Between the Dying and the Dead
First published in 2006 by Vision, a division of Satin Publications Ltd 101 Southwark Street London se1 0jf UK info@visionpaperbacks.co.uk www.visionpaperbacks.co.uk Publisher: Sheena Dewan
© Neal Nicol and Harry Wylie
The right of Neal Nicol and Harry Wylie to be identified as the authors of the work has been asserted by them in accordance with the Copyright, Designs and Patents Act of 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission of the publisher.
A catalogue record for this book is available from the British Library.
HB ISBN: 1-904132-72-3 EXPORT PB ISBN: 1-904132-82-0
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Cover photo: Amy Powers/Agape Images Cover and text design by ok?design Printed and bound in the UK by Mackays of Chatham Ltd, Chatham, Kent
Few men are willing to brave the disapproval of their fellows, the censure of their colleagues, the wrath of society. Moral courage is a rarer commodity than bravery in battle or great intelligence. Yet it is the one essential, vital quality for those that seek to change a world that yields most painfully to change.
Robert Kennedy
This book couldn’t be without Dr Jack Kevorkian – his work, his dedication and of course his blessing. Others have contributed immensely, we trust we have omitted no one and we list alphabetically: Doug Conciatu, Mary Cuddihy, Jim Dean, Geoffrey Fieger,Vanig Godoshian, Ray Good, Ruth Holmes, Sharyn Kolberg, Norbert Lakemaker, Jack Lessenberry, Dr Stan Levy, Gary Lind-Sinanian, Dr Jack Lynch, Mayer Morganroth, FuensantaPlaza, Brian Russell, Bob Ryeson, Diane Ryeson, Gene Ryeson, Michael Schwartz and Melody Youk.
We were visiting Prisoner # 284797 at Michigan’s Thumb Correctional Facility. We had been travelling to see Jack at six prisons over the previous five years, usually on a monthly basis where we stayed for about five hours; we wanted him to be free of his cell for as long as possible. Other prisoners with family and friends would look disparagingly at our coffee table because we were either in heated argument or uproarious laughter. We were sometimes rebuked by the guards, but generally they left us alone, perhaps appreciating a change to the typical dour composure of inmates and guests.
The level of banter this particular day was no different from others. It is difficult to describe the joy of jousting verbally with a person like Dr Jack Kevorkian. The conversation may have started about a comment on the Iraq confl agration which reminded someone about All Quiet on The Western Front with Lew Ayres, which brought to mind Mae West that bounced off to World War II life preservers, and perhaps breast implants and then general chemical breakthroughs and Germany’s dominance in chemistry, perhaps Austria, which reminded someone of Freud and his contribution to modern psychiatry, perhaps Jung – it was always thus; wonderful!
Jack has had much published, from serious papers in medical journals to not so serious medical books like Slimericks, a diet book by Limerick format.We asked Jack why he never wrote his biography, especially now that he had some time on his hands, and he said that Neal had all the information and requested he carry out the task. Neal deferred the research and composition to me, and a partnership was established.
We hope this biography illustrates that the abrasive persona he put forth to the public is not the real Jack Kevorkian. Jack is brilliant, eccentric and self-deprecating. He is tremendously witty and great fun to be with. He is an artist, a musician, a composer, a linguist and a philosopher. And he has personally helped many individuals end their suffering and changed the way society thinks about dying.
Few people know that he was sentenced, for all intents and purposes, to life in prison. Many believe him dead. The institution called Legislative America has so isolated him from the public that, by disallowing media contact and legal appeals, they have succeeded in their goal of shutting him in and shutting him up – out of sight, out of mind. Jack is a remarkable human being, whose life and work deserve to be celebrated.We hope Between the Dying and the Dead will educate the world to the plight of this humanitarian.
Harry Wylie
The Crucible
To many of those who have known him personally, he is a saint and a saviour.To many of those who only know of him, he is the worst kind of sinner. Millions of people around the world know the name Dr Jack Kevorkian, but few know anything about the man.When his fight to legalise euthanasia was making headlines in the 1990s, the public saw only the macabre ‘Dr Death’ – the often abrasive, always outspoken proponent of the right of the terminally ill to end their suffering on their own terms. But behind that persona lies a complicated man with a compelling story. He was a former child prodigy, the son of Armenian refugees who came to America to escape the Turkish genocide. Starting with nothing, his parents soon found themselves raising a precocious student, a boy his less-gifted teachers dreaded but whom the neighbourhood kids idolised. His early talents ranged from woodwork to linguistics to science experiments in the basement. Later, he became a brilliant pathologist, devoting his life to the unusual pursuit of extracting social benefi t from death.
