Euthanasia debate becomes personal for Nikki Gemmell after mother's 'lonely death'

Updated March 20, 2017 08:21:34

Nikki Gemmell says her mother never left a note explaining her suicide. Video: Nikki Gemmell says her mother never left a note explaining her suicide. (ABC News)

Nikki Gemmell found it hard to listen to her elderly mother when she talked about euthanasia as a way out of her debilitating chronic pain.

"Don't you want to see the grandkids grow up?" Nikki would cry.

As she told Australian Story, she wanted her four children to grow into adulthood with their beautiful, fabulous Nonna — an empowered, independent grandmother who took them to shows and arrived with beautifully decorated cupcakes on their birthday.

Nikki knew her mum Elayn was in pain after a failed foot operation ended up causing leg and back pain. She suspected an opioid addiction was making her feel even more desperate. But nothing prepared her for the police on her doorstep one morning in October 2015.

"Mum had sat down on her favourite chair in front of the TV and ate pills like lollies and drank Baileys Irish Cream until she fell asleep," revealed Nikki's brother Paul Gemmell.

Blindsided by shock and grief, Nikki was aware that the police officers in her kitchen that day were also taking notes. Had she known about her mother's plan? Had she helped her in some way?

It suddenly dawned on Nikki that they were fishing to see if she had helped her mother to die.

Desperate for answers, Nikki and Paul searched their mother's apartment. Had she left a note with some explanation, some last expression of love? Was it an accidental overdose or a deliberate act? Were those clothes hanging on the door a suggestion for a burial outfit?

There was the trauma of identifying her cold body in the morgue the next day. The anxious wait for the results of the autopsy. The exhaustion of calling up her friends to break the news. Had Elayn talked to anyone of her plans?

But there was no note. No last expression of love.

And the autopsy would reveal Elayn died from multi-drug toxicity. In other words, an overdose.

"Mum's death was horrifically lonely and bleak because she couldn't tell anyone what she was going to do for fear of implicating her family and friends, so she did it entirely alone," Nikki said.

Nikki Gemmell's wonders why her mother never acted on a referral to a pain management specialist. Video: Nikki Gemmell's wonders why her mother never acted on a referral to a pain management specialist. (ABC News)

Empowerment or despair? Exploring the euthanasia debate

Like a detective, Nikki set out to piece together her mother's last months, days and hours. A prolific writer, she began to also explore the often tempestuous and difficult relationship that had dogged her life in a book about her mother's life and death.

"Mum was the love of my life and the hate of my life. When we were good, we were very, very good. When we were bad, we were horrid. We both knew how to hurt each other," Nikki said.

"If I had just one minute with her again, just a minute, I would just tell her, 'Mum, you were magnificent, you were so magnificent and I love you so much'.

"I feel like I never told her that in my life."

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Elayn's death sent Nikki down the rabbit hole of the euthanasia debate, examining the issues around elderly suicide and assisted dying.

"I just wish I'd listened to Mum rationally. I wish I'd had a very calm conversation with her about what she really wanted to do in terms of the end of her life without me getting emotional, without me talking about the grandkids," Nikki said.

"I wish I had been there for her, in a way that I just wasn't."

As a columnist for The Australian, Nikki went public about her mother's suicide, asking her readers if her mother's final act was one of empowerment or despair.

Nikki's experience and time spent researching the euthanasia debate has made her a passionate advocate for change. She is watching with interest as Victorian Premier Daniel Andrews plans to introduce a bill supporting assisted dying into Parliament later this year.

If these laws are passed, they would be the first in Australia to legalise euthanasia since the Northern Territory's laws were overturned by the Federal Government in the 1990s.

"Because there is no law, it's this awful Catch-22 situation," Nikki said.

"Maybe you want to tell your family your plans to take your life to save them from all the trauma and the shock. But if you do implicate them, they can be charged. So we condemn these people who want to die, to this bleak and lonely death without anyone around them."

The 'mental tension' of dealing with chronic pain

Elayn's chronic pain began with an injury to her foot. Video: Elayn's chronic pain began with an injury to her foot. (ABC News)

Someone reached out to Nikki after her column and changed her life.

Helena (not her real name) is a doctor specialising in addiction and recovery and a mother of four adult children.

Twenty-three years ago, a viral infection led to a rare form of arthritis. She has been living with chronic pain ever since.

She reached out to Nikki to help her understand the nature of chronic pain and why her mother may have felt that taking her life was the only way out of her predicament.

"There's always been cases like Elayn, but if quick easy access to … pain management options were available and, alternatively, if carefully considered access to the option of assisted suicide or voluntary euthanasia was available, I would hope that a death like Elayn's would become far less common than it is," she said.

Despite her medical knowledge, Helena struggles daily against the temptation to abuse pain medication. She has watched her life become slowly reduced and says she can't live like this for much longer.

"The amount of mental tension it takes just to keep it under control is just absolutely extreme and you've got to fight against it becoming the central aspect of your life all the time," she said.

"Opiates are fantastic, they make you feel good and they make your pain better, it's a daily struggle against abusing them."

Pain specialist Professor Paul Glare said euthanasia was "never justified" in a patient with chronic pain.

"If Nikki's mother had have come here, she would have been seen by a doctor, a physiotherapist and a psychologist," he said.

"We make our assessments and then we combine them to come up with an integrated plan to offer her."

'If only we could have been there to hold her hand'

Although Helena would recommend and has been treated herself at pain clinics, she said the pain has finally become too difficult to bear.

"For the last five years I've been planning how and when I'm going to end my life," Helena said.

A year ago she gathered her children together and informed them that this would be their last year together. She withdrew some of her superannuation and took each of them on overseas adventures.

She said she plans to take her own life.

But it will not be a shock to her loved ones the way Elayn's death was to Nikki and her family. With her children and a friend, Helena plans to travel to Switzerland, to the accompanied dying facility Dignitas and be helped to die .

Helena's story is a counterpoint to the lonely isolated death Nikki's mother Elayn had endured, unable to tell anyone of her plans for fear of implicating them in her death.

"If only we we could have been there, if only we could have held her hand. It could have been so different if we could have just surrounded her with love."

Watch 'My Mother's Secret' on Australian Story 8:00pm ABC TV and ABC iview.

Topics: euthanasia, suicide, older-people, diseases-and-disorders, family, drugs-and-substance-abuse, australia

First posted March 20, 2017 06:02:15