779: Ends of the Earth

Ira Glass

Hi, everybody. It's This American Life. So one of our producers read this book a few months ago, and she was like, this story is really unusual. And, also, it happened to be written in a way that is perfect for radio. Could we maybe just condense it down and run it on the show?

And so a few of us read the book, including me. And we agreed. This is a story you really don't hear. Basically, the story-- there's this couple. He gets Alzheimer's. And, of course, so many of us know people with Alzheimer's. I feel like it's like watching somebody who you love-- I don't know-- just drift slowly off into space. The things that make them them get taken away, one after another.

And in this couple, the man, while he still had his wits about him, wanted some kind of assisted suicide before it got too late. And so his wife looks around and finds this place in Switzerland to go to. And what makes the book so special is that just-- I don't know-- the dailyness and realness of the way that his wife tells what that was like to go through.

And they're this interesting couple that you get to know. Very specific people going through this thing that-- honestly, for everybody I have known with dementia or Alzheimer's, I have never met anybody who made this particular choice. And you get to hear how that plays out. And it's very life-sized. You see this couple after they realize he has Alzheimer's. But, also, you see them before, when he's just kind of acting oddly, and it's a little annoying, but she doesn't know why just yet.

And so what we're going to do today in the first part of today's show is that story. And then after the break, it gets lighter. We have another wife and mother. This one, a professional comedian trying to do the best for her family. From WBEZ Chicago, I'm Ira Glass. And let's just get to it.

So you may know this book that we're excerpting. It got some attention. It's by Amy Bloom, who has written novels and short stories over the years. So this story is true. And it's her own story. It's called In Love-- the book.

And-- I don't know-- just to say this before we start-- this story is about somebody who's making the very difficult decision to end their life because of a progressive terminal disease which, of course, is very different from somebody thinking about suicide as part of a mental health crisis. But if you are having thoughts of suicide, take all that into account before listening any further. OK.

Ira Glass

We are at Act One, Exit Strategy. Here's Amy Bloom.

Amy Bloom

Sunday, January 26, 2020, JFK International Airport. This trip to Zurich is a new, not quite normal version of something Brian and I love-- traveling. As we usually do, we take a car service to the airport so we can be fancy and also avoid the park-and-schlep. And even before Brian had Alzheimer's, our combined lack of direction adds 20 minutes to all transportation transitions.

We have a restaurant meal before our 6:00 PM departure. I buy a stick of lipstick and a small tube of hand cream. Brian buys some candy. We share gum. We share a bottle of water. We are smiling from the moment we board. As soon as we get our beverages-- in glasses-- we toast my sister and brother-in-law who are paying for our business class trip to Zurich.

Dignitas's office is in Zurich, and that's where we're headed. Dignitas is a Swiss non-profit organization offering accompanied suicide. And it is one of the very few places in the world to go for painless, peaceful, and legal suicide.

In our Swissair pods, Brian and I toast each other. And we say, "Here's to you," a little hesitantly, instead of what we usually say, Cent'anni-- "May we have 100 years," a very Italian toast. There is no cent'anni for us. We won't make it to our 13th wedding anniversary.

I've insisted that we don't bring proper suitcases because I will not lug home a large suitcase full of clothes he will never wear and medicines he will never take. I won't dump his clothes at the Swiss version of Goodwill and leave his meds for the cleaning staff. Basically, I just won't deal with it-- with after.

After Brian has died, and I have to leave him, my goal is to get myself on a plane with my friend who has offered to accompany me home. Then my daughter, Sarah, will meet me at the airport. And Sarah and I will be met by my daughter Caitlin. And the two of them will say goodnight to me. And my fantasy is that I will fall into my bed and not get up for two weeks. This is absolutely not what happens.

March 2019, Stony Creek, Connecticut. Brian's memory loss began in 2016, and it was small and then bigger and then startling-- names disappearing, repetition, information turned upside down, appointments and medications scrambled. Suddenly, it seemed, we argued endlessly about everything.

A gregarious man, he didn't want to see friends except to fish. He now talked only about the past, his childhood, and football. I could not steer him to any other subjects. In the evenings, I said-- because I didn't know any better-- that maybe we could talk about our life now as it's going on-- him and me and his retirement and the kids and the grandchildren and our friends. And he said, sure. But we didn't. And the evenings were hours of television.

One spring morning, I'd been weeping because Brian seemed so distant. And in that moment, weeping the harder because, although I could see that he was concerned and truly sorry he had upset me, I could also see that he didn't really know why I was upset and reminding him of our long, pointless fight the day before wasn't helping.

We still had the occasional Sunday morning conversations that we'd always had and cherished. Somebody hurt somebody's feelings, and somebody is owed an apology, which will be forthcoming sooner from me, later from him, but delivered by dinnertime.

Brian was not immune to the lure of the "I didn't say it" or "If I said it, I didn't mean it" approach. But one of the things I loved was his willingness to own up. There'd be a burst of anger. The black cloud would pass. And my husband would dig a little deeper and usually come up with a genuine apology. My favorite-- I'm sorry I was such a knucklehead.