Dr Kevorkian’s passion brought him into constant confl ict with the society that he saw himself as trying to help.At every step along the way, he went at loggerheads with people who were not ready for his ideas. He did not just take on the medical establishment and the law; throughout his life he dared to challenge a taboo as old as human civilisation – the taboo against death. He dared to suggest that we treat dying, suffering and suicide rationally.
Jack Kevorkian is a complex individual, full of fascinating contradictions. He is outspoken, brash, egotistical and intensely committed to the causes in which he believes. He is also a shy, eccentric man who lived a monastic, ethical life, buying his clothes at the Salvation Army and subsisting on the plainest of food, particularly white bread. He lacks the capacity to lie so much that when he played poker with his friends he never bluffed, and if he bet, everyone folded.
Regardless of how one feels about his politics, Dr Kevorkian changed the way most of us think about dying. Because of him, we now have living wills and the right to refuse resuscitation. A November 2005 poll by the PewResearchCenter showed that 29 per cent of the people surveyed have living wills – more than twice the number who had them in 1990. Attitudes towards pain management for terminally ill patients have changed dramatically. Rather than being withheld necessary medication in case they become addicted, many patients are now given the ability, through implanted pumps, to self-control the dose of pain medication they receive. And the number of doctors who admit to quietly complying with a patient’s request for a lethal dose of medication is steadily rising.
None of these changes came without a fight.
By 1999, Dr Jack Kevorkian had become the well-known poster boy for assisted suicide, the infamous Dr Death of headline news. He had made headlines by evading prosecution countless times. Physician-assisted suicide had even been made legal in Oregon, and 86 per cent of the country supported its being made legal nationwide. Through the controversy he generated, he made dying with dignity part of the popular consciousness. But the movement was stagnating, in part because prosecutors had become reluctant to try Kevorkian under new laws against assisted suicide for fear that he might win in the Supreme Court and have the laws struck down.They hoped to wait him out, let his popularity die down as he got older and America quickly forgot him. So Kevorkian decided to force the law’s hand with a case that no one would be able to ignore – a case of a terminally ill patient who had lost so many of his faculties that he would be unable to work Kevorkian’s suicide machine, requiring the doctor to administer the lethal injection himself. He would videotape the suicide – or medicide, as he called it – and send the tape to the media, appear on national television and dare the state to come after him.
Tom Youk was a shy lumberjack of a man with thick curly brown hair who worked hard throughout his life, from delivering papers as a young boy, then labouring as a chef’s assistant and as a hospital orderly as a young adult.When the Air Force drafted him in 1966 he was considering becoming an auto mechanic.
A decorated sergeant in Germany, when he returned to America in 1969 Tom decided to go to college on the GI Bill and graduated with an accounting degree in 1974. He met his wife, Melody, in the mid 70s at a high school reunion. Later in life, when accounting started to tire him, he struck out on his own.A 25-year member of the Porsche Club of America, he had always loved mechanical work, so he turned his hobby of restoring vintage cars into a business,Vintage 356 Haus. He and his company flourished, and soon he was living out a fantasy, nursing dottering old 356 and 911 Porsches that everyone had given up on into growling, roaring racing machines. He even retooled a 1965 Porsche and began racing it at the age of 50, whipping younger drivers on local tracks. He toured the amateur circuit and fi nally, in 1996, he became the OhioValley champion. It seemed like nothing was impossible.
Then in June that year, Tom was diagnosed with amyotrophic lateral sclerosis (ALS), Lou Gehrig’s disease. ALS is a progressive neuromuscular disorder caused by the death of the motor nerve cells that control voluntary muscle movement.Tom soon discovered that he was facing an unwinnable race. There was no cure for ALS. He had, if he was lucky, three to five years to live. The path to his inevitable death wouldn’t be an easy one. His muscles would slowly stop responding. At first he might find it hard to walk. Then his hands would stop working. His tongue and jaw would become uncontrollable. He would drool. He would choke on his own spit. His faeces would have to be scooped from his bowels. He wouldn’t be able to move or to talk, and soon it would become hard to breathe. And through it all, his mind would be alive. He would know what was happening. He would be a prisoner in his own body without hope of parole.
He tried to fight it. He visited every doctor who offered a glimmer of hope, but the best they had was increasingly ineffective pain medication; medication which they limited, as the medical establishment dictated, fearing turning him into a drug addict.They told him to be brave. So Tom tried to fight ALS with the same analytic, determined approach he had used throughout his life, researching new information, seeking alternative treatments as well as participating in experimental drug therapies through the University of Michigan Hospital.
