There are, as I write, renewed efforts to introduce legislation in Victoria that would allow assisted suicide, but I don’t suppose that Steven Amsterdam or his publishers knew when they signed their contracts just how topical this book was going to be. The Easy Way Out is a confronting exploration of what assisted suicide might mean for anyone involved. The title is ironic: in the world created by Amsterdam, even though assisted suicide is legal, there is no easy way out…
Narrated with a kind of sardonic intimacy as if Amsterdam is not going to indulge any sentimental views about death, the novel traces a trajectory as Evan, a nurse who has chosen work as a suicide assistant, tests the boundaries of the law. Working in the confines of the Mercy hospital where every ‘assist’ is monitored and documented and scrutinised afterwards, Evan finds it hard to stay as detached as he is supposed to. Families don’t always follow the script, and the ‘simple’ act of drinking a cup of Nembutal isn’t always so simple for someone with muscles that don’t obey any more. And it’s not just that procedures don’t allow for human frailty, there’s also the psychological impact on Evan to consider. He doesn’t tell people what he does because not everyone shares his view that he is helping people to die a good death. Crucially, he doesn’t tell his lovers Lon and Simon.
Evan is gay, and Amsterdam has chosen to eschew any cosy domesticity which might offer support for Evan by setting up his relationship with these two men as a physical relationship only. (There’s a fair bit of gay sex in the novel). It’s not a case of three’s a crowd, because Lon and Simon would like to have a deeper bond with Evan, but he remains aloof. Indeed, Evan is in what looks like a lonely place: his own father committed suicide when he was a boy, and his mother, Viv, has built barriers around herself to prevent any intimacy developing. When Evan was twelve, she disappeared for a weekend, without telling him where she was, so that he would learn to enjoy independence, and that’s her style. She’s not into mothering, and when she herself develops a terminal disease, she expects Evan to take care of her as unsentimentally as he takes care of other people in the same situation.
Only it’s not that easy, of course.
Amsterdam is a palliative care nurse, so there’s authenticity about the situations he describes, and what he forces the reader to confront is that this issue is not that simple when you’re at the coal face. I think most people fear not death, but the process of dying, and many of us who have seen suffering would like to see reform that allows people to have death with dignity. But Amsterdam isn’t about to let us avoid the reality: in a legal situation, the most intimate private moment of his characters’ lives are witnessed by someone who is required to follow procedures and to stay out of it. Someone who begins to count in his head the number of times the loved ones say ‘I love you’ and who treats the end of life as routine. Someone more conscious of the TV monitor watching his every move than he is of the existential significance of the moment.
In the case of people who take matters into their own hands, there is the unsentimental matter of deliberately choosing who finds the body. One sets things up so that motel staff will discover it and the assumption is that they see plenty of death so it won’t affect them. Another performs a last macabre act of revenge by ensuring that it’s her mother who will find her. And just when the reader thinks that Evan has mastered the art of total detachment he confronts a suicide that was not performed as he expected and is horrified. Sometimes, this is a very difficult book to read.
Does Amsterdam have an agenda? I think he does. Smart, funny, compassionate Evan has to tussle with his conscience about the essential issue. When and how is it ok to assist someone to die? And whose choice is it, really, and the moment when it counts?
I take the cup of Nembutal to her bedside, put the straw in it, and hold it close to her, slipping a hand behind her warm back so she can sit up. The touch of my hand starts her purring louder again.
The cup is in front of her face. The straw is just out of the reach of her mouth. ‘[…]. This is Nembutal. If you drink it, your heart will stop and you will die. Is this what you want?’
She stops, jerks her hand up to her face, pokes her fingers against her cheek.
‘The choice is yours.’
I give her back a squeeze to keep her up in a drinking position. This starts her going again. It doesn’t matter that it’s not a massage. The touch is enough. The corners of her mouth even hint at a smile.
‘The choice is mine then’. (p.262)
Author: Steven Amsterdam
Title: The Easy Way Out
Publisher: Hachette, 2016
Review copy courtesy of Hachette.
Available from Fishpond: The Easy Way Out and good bookstores everywhere.