The cloud didn't pass now. The apology was thin or weary or cold. I could feel him through a glass, and I was banging on it, screaming at him, why is there a glass between us? Where did it come from? Take it down. And Brian looked at me with puzzled, irritated concern and said, in effect, what glass? And please, please stop complaining about this thing that isn't even there.

Monday, January 27, 2020, Zurich. We land in Zurich, and the hotel's car service takes us to the pretty hotel in the cobblestoned Old Town section. The city's warmer than we expect, and it's drizzling.

I feel shifty and out of place at the hotel's front desk. Brian wanders around in and out of the lobby. And when I see him walk through a pair of swinging doors at the end of the hall while I am searching for our passports, my stomach hurts, as it does every time he leaves my sight.

When he comes back a few minutes later, I've pulled myself together. Every time the concierge asks me a question, I fumble like a suspect. Why are we here? Would we like a map of all the stores on Bahnhof-strasse-- Gucci, Hublot, Cartier? May they show me the bar in the library?

I want to say to Brian that it reminds me a little of a hotel we loved in Amsterdam, but I am afraid that he won't remember the trip, the hotel. I'm afraid that he won't, but he will pretend that he does. And I won't know if he does or doesn't, which is awful. Or I will know he doesn't, which is also awful. And I don't say anything, which is usually the choice I make now. We are both exhausted by the time we get to our room.

Spring 2019, Stony Creek. Our normal life had begun to require a level of effort that I'd last had to make when I had had an unhappy marriage, a full-time job, a teenager, a toddler, and a baby-- with none of the joy. Having barely looked at another man or woman for 14 years, I was now imagining myself having drinks on a rooftop lounge with pleasant but unlikely, even unpromising, companions.

Brian and I were always stickily close. We liked to grocery shop together. Now I exhaled when he went for a long walk and ruminated late at night that maybe I could get him a small apartment in New Haven with some kind of helper if needed. How I could have contemplated helper and manage not to wonder why I was thinking that my 65-year-old husband who read Faulkner and worked out three times a week would need a helper, I couldn't-- absolutely could not say.

I didn't tell anyone in the world that I had these thoughts. I did tell close friends that he was driving me crazy with his male, mid-60s, early retirement loose ends. And it will pass, I said to myself, and look-- he's making stained glass. I found the teacher, made the appointment for the lesson, and located the studio. And he's going to his book club. I scanned the planning emails when he felt overwhelmed, and I ran to the library for the book.

And he's pursuing the occasional zoning fights in our little town and studying the town's bylaws with great enthusiasm, so, really, what's wrong? I couldn't say. But I knew that this man was not the man I'd married. And the change had happened not over 50 years, which would have been very sad but not puzzling, but just over the last three years.

End of life. It's amazing to me that people said to me, well, why go to Switzerland? I mean, why not Oregon or Colorado or Hawaii or Vermont? There are right-to-die laws in those states. That some people said this to me right before and right after my husband died was more than amazing.

The right-to-die, physician-assisted dying, laws in California, Colorado, Oregon, Vermont, Montana, New Mexico, District of Columbia, and New Jersey, Maine, Hawaii, and Washington require that you be or become a resident of that state-- sometimes quick and easy, not always-- in order to pursue your physician-assisted suicide and also, consistently, that you are mentally competent, medically assessed as having only six months to live, and can express your wish to die-- usually three times, twice orally and once in writing-- to two local physicians.

Practically speaking, you have to be damn close to death's door to get a doctor to swear that you'll be dead in six months. You have two physician interviews, some days apart, in which you assert that you are not psychotic or suicidal or depressed and hope the doctors agree with you. You have to be able to swallow whatever the doctor prescribes without any assistance.

Choosing to die and being able to act independently while terminally ill is a deliberately narrow opening. Many people can't get through it. They can't swallow well enough. They can't talk well enough. They can't hold the glass or mix the drink on their own, and helping someone hold the glass is a crime in much of America. People who do wish to end their lives and shorten their period of great suffering and loss-- those people are out of luck in the United States of America.

September 2005, Durham, Connecticut. How we met. Brian and I fell in love the way some middle-aged people in unhappy partnerships and in small towns do. Liberal Democrats in a Republican town, ethnic types in a town full of Northern Europeans, opinionated loudmouths, and people who were willing to man the Durham Democrats hot dog stand-- hot dogs and cider-- every September at the fair.

I overlooked his bad haircut and aviator glasses. I'm sure he had to overlook my lack of interest in sports and my impatience. Brian could talk about a plastic gazebo or additional parking at the library for hours. We had been walking together since our partners were not walkers and talking together in public at our local Democrats breakfast club, and then, suddenly, talking in private.

He said, "I was a three-sport captain in high school," and I laughed. He said, "It would have been four sports, but you can't do lacrosse and baseball." "Is that right?" I said. And he took my hand. He said, "What's your family like?" I said, "Jews from New York. You?" He said, "Well, we're a football family. We have three Heisman trophies in my family." I said, "What's a Heisman?" And he kissed me. I kissed him back. And sensibly, we avoided each other for the next year.