Tom Youk didn’t give up easily. He soon found that he couldn’t work the clutch on his racecar, so he modified it so that his hands could do the work his feet once did.Then his arms stopped working. Within a few months only the thumb and first two fingers on his right hand moved, and speaking took his full concentration. In spite of the doctors’ best efforts, he had trouble swallowing. His own body slowly began to strangle him. He had a food tube put directly into his stomach in late August, 1998, but his body wouldn’t metabolise the food. Nothing could help him breathe and his lung capacity dropped to 25 per cent of normal. He didn’t want to live totally paralysed, unable to speak, relying on machines and others for everything. He didn’t want to fight through days of pain, waiting for his body to finally decide to kill him.
One day he told his brother Terry that the agony was like having his body plugged into an electric socket. It was the kind of pain that medicine couldn’t help. ‘I don’t want to die,’Tom said, ‘but I don’t want to live like this either.’ He asked his doctors if they would help him commit suicide. He explained that he didn’t want to wait in pain, in constant panic when his body choked him, or when his lungs forgot to breathe. He wanted to pick the time and place of his death, to say goodbye with his family around him, to die with dignity. The doctors wouldn’t help him; their interpretation of the Hippocratic oath forbade them. Doctors train to fight death to the end and a doctor that actually caused death they deemed a traitor to their profession.Tom’s request dismayed the doctors who were unwilling to accept that they couldn’t do anything for him. Others pointed out religious concerns; the Church said he would end up in hell if he committed suicide. While several doctors sympathised, they considered their hands tied. If they helped him, they could lose their medical licences.The best they could do was give him more pain medication (mostly to relieve his anxiety rather than to reduce the pain) and tell him to be strong.
The Youk family contacted the Hemlock Society who recommended the hoarding of medication to die by overdose or placing a plastic bag over the head for suffocation, or both. The pain and suffering Tom would have to endure whilst hoarding medication was unthinkable, and death by baggy the family deemed barbaric.
Tom knew of one doctor who would help, and he asked his family to contact Dr Jack Kevorkian.They resisted, but he convinced them that death – on his terms – really was what he wanted. He was the one suffering, and it would be an act of cruelty to force him to keep living.
They found Dr Kevorkian’s address on the internet. Though Tom could barely speak, he dictated his letter to Melody and Terry. They sent the letter by overnight mail, and the next day Jack called them. He needed to see Tom’s medical records. He wanted to make sure that Tom had done everything the traditional medical establishment suggested for treating his disease and easing the pain.Tom’s family sent another overnight package, this one bursting with all of Tom’s medical files. Four days later Jack called them to say he would visit them soon. He wanted to talk to Tom.
Dr Kevorkian exercised care in selecting his patients. He received letters continuously – from the old and lonely, depressed by their isolation but otherwise healthy, to eccentrics claiming agonising pain because of constipation, obesity or fantasies that malicious aliens had invaded their bodies. He also turned down numerous requests from disgruntled children afraid of losing inheritances due to their mother’s love affairs with Las Vegas slot machines.
Dr Kevorkian chose his patients carefully, first and foremost because of his personal convictions, but also because he knew his enemies were waiting for him to make a mistake.
By that summer of 1998, he had been brought up on charges by the state of Michigan eight times. Each time he was acquitted, the charges were dropped or a mistrial was declared. The medical establishment also tried to prevent Jack’s work. Michigan state medical regulators had suspended Kevorkian’s medical licence in 1991. But when they issued him an order to cease and desist from practising medicine he publicly burned it. In 1993, the state of California – the only other state in which he was licensed to practise medicine – also suspended his licence. His involvement with assisted suicide incensed the America Medical Association (AMA), and they denounced him as a danger to society. In response, Kevorkian filed a $10 million defamation suit against the Michigan State Medical Society and the AMA, alleging that the two organisations libelled him in a November 1995 AMA press release that called him ‘a reckless instrument of death’ who ‘poses a great threat to the public’. The suit was dismissed by a Michigan appeals court in August 1999, saying that the statements were ‘protected opinion’.
In turn, Kevorkian claimed the medical establishment was corrupt. He had long retired from practising pathology in hospitals. He felt that money was more important to most doctors than easing pain and suffering. It also infuriated him when doctors began using religious arguments on the sanctity of life as a basis for denying him his licence.
Despite his personal views, Kevorkian had support from many churches, especially Presbyterian and Unitarian churches who opened their doors to many of his supporters. One Unitarian minister even requested of his superiors that he – and others who might want help – be allowed to have his own assisted suicide in the church. (He was turned down.)
