David Bierman

David shared his story in October of 2023.

There were two times that my wife clearly expressed, “I’m ready to go. I’ve had enough. I want to go.” She shared this with me and her social worker three months before she died and again to me and her hospice workers three weeks before she died. Kathy was a mostly private person who didn’t often share her feelings, but no one could dispute the fact that she wanted her suffering to end.

Kathy was a loving mother of two daughters, adored by her friends, and even staff members from the nursing home she spent her last months at attended her memorial service and shared the admiration they quickly developed for her. We spent over 40 years together, taking trips throughout the U.S. with a motorcycle group we were part of, and through this group we got involved with a pediatric brain tumor charity. Kathy became especially invested; it brought her joy to do for others. She never went into a store or restaurant without a letter in her hand requesting some help for the charity.

We also spent our time enjoying cruises all around the world, but as her disease progression ate away at her quality of life, she was able to participate less and less in the things she enjoyed most. Her last decade was a gradual decline. Our daughters and I witnessed Kathy begin to struggle to walk long distances, then wheezed and struggled with shortness of breath just walking to our car in a parking lot. You could see the change, but it wasn’t until 2013 that her decline significantly sped up. Kathy had no problem telling you what she thought, but she wasn’t very good at expressing her feelings. She had to be pushed to open up, including about her illness. She kept everything to herself until she couldn’t.

Two years prior, we had canceled a cruise to the Mediterranean because Kathy was in sudden severe pain from fractures in her vertebrae due to osteoporosis. Back then she was able to have an injection that had a cement-like effect on the fractures. There was a period when she was free of pain in her spine, but throughout her last months she accrued more fractures and was once again in excruciating pain.

Then in 2013 she was put on oxygen 24/7. I mistakenly thought because she was getting pure oxygen fed to her now that she would improve. I hadn’t realized the damage from COPD was irreversible. From September 2013 until June 2014, when Kathy moved into a nursing home full-time, she was in and out of the ER and rehabilitation then back home every couple of weeks. Somewhere within that window, her doctor told us that Kathy needed to get her affairs in order and that she was on a trajectory toward death, though he couldn’t tell us if it would be two months or two years. His point was that it was coming. That conversation helped us face reality, and when she had another drop in her health in June, we decided that she needed a higher level of care than I could provide for her at home.

Soon after moving into the nursing home full-time, Kathy asked her social worker for help getting me to understand that she was nearing the end of her life. That was the first time that Kathy shared that she had suffered enough and she was ready to go. I listened and understood, so when the idea of enrolling in hospice was brought to my attention just a few weeks later, I was accepting. However, when they told us that they expected that Kathy only had maybe a month to live, though the prognosis was very accurate, I didn’t realize or accept it at the time.

Hospice did a mostly good job managing Kathy’s pain and anxiety, increasing medications routinely in an attempt to stay ahead. But she still suffered, especially as she struggled to breathe. We can all appreciate the sensation of struggling to breathe and the fear and anxiety we experience from that; that was her every day, and it got worse as she neared the end.

The last weekend of her life, Kathy texted me “911, I need you.” The nursing staff called the hospice, and they came out to increase her morphine once again. Two days later Kathy was breathing/sucking in air 38 times per minute; she never opened her eyes after that. She died later that evening on August 10, 2014.

Once Kathy passed away, I didn’t cry. I was grateful that she was out of her misery. Her last 10 months were a struggle that only increasingly became more difficult and painful. It was good that she was finally at peace. The need for her suffering to end outweighed my loss when she passed away.

Kathy knew the path she was on, was in a clear state of mind, was ready, and I am confident that having the option to request a medical-aid-in-dying prescription would have eased the fear and suffering she experienced in her last three months, even if she never used the option. Watching her suffer was difficult, but the anguish she endured was exponentially worse. Dying residents in Illinois deserve the option of medical aid in dying.