After a year and some martinis in New Haven at the end of the day, he asked me to take a walk with him. He said, "I'm not stupid. I know how this will end. You'll tell me we should not do this to the people we love, or I'll tell you. And we will go back to our lives where we should be, and I will never get over this. Or we blow up our lives and be together.

"I just want to say this," he said, before we walked back to our cars. "I know who you could be with-- someone rich, someone fancy, some guy your sister finds for you-- but I know who you should be with. You should be with a guy who doesn't mind that you're smarter than he is, who doesn't mind that most of the time you'll be the main event. You need to be with a guy who supports how hard you work and who will bring you a cup of coffee late at night. I don't know if I can be that guy," he said, tears in his eyes, "but I'd like a shot." We married.

Thursday, August 15, 2019, New Haven, Connecticut. We have an appointment with the neurologist. We get there in plenty of time. The secretary/receptionist nods at us from behind the glass. There are around six million people with Alzheimer's in the United States and many, many more with MCI-- Mild Cognitive Impairment-- often one of the first stages of Alzheimer's but not for everybody.

And although re-evaluation every six months is recommended to people with MCI, no website can tell you why frequent re-evaluation is recommended as there is no successful treatment for MCI, or for slowing the progression of MCI to Alzheimer's, or, really, for Alzheimer's itself. Almost 2/3 of these six million people are women. Almost 2/3 of the caregivers for those Alzheimer's patients are also women. There are lots of theories about why more women than men get dementia but only theories.

I don't have the scientific training to assess these theories. There are no comparable theories about why women make up 2/3 of the unpaid dementia caregivers because no theories are needed. Who doesn't know? Sisters, daughters, wives-- of course they're going to take care of someone with dementia.

Thursday, July 18, 2019, Stony Creek. MRI day. The appointment for Brian's MRI is at 8:45, and it's only 15 minutes away. We both wake up at 6:30. Brian lies in bed for a while grumbling at his phone. He takes his morning meds and tells me he's contemplating a shower.

I encourage the shower because he has a bad case of psoriasis on his scalp, and the only thing that keeps it from trailing into his eyebrows and erupting around his nose is the medicated shampoo he uses every day. We have been talking about the psoriasis shampoo used daily for about a year and a half. Looking back, it seems like a lot of fraught conversation to have about continuing to do something he's done almost every day for the 14 years we've been together.

He's a good-looking man. My husband always smelled great and looked good and was vain about his good looks, his wolfish smile, and his dark, thick hair. I didn't mind the vanity which was not excessive and mostly shared only with me. About once a year, he grabbed his stomach and said, if it was free, I'd get a tummy tuck.

After he had his cataracts removed, he dragged me into the bathroom to look with him into the mirror. These bags, he said, you never told me. Six weeks later, he was getting an eye lift. When we'd go out to dinner and look out on a sea of men his age, even if we had been in a furious argument, he'd grin, tap me on the hand, and say, how do you like me now? And I'd always laugh.

I didn't understand why I was now having to say, wash your hair, honey, or, honey, take a shower. Now I understand. And now that I understand, I wish that it was middle-aged man laziness or retirement blues or a man's response to being told what to do. It's not. I've been reading, and it's mild cognitive impairment, which as far as I can tell-- our informative post-MRI meeting with the neurologist will be next week-- a wildly euphemistic name for the early stages of dementia.

The Clock-Drawing Test and the Mini-Mental Status Exam. In our second appointment, the neurologist gets down to it. Brian probably-- in a tone that says definitely-- has a dementing disease. It's probably Alzheimer's-- very, very likely.

I say that on the websites they describe the Alzheimer's trajectory as three to four to 20 years. The neurologist disagrees-- eight to 10 to maybe, maybe 12. But, remember, he's had these symptoms for at least two, I'd say, three years. The neurologist makes clear that those eight to 10 to 12 years for Brian would be the end of life-- the end of his body's life.

I have now watched enough Alzheimer's diary videos-- who records this grief and posts it on YouTube; who does this, I think, even though I am as grateful as I am horrified-- that it's very clear that the end of the body will be long after the end of the self. By moving to the practical, the neurologist signals that we are coming to the end of the appointment.

She says that Brian probably should not be driving even with the GPS and not because he'll get lost. "Because," Brian jumps in, "I might be in an accident." "You might kill someone," the neurologist says. We are both silent.

We get home, and we cry for an hour in each other's arms. We agree not to do much talking for 24 hours. Our whole weekend is crying and talking and binge-watching TV at night. I was sure that Brian had Alzheimer's before the MRI. I thought, it's not a surprise. But it was a surprise. The way every bad thing-- even as you see the flames in the distance, even as the terrible thing is upon you, breathing in your ear, hammering on your narrow bones-- is still a surprise.

Before we fall asleep, Brian muses aloud about his wish to control his death and how I will arrange that for him. He'd made up his mind after 48 hours and never wavered. We cried, and I agreed. And he said to me, "You go research it. You're so good at that stuff." Which meant that while I was looking up Exit International and The Hemlock Society and websites that would sell you both the plastic turkey bag and the helium machine for your own do-it-yourself suffocation, I was also researching how to get fentanyl and phenobarbital and sodium pentobarbital on the dark web.