Though Kevorkian understood that people might look to religious institutions for comfort at times of death, and encouraged patients to use the counsel of religious advisors, he considered all talk of an afterlife juvenile.When a person died, the body solely succumbed to natural decay. There was nothing else. Kevorkian felt assisting in someone’s suicide was a medical procedure no different than amputating a leg. It was a tough thing for a doctor to do, but it was sometimes necessary. In fact, Kevorkian believed doctors shouldn’t feel they were helping end someone’s life, but that they were ending someone’s suffering. Since not every doctor could be that detached, Kevorkian argued that it needed to be a specialty in its own right. He envisioned gathering other doctors like himself and training them in a new specialty, obitiatry. His goal was to have government sanctioned national clinics
– judicially bound and medically operated – to administer tothe physically disenfranchised until they could be trusted to be objective when it came to deciding whether to assist in ending a patient’s life.
As he planned for a future where numerous doctors assisted in ‘medicide’, he had realised that he needed to establish guidelines for the process in order to eliminate criticism. His developed doctrine stated that the patient had to clearly express a wish to die, and the family and outside psychiatrists had to be consulted in order to ensure that the choice wasn’t due to depression or family pressure.The attending specialist had to review the patient’s medical history to assure all possible alternatives had been explored and they had to perform the service for free, in order to prevent unscrupulous behaviour. Legal and secular counsel was strongly recommended. Finally, the doctor had to give the patient at least a month to consider their decision. He published his list of rules, passing it on to other doctors, which gained him both support and controversy. In the Tom Youk case, skirting his own rules haunted him in court.
When Dr Kevorkian finally reached the Youk home on September 16th, 1998, Melody Youk was surprised to find that Jack Kevorkian was not the man she had seen on television. He was quiet and calm, respectfully removing his hat as soon as he entered the house.
Tom Youk sat in a wheelchair in the living room. Jack Kevorkian introduced himself and his friend and helper Neal Nicol, and then, after asking permission, set up a video camera to tape their meeting.Tom was listless, but not in obvious agony. He struggled to swallow, and in that moment Kevorkian noticed the pain in Tom’s eyes.
Kevorkian would later say, ‘He just was terrified of choking to death, and he must have felt that he was on the verge of it. And I couldn’t have him suffer in that kind of frame of mind because if a man is terrifi ed, it’s up to me to dispel that terror.’
Kevorkian took Tom’s hand gently in his own, and leaned toward him. Tom’s body relaxed, a sad smile flickered across his face. Kevorkian asked him to talk about his disease and what it had done to him.Tom paused, and then explained with great difficulty that his troubles began in 1994 after a knee operation (he modifi ed his Porsche to operate the clutch with his hands so that he could keep racing for two more years) and that by 1997 he was in a wheelchair.The videotape shows Tom struggling to form the words and make himself heard. Jack had trouble understanding him. Finally, Melody interceded and translated for Tom, as she was one of the few people who could understand him.
‘Can you move your legs at all?’ Kevorkian asked.
‘No.’
‘How about your left arm?’
‘No.’
‘Try it,’ Kevorkian pleaded.There was no movement.Tom was able to twitch the thumb on his right hand. ‘That’s all you can do?’ ‘Yes.’ Kevorkian motioned to the armrest of the wheelchair. ‘You can’t lift your hand off the thing there?’ Tom sadly shook his head. ‘Have you talked this over with your mother, your brother and
your wife?’ Kevorkian asked. ‘I suppose they tell you they want you to go on, don’t they?’ Tom’s mouth laboured over the words before fi nally releasing them.‘No, they understand. It’s my decision.’ At another point, Kevorkian asked, ‘Tom, have you thought
about this now, your request? Have you thought hard about it?’ ‘If I had use of my arms, I wouldn’t be doing it,’Tom said. Kevorkian had previously assisted others in their suicides
through use of machines. With one machine the patient pushed a button, enabling a sedative to course through an IV into their body, followed soon after by a drug that would stop their heartbeat. The other machine had a gas mask connected to a carbon monoxide tank. The patient just had to pull a clip off the tube and release the gas. In both variations, the patient had control. They decided when they were ready to die. But Tom was worried. He didn’t have enough control over his hands to push a button or remove a clip. So he asked Kevorkian if they could forgo the machine altogether.Would Dr Kevorkian directly inject him?
Kevorkian had been waiting for a patient to ask him this question. He decided he would make a statement to the public after he assisted Tom. He had won a number of court cases over his assistance in other patients’ suicides, but in those cases the patients had used his machine.They had been directly responsible for their own passing. With Tom, however, Kevorkian would be the one directly ending his life, and he would have it on videotape. Jack could show it to the press, and when the inevitable court case came, and he won it, doctors would no longer fear doing what he did.
Kevorkian pulled out a consent form.
‘OK. Now I’m going to read it to you,Tom, and I want you to understand – I want to make sure you understand it, you have to listen closely and stop me if you can’t understand it.’
‘Yes.’
