James shared his story in October of 2022.
People felt safe with Pam. She was someone they felt the urge to confide in. We’d go to parties together, and she’d leave having been entrusted with the private lives of everyone in the room. A neighborhood kid would ride by our house, see her gardening out front, and the next thing I knew, his bicycle was lying on the lawn and he’d been talking to her for half an hour. Her warm and inviting smile was much commented upon.
For three and a half of the four years that she was sick, many people didn’t know it, because she smiled through the whole thing. I remember the day after Pam underwent major surgery, she was walking the halls of the hospital with me and her rolling IV poles, smiling at everyone, letting them know that she was just fine. But she wasn’t just fine. There was no stopping the cancer that would eventually ravage her body.
Pam’s smile had me smitten from the moment I met her in West Hartford, Connecticut, when we were both 17 years old. We traveled back and forth between our universities in Vermont and Rhode Island — me hitchhiking, Pam taking multiple buses — until we got married at 21. After our two kids were born, Pam went back to school and got her master’s degree in social work. She had found her calling; after all, people already confided in her. Being her husband meant getting drafted to help two elderly women move to their new home or directing a Christmas play with the special-ed kids she worked with at a local middle school. Inevitably, helping Pam was its own reward.
In 2009, Pam started to feel pressure in her solar plexus. She told her doctor, but he didn’t do anything about it. Finally, six months later, her doctor ordered an ultrasound.
I was in downtown Westport at the bank when she called me and said, “They’ve found a mass in my pancreas.” I’ll never forget the feeling. It was like a stab in my heart.
Pam needed to have the Whipple procedure, a very complex surgery that involves removing part of the pancreas, as well as parts of the small intestine, the stomach and the bile duct. The surgery went well, but recovery was brutal: Pam’s digestive system rebelled, requiring intravenous feeding for about a month.
After that, we began our odyssey of chemotherapy. Every two to three weeks, Pam sat in a recliner for several hours while poison dripped into her body. Of course, the reason people endure chemotherapy, despite how lousy it makes them feel, is the hope that it will kill cancer cells. But what happened with Pam was a vicious cycle in which, following chemo, the cancer cells in her body would develop necrotic tissue, a good sign. Then, after a few more weeks or months, the cancer cells would begin to revive.
This went on for two and a half years. At the end of all of this chemo, Pam’s doctor told us he didn’t have anything left to throw at Pam’s cancer. But, he said, there was a new clinical trial going on in San Antonio, Texas. Maybe Pam would be eligible.
Pam qualified for the trial, so for the next eight months, we flew to San Antonio every week.
During that period, I took on the responsibility of organizing our flights back and forth to Texas, making sure we had a way to get around, just keeping us moving forward. I was happy to have a real mission. We were doing whatever we could to get rid of this cancer. But then the cancer cells started to rebound, and the trial ended the way all the other treatments had.
In January 2013, things really took a turn for the worse. Pam had been so heroic for the past few years, and now there was truly nothing else we could do. The next three months were very, very rough. She was on a pain pump and on oxygen, and she developed a block in her bile duct that required an exterior drain. But one bright spot during this time was that our two grandchildren were around a lot, and Pam loved that. Our eldest grandchild would arrive and immediately he would say, “Hi Poppy, where’s Baba?” (“Baba” was Pam, of course.) I called her the baby whisperer.
One morning in March, Pam looked at me and said, “Jimmy, I don’t want to wake up anymore.” I was taken by surprise. Pam saw my reaction. “Well, we’ve always known this was a fatal disease,” she said. In that moment, I understood what she needed: a release from having to try to be heroic and put up with the pain anymore. It was the end; she was ready to go.
That night when I crawled into bed, she woke up again. Peering at me in the darkness, in a haze from the pain meds, she said, “Oh, I thought I wasn’t going to have to wake up anymore.” I can still remember the feeling of failure I had then. My wife of 46 years had told me what she wanted, and there was nothing I could do to help her.
That moment is what brought me where I am today. It has motivated me to testify, to call my prospective legislators, to go on the radio and write op-eds and do interviews. Because if Pam had had the option of medical aid in dying, she would have availed herself of it.
Pam died shortly thereafter, on April 9, 2013. It had been a privilege to care for her. My overwhelming regret is that after all she had been through, she had to continue suffering for absolutely no reason.
A couple years ago, a friend of mine who had worked with me on Broadway died of lung cancer in California. His wife emailed us afterward to say that on a Saturday, after spending the morning listening to his favorite music and looking at their photo albums together, he took his aid-in-dying medication and passed away surrounded by his wife and children. His last words to his wife were, “Please write to our friends and let them know that I am proud I live in a state that recognizes a person’s right to die with dignity.”
The flip side of this is a person I know who is from Connecticut but has established residency in a state with authorized aid in dying so she’ll be ready when her time comes. It strikes me as cruel that at this time in her life, she had to give up her home, her family, her friends, her support system and her doctors, just to have control of her dying process when the end is near.
If Pam had had the option of medical aid in dying here in Connecticut, it could have given her peace and taken away any fear about what was to come. That’s one of the great gifts of medical aid in dying. In states where it’s on the books, a lot of people who go through the process don’t end up needing to take the medication, but having it allows them to live their remaining days without additional agony.
I understand that some people’s beliefs would prevent them from making use of an aid-in-dying law. And that’s completely fine. But dying people should get to make the decision for themselves about what their last moments look like. Those of us who have been there know that we each deserve that autonomy.