I research at the public library-- not on the phone, not on my laptop. The internet tells me again and again not to search anything from my own computer and that if I need to know something, call, don't text, and don't use my own laptop.

I was discovering the limits of my friends with medical degrees and the possibilities of carbon monoxide poisoning-- in your car, in your garage-- but it's become more iffy since 1975, when the car industry adjusted the CO emissions and then applied catalytic converters. Also, we don't have a garage.

Brian's dearest, oldest friend-- his fishing buddy since 1979-- says to Brian, "If you think you don't need to go right now, and you want to wait a while, I can just shoot you myself in a year or two in a field." Brian hugs him.

I look up how it feels to drown. Lots of people have first-person accounts about near-drowning, and they seem divided between peaceful brain fog as the white light shines brighter and clawing one's terrified way through terrible suffocation. I mention that drowning is a way some people end their lives. Brian looks at me hard. "Are you kidding me? It's cold. No."

In the depths of Google wormholes for end of life, for assisted suicide, for euthanasia, for terminal illness, and for making end-of-life choices, in August, I finally find Dignitas, a Swiss organization to which even a foreigner can apply for an accompanied suicide if you meet their criteria-- be of sound mind, have medical records supporting this, have $10,000 to commit, and be sufficiently mobile to get to the outskirts of Zurich.

Fall 2019, Stony Creek. Applying to Dignitas is pretty much my second job now-- getting medical records from the distant past, an autobiographical essay from Brian, current dental records, his birth certificate. But every mistake I make ends up costing us two weeks.

And the thing that takes up so much time is a careless note on a form from the neurologist that describes Brian as clinically depressed. He's not. But it's exactly the thing that Dignitas will not support. I have to find a psychiatrist who will certify that Brian meets all of Dignitas's criteria.

Brian is a certain kind of CEO for this project. He doesn't want to participate in discussions below his pay grade. He doesn't want to overhear troubling or puzzling discussions. He doesn't want any bad news. He doesn't want any unsolved problems presented, and regular progress reports are appreciated. No meeting should last more than 10 minutes.

Occasionally, when we hit a speed bump of which he's aware, he says, "This is crazy. It's my life. I should get to decide how to end it." Most days he seems to feel that I've got the situation well in hand-- that the end is coming too soon, certainly, but not right around the corner, not before we can do sushi and a movie many more times, and that nothing bad will happen in the process which will unfold as we expect. This is not true-- that nothing bad will happen-- and, therefore, not comforting to me. It leaves me quite alone with reality. But the way he feels is exactly what I want for him.

Talking with a friend, I rant about the American health care system, our refusal to let people die a dignified and comfortable death, the money made off suffering, the doctors unable to face their limits and meet the needs of their patients. Nobody can talk about it, I say. Nobody seems to know what they're doing. There is literally no treatment. The most advanced Alzheimer's research in the world says, eat fucking blueberries, get enough fucking sleep. My friend nods.

End of November 2019, Stony Creek. It's the day before Thanksgiving, and Dignitas tells us we now have the provisional green light. This is the call we have been working toward since August. Brian hugs me hard because we have accomplished the thing we wanted to accomplish and done it together, and he loves teamwork.

And then the light changes and dims. And I am in the world without him in it. He sees clearly the world going on without him, me alone in the kitchen and him not next to me. We cry in each other's arms, and, without speaking, we go right up to bed for a nap at 11:00 AM and only come down when the kids come through the door ready to start Thanksgiving prep.

I start dropping things. I drop the ceramic pie weights onto the kitchen floor. I drop an entire open bottle of corn syrup into a bowl of butter and eggs. I burn the toast. I actually set one pie on fire in the oven and quadruple the amount of bourbon in the other so that no one who is not a Kentucky drunk could eat it.

Thanksgiving is done. Christmas is coming. And so is my mother-in-law. Brian and I already knew a lot about Alzheimer's from my mother-in-law's best friend of 50 years. Joanne, Yvonne's best friend, was an aunt to Brian, a regular dinner guest, formidably well-dressed in the Nancy Reagan mold, a great golfer, a devoted philanthropist to causes I reviled, and my mother-in-law's boon companion for movies, dinner, and drinks at the club.

She had descended into Alzheimer's these last few years as if on an express. First, she complained about the cleaning lady. Then she complained about her occasional guests. Then she complained about her son. Then she complained that valuables were being moved to odd places and probably stolen.

Then she could no longer navigate, not even on roads she'd driven for 50 years. Then she became violent and tearful, afraid of the terrible real and imaginary forces beyond her control. And then she didn't have the capacity to behave well in the communal dining room, or dress appropriately for the yoga class, or even to keep herself clean and get along with her health care aide.

Then her son moved her into a memory-care unit. And she still knew my mother-in-law and, weeping at every visit, begged her friend to take her home. Yvonne shared every detail of her dear friend's decline with Brian, who took note. I love my mother-in-law. Brian often quoted a favorite saying of hers, "We're not here for a long time. We're here for a good time." You can imagine how often he said that.