‘It reads this way. “I, Thomas Youk, the undersigned, entirely voluntarily, without any reservation, external persuasion, pressure or duress, and after prolonged and thorough deliberation, hereby consent to the following medical procedure of my own choosing.” And that you have chosen direct injection, or what they call active euthanasia, “to be administered by a competent medical professional in order to end with certainty my intolerable and hopelessly incurable suffering”. Did you understand all that?’
‘Yes.’
He handed Tom a pen to sign the form.
Tom struggled with his hand, forcing the pen to scratch his name. He wanted there to be no doubt that this was his choice, and with a measure of vanity, he wanted his final signature to be elegant and powerful, a fi nal reminder of the man he once was.
Kevorkian studied the form. ‘That’s a fine signature,’ he said. ‘Were you an artist?’
Tom made an attempt to laugh and shook his head. He shared a smile with Kevorkian. It was a moment of life in the face of death. He no longer had to worry about when or how he would die. He now knew, and there was a peace in knowing.
But Kevorkian wasn’t going to assist Tom that day. He had to give him a chance to change his mind.
‘You’re sure you thought about this very well, now?’ Kevorkian asked.
‘Very much.’
‘You don’t want to wait another month or so?’
‘No, I …’
‘You want to wait a week? How about two weeks? Two weeks?’
Tom shook his head in frustration.
‘One week? Can you wait one week?’
‘Yeah.’
‘All right, we’ll stretch it out one week, OK? Let’s not hurry into this.’
Tom nodded.
Kevorkian shook Tom’s hand, gathered up his video equipment, and prepared to walk out the door. Melody touched him on the arm, and said thank you. She then asked Kevorkian what would happen when he ‘was done’.
‘I’ll leave the body here,’ he said.
On the drive home from the Youk house, Kevorkian considered the choice that Tom had made, a choice Kevorkian had helped others with over 130 times in the past eight years. It was a choice that had been unavailable to his mother, Satenig, a refugee from the Armenian holocaust. When his family had learned she was dying of cancer, they had begged her doctors to help her die, but none would help. His mother suffered greatly and died in terror.
Kevorkian returned home, and spent the evening listening to a fl ute concerto.
Terry Youk called the next afternoon to say that Tom wanted it done ‘now’. Kevorkian said he would do it, but that he didn’t want Terry or Melody there. If the police were to come, he didn’t want the two of them to have to face criminal charges.
‘Would they really do that?’Terry asked.
‘They think I’m a murderer,’ Jack replied. ‘They’ll call you accomplices.’
When Kevorkian arrived, he found the door of the Youk house unlocked. He walked to Tom Youk’s bedroom. Tom waited for him, propped up in bed. He gave a weak smile to the doctor. Dr Kevorkian, alone this time, again set up his video equipment.
‘Are you sure you want to go ahead now?’ Kevorkian asked.
Tom nodded. Dr Kevorkian methodically unpacked his equipment. He readied the appropriate solutions, then stepped over to Tom. He attached an EKG to Tom in order to measure heart rate. The IV would have to go into the veins on the back of Tom’s hand.
‘All right. I’m going to have you sign your name again and I’m … and we’re going to date it today, OK?’
Tom struggled with the form, and so Dr Kevorkian reached over to guide his hand.
Kevorkian straddled Tom’s lap and began the search for a vein. His needle poked Tom in the shallow skin along the back of his left hand repeatedly, and Tom yelped in pain.
Dr Kevorkian stepped away. He turned off the video camera and returned to Tom. He tried the veins on the back of Tom’s right hand and finally found one that would work. He restarted the video camera and began to prepare an intravenous line.
‘Are you sure you want to go ahead now?’ Dr Kevorkian asked.
Tom nodded again.
‘We’re ready to inject.We’re going to inject in your right arm,’ Dr Kevorkian said.
As he prepared to inject Seconal, a sedative,Tom Youk’s body let out one final gasp.Thomas Youk’s chin rested on his chest as the sedative flowed into his arm.
‘Are you awake?’ Dr Kevorkian asked.
Tom did not respond.
Dr Kevorkian injected a muscle relaxant, followed by potassium chloride, the drug that would stop Tom’s heart quickly and pain-lessly.Tom’s head tilted back. His mouth was open wide.
Kevorkian watched the electrocardiogram.
‘Now there’s a straight line,’ Kevorkian pronounced. ‘His heart has stopped.’
It took less than five minutes to end Tom Youk’s life. Kevorkian had done so less than three weeks after the enactment of a revised Michigan law making assisted suicide a felony punishable by up to five years, and despite a court order banning him from assisting in suicide.
Dr Kevorkian left the house, and the Youks called a hospice worker to come and pronounce Tom deceased. The worker discovered a receipt for the package of medical records sent to Dr Kevorkian via Federal Express, which the family had left lying out. She called the police, and they immediately rushed to search the Youks’ house.
