An excerpt from The Noonday Demon: An Atlas of Depression
On the day it took place, I was 27. I understood and believed in the reasons for my mother’s suicide. She was in the late stages of terminal cancer. In fact, with my father and brother, I helped my mother to kill herself and, in doing so, experienced a great intimacy with her. We all believed in what she did. It was not easy to arrive at this decision. It was slow, tangled and peculiar. Its convolutions were as madly individual as those experiences of love that can lead to marriage.
My mother’s suicide was the cataclysm of my life, though I admired her for it and believed in it. It so distressed me afterwards that I mostly drew up shy of thinking and talking about its details. The simple fact of it is now a fact of my life, and I will gamely share that with anyone who asks. The reality of what happened, however, is like something sharp that is embedded in me, that cuts whenever I move.
In our family, discussions about euthanasia began long before my mother developed cancer. We all signed living wills in the early Eighties, and talked at that time – entirely in the abstract – about how uncivilised it was that the euthanasia options famously available in the Netherlands were not available to the rest of the world.
‘I hate pain,’ my mother once said casually. ‘If I reach the point at which I’m in nothing but pain, I hope one of you will shoot me.’ We all, laughingly, agreed. We all hated pain, all thought that a quiet death was the best kind – in your sleep, at home, when you were very old. Young and optimistic, I assumed that we would all die that way at some point in the very remote future.
In August 1989, my mother’s ovarian cancer was diagnosed. During her first week in the hospital, she announced that she was going to kill herself. We all tried to shrug off this declaration, and she didn’t particularly insist on it. She was not, at that time, speaking of a considered agenda of terminating her own symptoms, but was, rather, expressing a sense of outrage at the indignity of what lay ahead, and a profound fear of being out of control of her own life. She spoke of suicide, then, as people disappointed in love may speak of it, as a swift and easy alternative to the painful, slow process of recovery. It was as though she wanted vengeance for the snub she had received from nature: if her life could not be as exquisite as it had been, she would have no more of it.
The subject lay low as my mother went through an excruciating bout of chemotherapy. When, ten months later, she went in for exploratory surgery to assess its efficacy, we discovered the regime had not been as effective as we’d hoped, and a second round was prescribed.
After her surgery, she lingered for a long time in a resistance to consciousness forged out of rage. When she finally began to speak again, a flood of anger came out of her, and this time when she said she was going to kill herself, it was a threat. Our protests were thrown back in our faces.
‘I’m already dead,’ she said as she lay in her hospital bed. ‘What’s here for you to love?’ Or else she instructed: ‘If you loved me, you’d help me out of this misery.’ Her meagre faith in chemotherapy vanished, and she insisted, as a condition of her accepting another round of punishing treatments, that someone would have to get her ‘those pills’ – Seconal, a tradename for the drug secobarbital – so that she could stop whenever she was ready.
One tends to accommodate the very, very sick. There was no answer to my mother’s rage and despair but to say yes to whatever she demanded. I was living in London at that time: I travelled to New York every other week to see her. My brother, David, was in law school in New Haven, Connecticut, and spent long days on the train. My father neglected his office to be at home.
We were all clinging to my mother – who had always been the centre of our close family – and we wavered between a light but meaningful tone and a terrifying solemnity.
Still, when she had relaxed into a facsimile of her usual self, the idea of her suicide, though it had gained resonance, receded. My mother’s second round of chemotherapy seemed to be working, and my father had researched half a dozen more treatment options.
At four o’clock on a blustery September afternoon in 1990, I called to check on some test results that were due that day. When my father answered, I knew at once what had happened. We would continue, he told me, with this therapy for the moment while we explored other options. I had no doubt what other options my mother would be exploring, so I should not have been surprised when she told me, in October, over lunch, that the technical details had been taken care of and that she now had the pills.
In the early stages of her illness, my mother had suffered the loss of her looks as a side-effect of her treatments, a ravagement so obvious that only my father could contrive to be blind to it. She had previously been beautiful, and she found the physical losses of chemotherapy intensely painful – her hair was gone, her skin too allergic for any makeup, her body emaciated and her eyes were ringed with exhaustion and constantly drooping.
By the time of that October lunch, however, she had begun to take on a new kind of pale, ethereal beauty, completely different in its effect from her Fifties all-American appearance I remembered from my childhood.
The moment that my mother actually sought the pills was also the moment at which she accepted that she was dying, and this acceptance afforded her a radiance, both physical and profound, that seemed to me more powerful than her decay. When I remember that lunch, I remember, among other things, how beautiful my mother had become again.