I hadn't said anything to Yvonne over the phone. Now I stand outside her bedroom door on our second floor until I hear bustling sounds. I knock, and she lets me in. She's already nicely put together. I sit on the bed beside her and tell her about our plan with Dignitas. She pulls away from me and wipes her eyes, and I wait with my hands clasped. I don't want a scene, but if there is one, I want it to happen while Brian is still asleep.

Then she says, "I am so relieved. I realized that last night. I was praying about this and praying all night, and I realized that what I prayed for was that he would not have to suffer as Joanne does. I'm shocked that I'm so relieved. But I am." We hold hands and cry. And she says that I was a gift to her son. And I throw myself in her arms as if she is my own mother.

December 2019, Stony Creek. I am practicing being a widow, preparing myself to do things alone, taking down the strings of lights by myself, listening to Brittany Howard, and having a snack. It is about as much like actual widowhood as our granddaughter Ivy making a fist and waving it overhead, saying ferociously, "When I do like this, I am magic, and you cannot catch me."

Monday, January 27, 2020, Zurich. We have an appointment with Dr. G at our hotel. As I understand it, Dr. G is both our guide through the process and a possible speed bump. The friend of a friend who'd brought her father with brain cancer to Dignitas told me that it was very important that Brian opened the hotel room door, showing that he's in charge of the process.

I tell Brian this, and he nods. But I can tell he's not going to jump up at the first knock. Brian is not someone who rushes-- period-- to host at any gathering we've ever had. He loves being the guest, and he makes up for it by doing a ton of dishes after. I don't know how to make sure he answers the door or even if it's important. I just keep saying, "The doctor's going to knock on our hotel room door."

I'm also worried about etiquette. Will the doctor expect a cup of tea? Does he look like the grim reaper? No and no. The doctor does knock on the door, and I almost scream. Brian strolls over to the door and is his most amiable and pleasant Brian self. We used to say that Brian could talk to anyone. He could make small talk with a stump and, in the end, that stump would be hugging Brian goodbye, thanking him for a great evening, and inviting us all to the next stump get-together.

Dr. G is a small man with large, lovely, mournful eyes. We all shake hands and Brian and Dr. G sit across from each other. I ask Dr. G if I can stay for the conversation, and he looks surprised. He says gently that, of course, I should stay as this all concerns me as well. I begin crying, and both men look at me kindly.

I pour myself a glass of water. Dr. G, "Moishe," he says-- that's my father's name, and I feel lightly blessed somehow, and I know that I have lost my mind-- asks about our flight.

He mentions-- complaining lightly, just en passant, in what I can only describe as the Jewish fashion of complaining while assuring us at the beginning and end of each sentence that he is certainly not complaining-- that he had to come so late at night because he was at a concert in the city. And it was most convenient coming after the concert because he lives by the lake and doesn't come into town every day. But since we chose to stay in the Old Town, he had to make a special trip just to see us, not that he's complaining.

I beg him to take a glass of water, and he does, probably so I'll stop crying. He opens a folder and says to Brian, "After I read your application, I knew I would see you, but I didn't think it would be this soon." Brian says, "It's not a big window. I mean, no one knows how long they have, how much time they have to make this choice." Dr. G looks like he might argue, but instead he says, "You're absolutely right."

He says to Brian, "I will ask you several times-- many times-- if you are sure that this is what you wish to do. And I want you to understand that at any time-- at any time between now and the final act-- you are free to change your mind and not do this. I hope you will not do this," he says softly. And Brian nods. "So," Dr. G says, "are you sure that you wish to end your life on Thursday?" Brian says that he is sure.

I start crying again, and, thank God, both men ignore me again. Dr. G smiles and nods. "It seems to me," he says pleasantly, holding up the folder, "you don't believe in anything, Mr. Ameche." Brian laughs and says, "I believe in a lot of things, but religion and the afterlife are not among them." "Well," Dr. G says, chuckling, "you'll find out before I will. Let me know." Brian smiles.

Dr. G's tone changes. "Let me tell you what will happen. You will arrive at our apartment building in the suburbs of Zurich in the morning by 10:00 AM. Do not be late. You will be greeted by two people from Dignitas. They will invite you in. You can take your time," he says.

"There will be no rushing. There is some paperwork. There are chocolates. They will give you an anti-emetic," he says, "so you will not vomit. You have up to an hour after that to make your choice about drinking the drink. If you need more time, they will administer the anti-emetic again. And, again, you will have about an hour after that to drink the drink. After you drink it, it is a little bitter," he says. And I wonder how he knows.

"After you drink it, you will fall into a light sleep, then a deep sleep. Then it will be over. Mrs. Ameche, you can sit with him for a long time." I'm glad he calls me Mrs. Ameche. I know Brian always gets a kick out of that. Brian nods attentively. Dr. G says, "At any time in this process, you may change your mind-- right now or Thursday morning. No one will be surprised or distressed. We'll all be glad for you."

I don't know why this would be. Perhaps I would be glad, too, but only if it meant the spell was broken, and my whole husband was returned to me and to himself, and these last years turned out to have been just a terrible test-- one poisoned apple after another-- to prove that my darling deserves the life he had before. Brian shakes his head. "I know what I'm doing," he says. "This is the right thing for me." Dr. G nods. "I see that," he says, "but I will keep asking."