Melody Youk notified Kevorkian of the events. He then contacted Mike Wallace of CBS’s 60 Minutes and arranged to have the tape shown – knowing that he would likely be charged with murder when the authorities saw the tape. It took some time for 60 Minutes to edit the tape and schedule its airing. In the meantime, the Oakland county prosecutor was reluctant to charge Kevorkian for fear of losing the case, as others had before him. Kevorkian taunted the prosecutor publicly, but the prosecutor kept stalling.
Several weeks later, Jack called Ruth Holmes and asked to come and see her. Holmes was a trial consultant who specialised in determining the leanings of potential jurists by interpreting their handwriting. She forecast the psychological make-up of the fi ve juries that had kept Dr Kevorkian out of jail, and became one of the few people he trusted. Ruth, expecting to have a cup of coffee and chat, had joked, ‘OK, Jack, as long as you don’t bring any bodies.’
Kevorkian didn’t arrive until eleven that night. Ruth pulled out a midnight snack for him – his favourite white bread. Jack placed a plastic bag on the kitchen counter. Inside were a toothbrush and change of clothes. Jack told Ruth they were going to air the videotape he’d made of the Tom Youk medicide on 60Minutes that week.
‘You know how the media will be,’ he murmured, ‘I can’t go home.’
‘Then stay here,’ Ruth said.
On November 22nd, 1998, 60 Minutes broadcast the videotape, which showed Dr Kevorkian giving the lethal injection to Thomas Youk. The programme triggered an intense debate within medical, legal and media circles. Kevorkian watched the broadcast from Ruth Holmes’ living room with a group of friends. He was incredibly excited. He’d already formulated his plan of attack for the trial, and was eager to explain how he could win the case.
Three days later, the state of Michigan charged Jack Kevorkian with first-degree murder, violating the assisted suicide law and delivering a controlled substance without a licence. Prosecutors later dropped the suicide charge.
America saw the bombastic Dr Death on 60 Minutes. When Mike Wallace asked Kevorkian what the difference was between murder and the service he had performed for Tom Youk, Kevorkian said,‘It could be manslaughter, not murder … It’s not necessarily murder, but it doesn’t bother me what you call it. I know what it is.This could never be a crime in any society which deems itself enlightened.’ He was intent on being prosecuted for his act, and so he didn’t care what he said. He wanted a court case. He wanted to change the laws. But what America saw was a man who had caused another man to die, and who didn’t seem bothered by what he’d done.
Mike Wallace asked, ‘Did Tom know that you were making, in effect, an example [of him]?’
‘Yes. And … and I sensed some reluctance in him. I … I did.’
‘Because he had thought he was getting assisted suicide?’
‘That’s right. And … and actually, this is better than assisted suicide. I explained that to him. It’s better control. And then, he … he did agree, which I … I think … I didn’t force him to agree. He did agree. Maybe …’
Once again, Jack wasn’t being careful about what he was saying: Youk had initially asked for direct injection.
Wallace then asked,‘How do you know he agreed?’
‘I had him sign, saying that he chose direct injection.And he … and he signed this … and he signed it.’
The interview gave even more ammunition for those that claimed that Dr Kevorkian was only involved with Tom Youk in order to gain publicity.
Mike Wallace announced,‘After more than 130 cases of assisted suicide, Dr Kevorkian says this is the first time that he taped the moment of death, and he says he did it to force his own arrest for euthanasia so he can have a trial to finally resolve whether he is right or the prosecutors are.’
Kevorkian replied, ‘Either they go, or I go … If-if I’m acquitted, they go because they know they’ll never convict me. If I am convicted, I will starve to death in prison. So I will go. One of the two of us is going to go. And that’s why I did this. The issue has got to be raised to the level where it is fi nally decided.’
‘You were engaged in a political, medical, macabre publicity venture, right?’
‘Probably.’
‘And in watching these tapes, I get the feeling there’s something almost ghoulish in your desire to see the deed done.’
‘Well, that could be. I … I can’t argue with that. Maybe it is ghoulish. I don’t know. It appears that way to you. I can’t criticise you for that. But the main point is you … the last part of your
statement,“that the deed be done”.’
‘[You] gave us the tape ... to force their hand.’
‘Absolutely, absolutely. I’ve got to force them to act.They must charge me, because if they do not, that means they don’t think it’s a crime. Because they don’t need any more evidence, do they? Do you have to dust for fingerprints on this? … If you don’t have liberty and self-determination, you got nothing. That’s what this country is built on.And this is the ultimate self-determination: to determine when and how you’re going to die when you’re suffering.’
‘And those who say that Jack Kevorkian – Dr Death – is a fanatic?’
