This essay is an as-told-to account of a chat with Shava Nerad. It has been adjusted for both length and readability.
Once, I dissuaded a close friend from suicide.
I asked, “If you could accomplish anything in life, what would it be?” when we were both in our twenties. He stated that he would become a roadie and study lighting for bands. So I advised him to quit his job, get rid of everything, and give it a shot. Then I stated, “You may always commit suicide afterwards.”
He heeded my counsel. In the 1980s and 1990s, he worked as a lighting director for some of the most prominent musicians.
Now, thirty years after that talk, I want to end my own life. I am not pro-suicide, but I am opposed to the concept of a worthless life, which I foresee in my future. The receipt of millions of cash would not restore my health. If you are unable to accomplish what you love and are in constant agony, it may be time to leave.
Before I can end my life properly, I need approval from my health insurance company.
However, it’s not that straightforward. I will not hang myself because it sounds horrible. All I want is to depart on my own terms while I still have the ability to say goodbye. The best method for me to die is to cease eating and drinking voluntarily, or VSED.
I believe it is the most humane manner of suicide, both for the individual and their family. Your loved ones are welcome to be at your bedside, as it is not painful and you are barely conscious in the latter stages. Before I can proceed with VSED, though, I must tear up the red tape and update my advance instruction. My health insurance will not cover the geriatric psych evaluation I need to demonstrate that I have “sound mind.” If I do not receive the clearance, I cannot receive any sort of hospice care.
Nerad was 45 years old. She is a journalist in retirement.
Steve Garfield
My chronic health problem has been present since 2007. I sustained a head injury in a car accident but did not receive sufficient medical care. Headaches, disorientation, focal seizures, and aphasia were among my symptoms. I had numerous endocrine difficulties, including libido loss.
My problems were addressed by numerous experts throughout the years, ranging from orthopedists to memory specialists. But nobody could determine the root cause. In 2013, I met a physician who went “House” on me. Before sending me for imaging and other testing, he analyzed my medical history and physical condition.
I have had horrible pain for almost 15 years.
They discovered that half of my hypothalamus was missing. It is a region of the brain that secretes hormones that regulate processes such as sleep, hunger, and sexual desire. The neurologist speculated that a blood clot in my collarbone had gone to my brain and hardened there. He believed that my stroke was caused by the vehicle accident.
I was then diagnosed with Behcet’s condition three months later. It is an autoimmune disorder that causes inflammation and blood vessel constriction. My rheumatologist informed me that it was a progressive disease that may result in organ damage, and that it posed a risk of death. She stated that Behcet’s worsened a stroke.
I suffered from severe headaches and terrible joint pain. It seemed as though my entire body was covered with hives. I was compelled to resign my position as the director of a software project for a charity organization. I utilized a walker due to my mobility issues.
I believe that biometric pressure impacts my pain threshold. In 2019, I felt better than I had in years during a trip to South Africa. My problems appeared to improve in warm, dry conditions. The same year, I relocated from Boston to Fremont, California. The shift of site was first beneficial. But if a doctor asked me how I was feeling today, I would respond “bad, awful, terrible.”
Behcet’s tends to worsen any injury, whether old or fresh. Currently, the inflammation is located in my left hip. I’ll feel it in my shoulder, back, and even my feet. I am on medication for diabetes and thyroid conditions. I have experimented with vitamin D and herbal supplements. Nothing has done an exceptional job. CBD alleviates the discomfort or enables me to ignore it more effectively.
I contracted COVID in January of this year. I suffered increased discomfort and weariness. Due of permanent double vision, I can no longer drive. The eye strain has made reading and writing difficult. As a retired journalist, this distresses me most. I average 18 hours of sleep per day. I only leave my residence for doctor’s appointments.
I don’t want to endure a terrible, protracted death as my mother did.
I chose to terminate my life one month ago. Joseph, my 29-year-old son, supports me. He is aware that I have been ill for fifteen years and am in decline. I was aware that I did not qualify for any Death with Dignity laws. It was quite implausible that a physician would estimate that I had six months to live. Behcet’s disease is a slow-progressing condition. It could kill me next January, or when I’m in my nineties.
My mother experienced a protracted and agonizing death at the age of 94 from Lewy body dementia, the same condition Robin Williams suffered. She became queasy when she considered death.
VSED is the only legal alternative available to me. The Supreme Court declared that everyone has the right to refuse medical care, including hydration and sustenance. At the point where I cease eating and drinking, I am unable to obtain medication to aid in my demise, just medication to reduce my distress.
During her 2019 holiday in South Africa’s dry climate, Nerad said that her ailments improved.
Thanks to Shava Nerad
I have contacted a number of VSED advocacy groups. They instructed me to amend my advance directive once an experienced geriatric psychiatrist certifies that I am “of sound mind” without depression or dementia.
The certification is not required for me to proceed with VSED, but it is a significant measure. If I had the legal documents, my decision would be much less likely to be challenged, according to the advocates. They stated that the requests of some VSED patients had not been followed.
However, my HMO, Kaiser Permanente, has refused to pay for the psychological evaluation. I stated that I required the reference in order to pursue VSED and obtain hospice care. They have not been forthcoming with their denial.
If I must pay out of pocket, I will be out tens of thousands of dollars. I am a retiree with a fixed income.
I believe it is time for me to depart.
It requires considerable fortitude to discuss solutions such as VSED. We frequently encounter social taboos. As a result of how extremely effective modern medicine is, it is difficult for people to pass away. We are so intent on extending life that we neglect to discuss its quality.
I would prefer to pass away at home with hospice care than in an institution. People I have not seen in years have traveled to see me. They are pleased to have the chance to say farewell, which is appropriate. I suggest we light a few candles on my “unbirthday cake” because I have a wicked sense of humor.
I have lived a fulfilling and eventful life. I recall Joseph’s birth and the first few hours I spent holding him. When I was to marry his father, I fashioned my own bridal dress. I enjoyed dancing and mountain climbing in Vermont, where I grew up.
I want my passing to be as peaceful as possible for all parties concerned. I hope to be just as courageous, determined, and loving in death as I was in life.
Insider requested a comment from Kaiser Permanente regarding Nerad’s case. A representative stated that, in accordance with HIPAA regulations, they could not comment on individual situations.
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