Brian and I sit back down after he's gone. I say that Dr. G seemed nice, and Brian agrees. Brian says, "It's going OK," and I agree. We sleep side-by-side, fingertips touching.

Thursday, January 30, 2020, Zurich. The night passes, and the next morning we have a car take us to Pfaffikon, where Dignitas has its apartment or house. I couldn't really tell. It's a residential structure in an industrial park. Two nice women in nice clothes, sweaters and slacks-- I mean, I feel that an effort was made; they didn't just throw on their sweats and come over-- greet us. They have dressed for the occasion of shepherding us across the river, and they take it seriously.

I have never been treated with such seamless, attentive tact. They walk us in, up a few steps to the door-- and I see a snow-covered garden, the kind of gesture toward a garden that you'd find in an industrial park-- and into a large, odd, immaculate room. There's seating in every corner-- two small armchairs, a large pleather recliner, a pleather sofa, and a hospital bed as well. It dawns on me later that it's important that everything that can be sat on or laid down upon be washable.

In the center of the room, there's a table with several chairs. The ladies bring our paperwork to the table and point out the many bowls of chocolates. They review all of the steps, which Brian and I can now both recite. They look at him closely and say, "At any time in this process, including after you drink the anti-emetic, you can choose not to do this. We'll be very supportive of you changing your mind, rest assured." We are assured.

The only sign of reluctance on Brian's part is what he warned me about-- is making conversation before taking the sodium pentobarbital. He said to me that he thought he might be inclined to just bullshit around for a while when the time came to take it. "I know I have to go," he said. "I know I'm going. I'm ready. I'm just not going to hurry."

He doesn't hurry. He drinks the anti-emetic and gets comfortable on the couch. I sit next to him holding his hand, but I have to let it go because he's gesturing while storytelling.

The stories are all about football at Yale and his coach, Carm Cozza, and I could tell them with him-- Brian and a friend winding up in jail because of a young, dumb fight in front of the Anchor Bar and Carm Cozza, stern and forgiving, bailing them out; Brian talking about quitting football because he didn't get to play enough his first season, and Carm telling him that he, Carm, would let Brian play when Brian was good enough and not before, and Brian resolving to be good enough; Brian's father and Carm Cozza playing handball together one time, his two fathers.

I cannot manage to look interested in these stories because I'm not. Brian says nothing about his life, about our life, about our love, about the children and grandchildren, nothing about the beautiful public housing he designed and cared about so deeply, or the work he did for conservation and open spaces, or even-- and you know I must be reaching here-- about fishing. But I do try not to look like I'm in agony, which I am.

The ladies wait in the back room-- a kitchen, I think-- and after about 45 minutes, they come out again. They tell us that the anti-emetic has now worn off and if Brian wishes to continue-- "I do," he says-- he will have to take it again. They say, "You can take your time." And I roll my eyes because of course he will. He always does, I think, as if we are in some other room, on some other occasion, and then I remember where I am, and I am ashamed of myself.

Brian smiles slightly. "What time's your plane?" he says, and I have never felt so bad about being me in my entire life. He takes the anti-emetic again, and the ladies put an airplane pillow around his neck. Brian falls silent, and now I long for the football stories. I take both of his hands, and he lets me. "I love you. I love you. I love you," I say. "I love you so much." "I love you, too," he says, and he drinks the sodium pentobarbital. I kiss him all over his handsome, weary face, and he lets me.

It is impossible to think about the next 20 minutes. I keep my eyes and hands on him as if I'll forget what it is like to breathe next to him or feel his presence. I don't-- not for a minute. I hear his breathing when I go to sleep, and I feel his body heat when I wake up. He falls asleep holding my hand, and his head falls back a little on the neck pillow, whose purpose I now understand.

His breathing changes, and it's the last time I will hear him sleeping, breathing deeply and steadily, the way he has done lying beside me for almost 15 years. I hold his hand. I can still feel its weight and warmth. His skin color changes from ruddy to paler pink. I sit there and sit there as if some other thing will now happen. He is quite pale, and I see that he has gone from this world.

I sit holding his hand for a long time. I get up and wrap my arms around him and kiss his forehead, as if he is my baby, at last gone to sleep, as if he is my brave boy going on a long journey miles and miles of Nought.

There's not much else to do. The ladies would like me to go before the Swiss police come. It is simpler, they say. It doesn't feel that we have done something illegal, but I can tell that it would be better-- perhaps better for me, for Dignitas-- for me to not be around while a Swiss policeman identifies Brian's body. That's what his passport and dental records are for, as I understand it.

I call an Uber and hug the ladies. I head to the airport. In the Zurich airport, I sit in the fancy lounge, and I look around for faces, people watching. Since the moment of Brian's death, I find most people, especially men, disgusting-- not just unappealing, but disgusting, like yesterday's oatmeal, like eels in a bowl. I find heterosexual couples dismaying.

In the lounge, I feel like an alien examining pairs of earthlings. What is the meaning of that? How could a creature like that be the choice this other creature makes? How can one recognize choice in these random movements?