‘Zealot. No, not a tr– sure, you try to take a liberty away and I turn fanatic.That’s what I’m fi– I’m fighting for me, Mike. Me. This is a right I want when I g– I’m 71. I’ll be 71.You don’t know what’ll happen when you get older. I may end up terribly suffering. I want some colleague to be free to come and help me when I say the time has come.That’s why I’m fighting, for me. Now that sounds selfi sh. And if it helps everybody else, so be it.’
During his stay with her, Ruth Holmes read him the letters he received and searched daily for positive articles that could encourage him. But Dr Kevorkian had a ruthless distaste for the slightest incompetence. She quietly bore his tirades and affronts. He derided her for the criticism he received in the press after the 60 Minutes piece, but would then go out of his way to give press conferences in which he would ignore the suggested responses given him by legal council. She tolerated his outbursts as the price to pay for having such a noted doctor as a houseguest.
The Holmes family discovered that Jack didn’t sleep much and didn’t think others needed much sleep either. He would go to bed at one or two in the morning and wake up promptly at fi ve, energetically tramping about the house. He coated the house in protective plastic pads, covering the edges of tables, chairs, the refrigerator and the stove, as he didn’t want to accidentally bruise himself when roaming the house at night. Meals had to be carefully negotiated. They would catch him starting fi res in the fireplace so that he could roast potatoes and marshmallows to go along with his toasted cheese sandwiches, and he wasn’t happy until his food had a burnt carbon shell. He said burning food removed germs, but it was clear he also took pleasure in the charcoal taste.
When he stayed up late he initially only read or did jigsaw puzzles alone, but soon he grew accustomed to Ruth, her husband Peter and the occasional visits from daughter Sarah and son Nick. He hated seeing them watch TV, but when he discovered educational channels, he tried to get them to join him in watching a ‘lovely’ algebra programme on public television. Over time, the clatter of his morning routine diminished, and they often found him trying to ‘quietly’ play the piano rather than disturb them. Peter would come down early in the morning and banter with Jack over a cup of coffee, arguing politics, religion or economics.When visiting, Sarah was up next and they would play their flutes for an hour. Next Ruth would meet him for breakfast and they would go over letters he had received or legal issues he had to take into consideration. Jack would then retire to his room to paint. He gradually became a warm, fl ute-playing, Limerick-spinning grandfatherly figure they could count on for advice.
He often peeked out the curtains, looking for the telltale sign of snooping reporters, but it seemed like no one had discovered his hideout. One day a reporter banged on the front door. Kevorkian went into his room and drew the curtains and when Ruth fi nally opened the door, the reporter thrust a microphone in her face. She volunteered, ‘I have no comment on Dr Kevorkian at this time. I will not address such issues from within my own home. There is a more appropriate time and place for any such inquiries.’
The reporter looked quizzically and responded, ‘I just wanted your thoughts on the Monica Lewinsky scandal. What does her handwriting tell you about her? I’ll ask about Kevorkian whenever he shows up in court.You don’t happen to know where he is, do you?’
Ruth smiled guilelessly. ‘He could be anywhere. He might be in one of your vans. Who knows, maybe he’s hiding in my house.’
Geoffrey Fieger and Jack’s other lawyers visited frequently to go over their strategy for the court case. If they were going to win, they had to convince the jury of Tom Youk’s suffering and enable the jury to see Kevorkian the way Tom had – as the only person who could end his suffering.
Fieger warned Jack that the prosecutor would try and make him look like a monster. He also warned him not to repeat the fi ngerjabbing and screaming at the prosecutor that had gone on at the last trial. Kevorkian bristled, especially when Fieger told him he was trying to get the Youk videotape excluded as evidence. He didn’t want the jury to see the tape; he knew that’s what would get a conviction.
Kevorkian exploded. He wanted a conviction – he wanted to take his case to the Supreme Court. Fieger refused to help Kevorkian lose. To Feiger, having Jack acquitted of euthanasia in the county court would be groundbreaking in its own right, an important fi rst step. Kevorkian’s response was,‘Consider yourself fi red.’
With no training in the law, nor any real idea as to courtroom procedure, he enlisted two young lawyers to replace Fieger and coach him on what to do. Neither had ever worked on a trial. One of the lawyers had even been fired from Fieger’s law offi ce, and it almost seemed as if that was exactly the reason Dr Kevorkian hired him. During the evenings spent with his new lawyers, Kevorkian’s temper often got the better of him, and he would yell about their incompetence. He believed he knew what he was doing. He believed that he would get euthanasia acquitted in the Supreme Court. He talked of a Nobel Prize.
