the more truly unhappy, because they see no way out. They’re mired in inaction, whereas suicide has found something they can do.

And here is another mystery at the heart of Headlong. Some of you may have read Heddy and Me and will know that my mother was a kind of heroine. In the war years in Hungary she fought like a tiger to protect her small daughters, then battled to survive on her own after her husband’s death in a labour camp. Post-war she came to Australia with a new husband whose first wife and two little sons had perished in the Holocaust and together they forged a new and successful life here. Heddy was a positive, unsubtle life-force, a real doer. She was the last person anyone would have thought would commit suicide. Yet Kati comes to see that Julia, who is frankly modelled on Heddy, has in the end been defeated by the accumulated traumas of her life. She had never had time to grieve, never indulged in introspection, never came to terms with all her losses. Once her husband dies – and she is genuinely old, in her mid eighties – she no longer wants to keep fighting. Life no longer interests her.

Was she within her rights to say, “Enough, I want to go”?  Not all people who attempt suicide are necessarily mentally ill. Perhaps there is such a thing as a right to die.  And surely there is such a thing as genuine overwhelming grief or sadness – I query whether it should always be medicalised as Depression with a capital D:

I hate that slippery word, “depression”. It was just called “sadness” once. It can look suspiciously like “grief”, too. Depression, sadness, grief – they’re as close as sisters. And when does the common or garden depression slip into the clinical variety? How do you grasp that someone you thought you knew has slipped beyond the reach of love and reason? There’s no florid “madness” associated with either sort of “depression”. How are you meant to know?

Surely too, psychic pain can be as legitimate a reason to want to die as physical pain. In one Dutch study done a few years ago, fully 62 per cent of respondents cited psychic pain as a reason to want to die and to ask the State’s help in doing so. How can we ignore that? The world can be pretty grim. We can have good reasons for wanting to be a part of it and we can also have good reasons for not wanting to be a part of it.

Statistics can be mind numbing, but just let me tell you a few, and these are now a few years old. At least three people over 75 kill themselves each week in Australia because there are no civilised options available to them. The Euthanasia Society estimates that more than 3000 Australians over sixty five die each year in the same way – and that this is actually a gross underestimation, as it does not take into account the deaths discreetly lied about or where the morphine is quietly upped on request.

If there is one point that Headlong does make, even by implication, it’s that an old person like Julia, and my own mother, should not be forced into a violent and lonely death. Not all of us are thoughtful preparers for the future – not all of us are joiners of organisations. As a society we must understand how difficult we make it for the elderly to die peacefully and with dignity. We are engaging in an unthinking cruelty in giving them so few options. In stigmatising suicide, keeping it shameful and hush-hush, we betray a lack of compassion and understanding. In not pushing our politicians to create humane, well thought out euthanasia laws we show a lack of moral purpose. As things stand, with all the best will in the world, we are failing our old people. It’s time for change.

Finally, on a gentler note, and because I am a novelist and writer above all, I want to finish with a last short passage from Headlong about parents and their meaning in our lives:

I’m so sick of it, yet I keep writing. I suppose while I write I’m bargaining with the gods for a little more time – let me try to make them immortal so that others may know even when I’m dead. While I write I continue the old conversation with them – what, truly, are the best values: those you taught me or those I’ve forged for myself? The dead can no longer answer me, but I am conducting my conversation with the whole person, with the completed life, and I weigh and measure that against my own life-in-progress.

These measured conversations eluded me during the long painful years of our real relationship. Till the moment of death it was about ‘how to deal with Mum/Dad today?’ Now, it’s about ‘who was she, who was he, and who am I?’

Ah, but with death we speak in constant metaphors. The dead are not ours to talk to, to hold on to or to let go. They are gone forever. The ‘conversation’ is only with ourselves. The rest goes singing in the wind.