September 15, 2007, Durham, Connecticut. Our wedding day. My mother isn't there to see it, and that is my only grief. The last time she was in the hospital, Brian dropped me off and went to park. My mother waved me into her room and kissed me. "Is Brian coming up?" she said. When I said, "Yes," she practically pushed me off the bed and began firmly and pleasantly directing me in how best to help her-- bed jacket, comb, blush, and lipstick, please. Hairspray-- hurry, please.

By the time Brian came to her door, she was in full Greer Garson and sent me to get tea for both of them. Oh, she would have said over breakfast on our wedding day, isn't this lovely? Aren't you gorgeous? Isn't he the handsomest thing?

Friends from all pieces of our lives are there-- some neighbors who disapproved of our scandalous beginnings and come around. We had both been with other people. We didn't behave well. We fell in love and left our partners. We didn't slink out of town, and we glowed like radium.

Our minister speaks wisely and warmly, and I am delighted, but I barely listen. Brian takes my hands, and I cannot see anything except his face. He says, "I prepared some," and then he squeezes my hands tightly, and he begins to cry. "I love you so much," he says. "That's all I can say. I love you so, so much. And I will love you every day of my life." Then he says, quietly, "Your turn."

I say, "Middle-aged women are supposed to look for the safe harbor, for the port in the storm of life. We are supposed to look for the calm and the comfortable. You are the port in the storm. And you are the storm. And you are the sea. You are the rocks and the beach and the waves. You are the sunrise and the sunset and all of the light in between."

I think I have more to say, but I can't. We are holding hands, pressed against each other, holding each other up. I whisper to him, "Every day of my life." And he whispers to me, "Every day of my life."

Ira Glass

Amy Bloom. Some of the audio you heard was excerpted from the official audiobook of In Love by Amy bloom, narrated by the author, courtesy of the Penguin Random House Audio Group.

If you happen to be having thoughts of suicide, please reach out to the National Suicide Prevention Lifeline at 988 or the Crisis Text Line. For that, you text talk-- T-A-L-K-- to 741741. Coming up-- jokes that are not entirely jokes that a mother tells about her daughter. That's in a minute from Chicago Public Radio when our program continues.

Ira Glass

It's This American Life. I'm Ira Glass. Today's program-- "Ends of the Earth," stories about the very upper limits of what you do for somebody you love, of people going way further than you usually see for their family members. We have arrived at Act Two of our program-- Act Two, Comedy Duo.

Zoya is in college, but she and her mom, Zarna, are really, really close, talking and texting every day about the most mundane stuff, like what they're eating for lunch. But they deal with the big stuff too.

Ira Glass

But ever since Zoya went away to college-- 3,000 miles from her mom-- they've been fighting more than ever, mainly because at her school, Stanford University, for the first time, Zoya realized that kids her age, her peers, were making decisions, even big ones, without consulting their moms.

Ira Glass

If Zoya could make her own choices at college without her mom-- well, she loves the arts, painting, writing. An essay of hers was published in The New York Times. Her mom, Zarna, is like, sure, a little of that.

I don't know. Maybe the quality of that joke tips you off. Zarna is a stand-up comedian-- Zarna Garg, kind of a rising star right now. She just filmed her first comedy special. She's huge on TikTok, plays the rooms in New York City that the most famous headliners do. And what makes her act so unusual is that it is happily, almost giddily, from her point of view as an immigrant mom born in India. Here she is telling an audience about something she truly did not know about college in America till Zoya got to Stanford.

Ira Glass

She tells the audience about the fun non-computer class that her daughter wanted to take at Stanford.

Ira Glass

Zarna's entire act is this tricky thing of embracing every stereotype of the immigrant Indian mom while also kind of-- I don't know-- winking at the audience like, I know this is over the top. I know how funny this is. She does this bit about telling Zoya not to become friends with kids at Stanford who might pull her down the wrong path.

Ira Glass

OK. So this is both a joke, and it really happened. At a cafe one day, she told Zoya the kinds of majors that she might look for when she makes friends at school.

Ira Glass

So her mom is joking on stage, and it's real. To get where her mom Zarna is coming from on all this, some background-- probably the pivotal moment in Zarna's life was when she was 14, back in India. Her mom died. And this completely crushed her dad. Zarna was the youngest of four kids, and he didn't want to keep raising one last child. He wanted to get her married off as soon as possible.

Ira Glass

She said no to marriage. Her dad kicked her out, and she had to make her own way in the world. She remembers standing out in the rain in front of the US embassy, who would not accept her paperwork to come here. She finally made it here, got a law degree, placed an ad to find exactly the kind of husband she wanted, which is a whole other story.

And since then, she has devoted herself completely to her three kids to get them to a life that is safe and secure and very unlike her own teenage life. Zoya is the oldest, the pilot project. And for Zoya, this has meant just years of math camps and tutoring every summer and volunteer jobs that her mom arranged and after-school activities-- all, you know, to get her into a good college and, ultimately, a safe, comfortable job in tech or engineering or maybe medicine, which went great when Zoya was at home in high school.