Kevorkian thought he had it all. He had a victim with a devastating terminal illness.The Youk family was supportive.The Oakland County prosecutor had been reluctant to bring charges for prior deaths. And Kevorkian had just been the ‘star’ of Time, the biggest news magazine in the world. But he had also rushed into the euthanasia of Tom Youk, sidestepping the one-month waiting period, ignoring the need for a psychological evaluation and, instead, trusting in his own judgment even though he barely knew Tom. He taped everything so that as far as the prosecution was concerned there was no doubt, no legal wrangling, as to who and what caused Tom Youk’s death.Worst of all, he decided he knew enough of the law to represent himself in the biggest case of his life.
The case was a fiasco. Kevorkian made numerous factual errors regarding criminal law during his opening statement, and Circuit Judge Jessica Cooper had to stop him and ask the jury to leave the room. She told him that he should consider getting legal representation. He refused. But this was certainly not the only legal abrogation that transpired.
The most monumental mistake, says Mayer Morganroth, Jack’s present lawyer of account, was that one of Jack’s young lawyers:
… contrary to the advisement from Jack and greater legal minds, [the lawyer] made the motion to dismiss the assisted suicide charge. Apparently his thought was that they would never convict Jack of murder. The motion was filed and they had a hearing in front of the judge. She was incredulous and asked if he was sure that was what he wanted to do … She cautioned him that if he went ahead he couldn’t put in any evidence for pain, suffering and the mental state of the deceased.This could only come in under assisted suicide. He still said yes so she denied his motion. The prosecution, hearing that, two weeks later dismissed the charge of assisted suicide.
This meant that Kevorkian’s only defence was that the service he rendered should be legal.As she had stated, the judge did not allow any family members to testify as to Youk’s wishes. Jack’s lawyer argued that the jury should consider Youk’s state of mind – that he wanted to die. But this was actually irrelevant. What was relevant was Jack’s state of mind – that his intention was to not to kill Youk, but to end his suffering.This was not brought out in the trial because Jack was not allowed to have witnesses to attest to these truths. The prosecution was able to argue, without any witnesses and solely based on the tape, that Jack was an insensitive murderer. *
The trial lasted just one-and-a-half days. (The OJ Simpson trial lasted nine-and-a-half months.) The jury found Dr Jack Kevorkian guilty.The Prosecuting Attorney recommended a sentence of fi ve to seven years in a Federal Penitentiary; the judge sentenced him to 10 to 25 years in a maximum-security penitentiary in Michigan.
Jack Lessenberry, professor of Journalism at WayneStateUniversity and a freelance journalist for the New York Times, the Boston Globe, the Detroit Free Press,Vanity Fair and numerous other publications, wrote in the Oakland Press:
All the controversy surrounding his assisted suicides obscured some of his other achievements. Before Dr Jack Kevorkian there wasn’t any pain management to speak of in America. The medical profession resisted giving painkillers in suffi cient quantities to the terminally ill, fearing the patients could die or become addicted. Kevorkian, however, insisted that even if their lives could not be extended, they could at least live out their remaining weeks without torturous pain if they were given the proper amounts of pain medication. Medicide would be a last resort.
Kevorkian trail-blazed physician assisted suicide in Oregon and Belgium through colleagues and patients. He prompted durable power of attorney, the ability to assign the right to make medical decisions to another person if you become incapacitated. He compelled advanced directives, statements about one’s wishes should they become incapacitated: eg.‘DNR’ – Do Not Resuscitate. Granted, he didn’t work alone, but their acceptance and furtherance owe homage to Dr Jack Kevorkian.
His fatal flaw emerged in his desire for the immortal ity bestowed upon many great human rights activists … The self-destructive ‘Dr Death’ persona overwhelmed the eccentric, but kind aspects of his personality … His normal self was quiet and rational … But ‘Dr Death’ was all about fl amboyance and emotion, about taking risks, about pushing people’s buttons in order to get them into a fight … Unfortunately … the Kevorkian case became a launching pad to higher offi ce for prosecutors intent on advancing their careers. His lawyers tried to take the case before the Supreme Court, but the court refused to hear the case. So, locked in a cell with another convicted murderer, Dr Jack Kevorkian has little chance of ever seeing the outside world again. He is known now only as Prisoner # 284797.
While in prison, Kevorkian’s health began to fail. While walking through the ‘recreation’ yard he fell and broke two ribs. He suffered a double hernia and had to wait two years for corrective surgery. He is suffering from high blood pressure, cardiovascular disease, temporal arthritis, peripheral arthritis, adrenal insuffi ciency, chronic pulmonary obstruction disease and cataracts. His hepatitis C – contracted through research into blood transfusions
– has reached dangerous levels.
In the most recent of his rare letters, he has told his friends that he is ready to die. He is at the end of his life, and there is little hope of him ever leaving prison. He is faced with the same situation Tom Youk was faced with, a terrifying future filled with misery. In his case, however, there is no one who can alleviate his suffering.