Anita Rufus

Anita and her husband, John Aylesworth, had many conversations about the end-of-life healthcare they wanted and documented their wishes. When John was hospitalized with a serious illness at age 82, they chose to decline life-sustaining machines so that John could have the peaceful death he desired.
Anita Rufus standing in front of a scenic mountain view

“I’ll miss John every day for the rest of my life. I will never be sorry for honoring his wishes.”

Anita shared her story in June of 2022.

I met John on a Love Boat cruise. It was December 1984, the end of a long year I had spent going through a divorce. That’s when I found out there was a Love Boat-themed cruise going from Los Angeles to Acapulco. 

I got on the cruise, and the maître d’ put me at a table with a man named John, among others. By the time we got to Acapulco, John was proposing to me. He and I were together from that point on. 

A successful comedy writer and producer in television, perhaps best known for co-creating “Hee Haw,” John had worked with everyone from Frank Sinatra to Perry Como and Julie Andrews. He was very, very funny and smart. Once, on a trip to Italy, we arrived after our long flight, totally exhausted, and our hotel rooms weren’t ready. We had to sit and wait in the lobby. As the more left-brained person in our relationship, I was getting irritated, but John was so calm. 

At one point I turned to him and asked, “How can you be so calm?” And he smiled and said, “You know, the first time something goes wrong, I notice it. If it happens again, it annoys me a little bit. By the third time, I start looking for the absurdity in it all.” And that is the way he approached life. 

John and I talked many times about our wishes for what might happen at the end of our lives. We filled out advance directives as soon as I was aware of being able to do that. We had lots of conversations with family, with his children and mine, as well as our primary care physicians. 

We both made it clear what we would and would not want: I, for example, would never want my life sustained if I were unable to communicate in any way. For John, the bottom line was no machines, just a natural — and hopefully peaceful — death. 

At 13 years older than I am, John got there sooner. 

John was pretty healthy at the age of 82. He took fewer pills than I did. He had developed macular degeneration, requiring the use of a magnifier to read the newspaper (an indignity that annoyed him to no end), but he was still sharp and funny and feeling pretty good. He did have a past history of alcoholism, had been a lifelong heavy smoker and had survived open heart surgery; as a result, he was slowing down. 

When John’s calves started seizing up, he struggled to walk more than a couple of blocks without stopping and waiting for the pressure to ease. It got to the point where he couldn’t comfortably walk very far at all anymore. That really disturbed him, because John loved to walk. 

We talked to his heart doctor to see what could be done and were referred to a vein specialist who suggested a simple angiogram to show where blockages might be. 

The angiogram seemed to go well, but less than a week later, John was back in the hospital with double pneumonia. Specialists came in to consult and went away not knowing what was causing John’s pneumonia. Whatever had invaded his lungs, the doctors were never able to find a strong enough antibiotic to kill it. His prognosis was “iffy.”

He was hospitalized three separate times and came to require constant oxygen. His ability to concentrate or read was gone. Any activity, even a visit from a friend, left him completely exhausted. 

The third time he went into the hospital, only three months after his angiogram, John’s ability to breathe was minimal, even with oxygen flowing through the nose plugs. The doctor suggested that there was a breathing device, a BIPAP machine, that could help John by pushing oxygen in when he inhaled and expelling it completely when he exhaled. They brought it in and tried it on.

John could talk through the mask, and we could open the front so he could eat, but it was uncomfortable and he didn’t like it. “That’s not what I want,” he said, so the mask was removed. He was still hooked into the hospital’s oxygen system when I left for the night.

The next morning, when I got to the hospital, there was John wearing the mask. 

“I had trouble breathing during the night, and they said I had to have the mask,” he told me. “I didn’t want it, but you weren’t here and I didn’t know what to do, so I let them put it on.” I told him that of course he had done the right thing.

I then went down the hall and talked to the medical staff. They made it clear he could no longer breathe on his own, even hooked up to the hospital oxygen system. 

“This is exactly what he has always said he didn’t want,” I said. “What happens if we take the mask off? Is there anything else that can be done?” Without the BIPAP, they replied, John would not live long.

I told John what I had learned. All of our conversations over the years up to this point had prepared us for this moment. When John had been on oxygen, even with the nasal plugs and long wires, he could still move around and take care of himself, which was important to him. But the BIPAP machine was a bridge too far. He didn’t want it. 

By that evening, three of John’s children were there. I explained everything I knew, and they all accepted that this decision was John’s to make. Each one spent some time alone with their dad, laughing and having good conversations. 

On increasing amounts of tranquilizers, and then morphine, John was more and more relaxed. At one point, he suggested that he keep the mask on just overnight. I told him it was up to him, but reminded him that keeping the mask on was not a temporary solution; he would have to be attached to it indefinitely, day and night, in order to live. “Is that what you want?”

“No,” he replied. “That’s not what I want.”

All his children and I gathered around his bed and held hands, each with one hand gently underneath his body. Then the nurse asked him, “Are you ready for me to remove the mask?” He nodded yes, and she did.

Twelve minutes later, John was gone.

As sad as it was, John’s death was peaceful for him, for me and for his children. The experience was so impactful, in fact, that John’s kids have now had these end-of-life planning conversations with each other and filled out their own advance directives. 

I’ll miss John every day for the rest of my life. I will never be sorry for honoring his wishes. 

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