But now, at Stanford, threats to this plan are just everywhere. One of the biggest threats-- this American idea that at college, kids should explore, take the classes they enjoy, find what makes them happy.

Ira Glass

Again, she delivers it like a punch line. It's totally over the top, but, also, she's not kidding.

Ira Glass

100% is something Zarna says to a bunch of my questions. Does she know what's best for her family?

Ira Glass

Does she think her children would thank her one day for forcing the hard decisions for their lives that they might not like just now?

Ira Glass

So with this in mind, Zarna is still trying to control Zoya's life from the other side of the country to a remarkable extent. Like, for instance, she texts the RA in Zoya's dorm to check on Zoya's room, to make sure she's working. She has various people that she knows or just meets call Zoya to give encouraging pep talks about how great a life in computers or medicine is going to be.

She consults with Zoya on pretty much every aspect of her life. This impulse to control her daughter is so instinctive and thorough that, after I interviewed Zarna, Zarna called Zoya, who I hadn't interviewed just yet, with instructions on what to say to me.

Ira Glass

Clearly, somebody is not sticking with the plan. But since she arrived at Stanford, Zoya has been pushing back on her mom more than she ever has. And the biggest thing they disagree about, the most serious battlefront in this war over how much control Zarna gets over Zoya's life, is what classes Zoya should take. When I asked Zoya, "Was your mom's voice in your head when you were picking your classes?" Her answer showed just how much her mom's voice is in her head.

Ira Glass

In fact, last year, when Zoya was a freshman, her mom did something very unusual for a Stanford parent. She sat in on Zoya's Zoom meetings with her academic advisor, mostly lurking off camera and making her wishes known to Zoya but sometimes speaking up. Zoya remembers one call, for instance, with an advisor.

Ira Glass

And to be clear, she doesn't think her mom is entirely wrong. When her mom says, "I'm paying for this. Why shouldn't I get to pick your courses?" Part of Zoya thinks, yeah, why should she be spending her mom's money to take an English class her mom doesn't like? Isn't that selfish of her?

But to show you just how messy and complicated all this is between them, I need to tell you this next story. Zoya knows her mom so well and is such a forceful, forward-looking kid, that Zoya is the reason that her mom, Zarna, became a stand-up comedian at all.

Four years ago, when she was 16, Zoya saw how unhappy her mom was. She had trained to be a lawyer but didn't like it and stopped when she had her kids. She'd been home raising the kids for years. Here's Zarna.

Ira Glass

So it took her all those months to convince her mom that she should do what she loved. And now it is not lost on Zoya that this is exactly what she's asking her mom to let her do at college.

Ira Glass

When I ask her mom about this, she says that it is different for her than for Zoya. When she started as a comedian, the family was financially secure. They were fine. Zoya doesn't have that, in her mom's view. She needs to invent a life for herself, where she's supporting herself. And some humanities degree-- a job as a writer, a job in the arts--

Ira Glass

It's just hard for her to put that feeling aside, given her past. What can I say? From my experience with my parents, who grew up without money and fought their way to professional jobs in the middle class, I'm really not sure there's anything that Zoya can say to Zarna, or Zarna to Zoya, to convince each other. It's almost like the parents did too good a job creating a safe life for Zoya. And now she's not scared the way they are about how badly things could go.

Ira Glass

And so Zarna doesn't trust Zoya to pick her own future.

Ira Glass

I ran that by Zoya.

Ira Glass

Zoya said that hearing that it took my mom till I was 41 years old to fully accept what I've done with my life made her heart hurt. She doesn't want to wait that long.

Ira Glass

Well, today's show was produced by Diane Wu. Elna Baker produced Act Two. Original music for Act One, Amy Bloom's story, by Found Objects and Jay Lifton. Music supervision by Karl Westman and Raife Burchell at Dirty Soup, and Stowe Nelson.

The people who put our show together today include Michael Comite, Andrea López Cruzado, Cassie Howley, Chana Joffe-Walt, Valerie Kipnis, Katherine Rae Mondo, Nadia Reiman, Ryan Rumery, Alissa Shipp, Christopher Swetala, and Matt Tierney. Our managing editor is Sarah Abdurrahman. Our senior editor is David Kestenbaum. Our executive editor is Emanuele Berry.

It's our production fellow's last week with us. Michelle Navarro, this has been so lovely. You are such a good writer. We all hope to have you on the air here again. Special thanks today to Brett Wean, to Dr. Charles DeCarli, and Andrew Francis.

Our website-- ThisAmericanLife.org, where you can stream our archive of over 750 episodes for absolutely free. Also, there's tons of other stuff there too-- links to our television show-- you know, we have a television show-- videos, favorites lists-- again, ThisAmericanLife.org.

This American Life is delivered to public radio stations by PRX, the Public Radio Exchange. Thanks as always to our program's co-founder Mr. Torey Malatia. You know, he still remembers the day, back when he was a little boy years ago, when he wrote down the word "hug," and then he added the letter "E" to the end. He was stunned by his creation.

Ira Glass

I'm Ira Glass, back next week with more stories of This American Life.

[MUSIC - DENROY MORGAN, "I'LL DO ANYTHING FOR YOU"]