Making Sense of Bioethics: A hundred love letters

In a recent essay in the Wall Street Journal, Kimberly Cutter chronicled the death of her father by suicide. As he struggled with rapidly progressing prostate cancer, he lost more than 30 pounds, becoming gaunt and emaciated. Back pain and nausea forced him to spend much of his time in bed.
 
A few days before Christmas, he shared with Kimberly that he was thinking about shooting himself. Kimberly argued with him, stressing that she and her sisters couldn’t accept a violent ending: “If he shot himself, my father would die alone. Someone in our family would have to find him,” she wrote.
 
His daughters convinced him to look into other options. When he started investigating lethal drugs, he ran into questions of reliability. He encountered horror stories about “wrong dosages and unreliable contents, painful, drawn-out demises.” A lifelong marksman, he deemed the gun his best option: “If I shoot myself, I know I won’t miss.”
 
Kimberly describes an important decision she made:
 
“I couldn’t accept my father’s threat to shoot himself. I thought about violence and the fear that always lies beneath it. How violence, in essence, is a twisted cry for help. At some point, it occurred to me that what I needed was a way to make my father feel loved.
 
If I could make him feel loved enough, maybe he would not forget my sisters and me in his lowest moments and do what his darkest impulses urged. Late that night, I had an idea. It was childishly simple. Corny, really. I would start sending him daily love notes. I sent the first email the next morning. The subject line read: ‘Reasons Why I Love You.’ … As soon as I sent it, I knew I was onto something.
 
For the next 99 days, I continued sending my father a different reason why I loved him each morning. They ranged from the ridiculous to the sublime – from memories of snorkeling with him through a school of angelfish in Jupiter, to his incomparable Daffy Duck imitation: ‘Suffering Succotash!’…I could tell the emails were working; I could hear it in my father’s voice when I spoke to him on the phone; could feel it in the grateful emails he sent back in response. The daily act of pulling up a reason I loved him and sending it to him seemed to restore him in some essential way… My father never again discussed with me his plans for how or when he would die.”
 
Kimberly’s 100 love letters emboldened her dad to live out his life more fully and resist his fears for much longer than he would have otherwise. Tragically, however, they did not stop his suicide. He ended up purchasing lethal barbiturates from a company in China and, late in his illness, consumed the fatal powder.
 
His death left painful contradictions, as suicide always does. He had acceded to his daughters’ requests to avoid shooting himself, using drugs rather than a bullet, but he still died alone, discovered by a stunned family member. And, while his suicide was perhaps not as violent, death by overdose can feel just as violent as death by gunfire. The underlying reality of pills, powders or poisons still involves a brutal devastation of our physiology. Our bodies often resist, with the vomiting of pills, convulsions, paralysis and the like. Although Kimberly and her sisters may have preferred that their dad succumb to toxins instead of a bullet, those sentiments, in the final analysis, are more poetic than rational.
 
Sometimes the poetic may feel like all we have when we’re confronted with the tragedy and incoherence of certain human choices. Another incoherent part of Kimberly’s story is the fact that, despite her father’s suicide, she seems to support the idea of physician-assisted suicide. While no one wants a loved one to experience pain and agony in the final days, only a false and misguided sense of compassion could conclude that instead of eliminating the suffering, we should eliminate the sufferer.
 
Kimberly may well have been aware of these inconsistencies as she embarked on the project of crafting a hundred love letters to her father, striving to help him understand that he was treasured and still a source of blessing to others in spite of his painful trials. Each of our loving human gestures speaks volumes about the singular power of love to overcome fear, and to strengthen us in adversity.
 
While the hundred letters did not ultimately dissuade him from giving into the temptation to take his life, they nevertheless give us a step we can take when confronted with loved ones who think their life no longer has meaning or that death is better than life. And, there is no need to wait until loved ones are in agony to pick up the pen to say, in one or more ways, how much and why they’re loved.
 
Rev. Tadeusz Pacholczyk, Ph.D., earned his doctorate degree in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River, Mass., and serves as the director of education at The National Catholic Bioethics Center in Philadelphia.