I protested, as we ate, that she might still have lots of time, and she said that she had always believed in planning things carefully, and that now that she had the pills, she could relax and enjoy whatever was left without worrying about the end. Euthanasia is a deadline matter, and I asked my mother what her cut-off would be. ‘As long as there is even a remote chance of my getting well,’ she said, ‘I’ll go on with the treatments. When they say that they are keeping me alive but without any chance of recovery, then I’ll stop. Don’t worry. I won’t take them before then. Meanwhile, I plan to enjoy whatever time there is left.’ Everything that had been intolerable to my mother was made tolerable, when she got those pills, by the sure knowledge that when life became unbearable, it would stop. The eight months that followed, though they led towards her death, were the happiest months of her illness. Despite, or perhaps because of, the suffering in them, they were the happiest months of our lives.
Once we had all settled the future, we could live fully in the present, something that none of us had really done before. I should emphasise that the vomiting, malaise and hair loss were all relentless, that my mother’s mouth was one great sore that never seemed to heal, that she would have to save up strength for days in order to have an afternoon out, that she could eat almost nothing, was a mess of allergies and shook so badly that, on some days, she couldn’t use a knife and fork.
Yet the excruciating business of the continuing chemotherapy seemed suddenly unimportant because these symptoms were permanent only until she decided she could take no more, so the disease was no longer in control of her. My mother was an adoring woman and, in those months, she gave herself over to love as I have never seen anyone else do. She had worked out the details, and my father, given to careful planning, went over the whole thing as though a dress rehearsal would exhaust some of the pain of the event itself. We discussed every detail down to the funeral home. We planned it together, much as we had previously organised parties and Christmases. We discovered an etiquette to the whole process. My mother very quietly set about making her emotions completely clear to all of us, intending, in the course of a few months, to resolve every family difference.
She talked about how much she loved us all, and unearthed the shape and structure of that love; she resolved old ambivalences and articulated a new clarity of acceptance. She set aside individual days with each of her friends – and she had many friends – to say goodbye.
She laughed often in that period; her sense of humour, warm and encompassing, seemed to spread to include even the doctors who poisoned her monthly and the nurses who witnessed her decline. She gave little things away to people, and sorted out larger things that were not for giving away yet.
She had all our furniture reupholstered so that she would leave the house in reasonable order, and she selected a design for her gravestone.
The fact that her suicide plans would become a reality seemed to settle on us. Later, she was to say that she had considered doing the whole thing on her own, but that she had thought that the shock would be worse than the memories of having been with her for this experience. As for us – we wanted to be there. My mother’s life was about other people, and we all hated the idea of her dying alone.
If you have never tried it yourself, or helped someone else through it, you cannot begin to imagine how difficult it is to kill yourself. If death were a passive thing, which occurred to those who couldn’t be bothered to resist it, and if life were an active thing, which continued only by virtue of a daily commitment to it, then the world’s problem would be depopulation and not overpopulation. An awful lot of people lead lives of quiet desperation and don’t kill themselves, because they cannot muster the wherewithal to do it.
My mother decided to kill herself on June 19, 1991, aged 58, because if she had waited longer she would have been too weak to take her own life.
Suicide required strength and a kind of privacy that did not exist in hospitals. That afternoon, my mother went to see a gastroenterologist who told her that large tumours were blocking her intestine. Without immediate surgery, she would be unable to digest food. She said that she would be in touch to schedule the surgery, then rejoined my father in the waiting room.
When they got home, she called me and my brother. It was bad news, she said calmly. I knew what that meant, but I couldn’t quite bring myself to say it.
‘I think it’s time,’ she said. ‘You’d better come up here.’ It was all very much as we had planned it. I headed off, stopping to collect my brother from his office on the way.
It was pouring, and the traffic was slow. My mother’s calm voice had made the whole thing seem very straightforward When we arrived, we found her lucid and relaxed, wearing a nightgown with pink roses on it and a long bathrobe.
‘You’re supposed to try to have a light snack,’ my father said. ‘It helps to keep the pills down.’ So we went into the kitchen and my mother made muffins and tea. My brother put out a box of biscuits and my mother, with that tone of fond irony that was so much her own, said: ‘David, for the last time, would you put the biscuits on a plate?’ What was so curious about this experience what that there was nothing sudden or unanticipated about it. The drama lay in the very absence of drama, in the choking experience of no one acting out of character in any regard.
Back in her bedroom, my mother apologised again for involving us all. ‘But at least you three should be together afterwards,’ she added. My mother – who always believed in having an adequate supply of everything – actually had twice as much Seconal as she needed. She sat up in bed and dumped 40 pills on the blanket in front of her. ‘I’m so tired of taking pills,’ she said wryly.
‘That’s one thing I won’t miss.’ And she began taking them with a sort of expert’s finesse, as if the thousands of pills she had taken during two years of cancer had been practice for that moment.
‘I think that should do it,’ she said when the heap had vanished. She tried to down a glass of vodka, but she said it made her nauseous. ‘Surely this is better than seeing me screaming in a hospital bed?’ And, of course, it was better, except that that image was still only fantasy and this one had become reality. Reality in these instances is actually worse than anything.
Then we had about 45 minutes, for her to say all the last things she had to say, and for us to say the last things we had to say. Bit by bit, her voice slurred, but it was clear to me that what she was saying had also been thought through. And it was then that the drama of her death came because, as she became hazier, she also became even clearer, and it seemed to me that she was saying even more than she could have planned.
‘You were the most beloved children,’ she said, looking at us. ‘Until you were born, I had no idea that I could feel anything like what I felt then.
Suddenly, there you were. I had read books all my life about mothers who bravely said that they would die for their children, and that was just how I felt. I would have died for you. I hated the thought of you being unhappy. I wanted to wrap you in my love, to protect you from all the terrible things in the world. I wanted my love to make the world a happy and joyful and safe place for you.’ David and I were sitting on my parents’ bed, where my mother was lying in her accustomed place. She held my hand for a second, then David’s. ‘I want you to feel that my love is always there, that it will go on wrapping you up, even after I am gone. My greatest hope is that the love I’ve given you will stay with you for your whole life.’ Her voice was steady at that point, as though time were not against her. She turned to my father. ‘I would gladly have given decades of my life to be the one who went first,’ she said. ‘I can’t imagine what I would have done if you had died before me, Howard. You are my life. For 30 years you have been my life.’ She looked at my brother and me. ‘And then you were born, Andrew. And then you, David. So there were three people who all really loved me. And I loved you all. I was so overwhelmed, so overpowered by it.’ She looked at me – I was crying, though she was not – and she took on a tone of gentle reprimand. ‘Don’t think you’re paying me some kind of tribute if you let my death become the great event of your life,’ she said to me. ‘The best tribute you can pay to me as a mother is to go on and have a good and fulfilling life. Enjoy what you have.’
Then her voice became dreamily torpid. ‘I’m sad today. I’m sad to be going,’ she said, ‘But even with this death, I wouldn’t want to change my life for any other life in the world. I have loved completely, and I have been completely loved, and I’ve had such a good time.’ She closed her eyes for what we thought was the last time, and then opened them again and looked at each of us in turn, her gaze settling on my father. ‘I’ve looked for so many things in this life,’ she said, her voice slow as a record played at the wrong speed. ‘So many things. And all the time, paradise was in this room with the three of you.’ My brother had been rubbing her shoulders. ‘Thanks for the back rub, David,’ she said, and then she closed her eyes for good.
‘Carolyn!’ my father said, but she didn’t move again. I have seen one other death – someone shot by a gun – and I remember feeling that the death did not belong to the person who died: it belonged to the gun and the moment. This death was my mother’s own.
After my mother’s death, I was the one who cleaned up my parents’ flat, sorting through my mother’s clothes, her personal papers, and so on. Back in the corner of the medicine chest, behind the vitamins, the pain killers, the drugs to calm her stomach, the ones to rebalance certain hormones – behind all of them I found, like the last gift out of Pandora’s box, the rest of the Seconal.
I was busy throwing away bottle after bottle, but when I got to those pills, I stopped. Fearful of both illness and despair, I pocketed the bottle, and hid it in the farthest corner of my own medicine cabinet. I remembered the October day my mother had said to me, ‘I have the pills. When the time comes, I’ll be able to do it’.
Ten days after I finished clearing out my mother’s bathroom, my father called in a rage. ‘What happened to the rest of the Seconal?’ he asked, and I said that I had thrown away all the pills in the house that were in my mother’s name. I added that he seemed very depressed and that it disturbed me to think of his having ready access to the drug. ‘Those pills,’ he said, his voice breaking, ‘you had no right to throw away.’ After a long pause, he said, ‘I was saving them for myself, in case I was ill one day. So I wouldn’t have to go through that whole process of getting them.’ I think that, for each of us, it was as if my mother lived on in those red pills, as if whoever possessed the poison by which she had died retained some strange access to her life. It was as though, by planning to take the remaining pills, we were somehow reattached to my mother, as though we could join her by dying as she had died. I understood then what suicide epidemics were all about. Our one comfort in the face of our loss was to plan to repeat her method of dying ourselves. It was years later that we reversed that formulation, by making a better story for ourselves. My recovery from depression was a triumph of my father’s love and of intelligence and will: he had tried to save one member of the family and failed, but he was able to save another. We had participated in one suicide and averted another.