Great title. Is there ever an easy way out – and when there seems to be the case, who really pays for it? This is a book by a gay man (US born) resident in Australia who is a part-time palliative care nurse. No surprise, then, that the book focuses on the twin issues of dementia and assisted dying – hot button issues for most ages but certainly for my age group of 75. It doesn’t sound too promising as entertainment but there are lots of sly wry comments and insights about these issues when seen from those most intimately involved – even flashes of humour. I genuinely found this a ’hard to put down’ read though a little slow to develop initially. It really is very thought provoking from the view point of those directly involved in care and decision making as well as those who are more peripheral.
Amsterdam has two other works to his credit which display an interest in ‘what if?’ themes. In this instance he imagines a situation where assisted death has been recently approved and initial attempts are being organised to regularise a systematic, safe and supportive process in a care context. There is a parallel shadowy organisation (Jaspers) doing the same thing in other external contexts not for a fee but for a voluntary (?) consideration. Both use similar processes (an anti-emetic followed by Nembutal (pentobarbital)) to achieve a hopefully calm ending to life.
The problems of each are examined in the context of the story line in which Evan, a youngish nurse who seems generally competent, thoughtful and helpful is being trained as an assistant who ensures that the final stage is carried out in accordance with law and determined procedures. He is also dealing with a mother who is sliding into some form of Parkinson’s and/or dementia and is at the slippery stage of determining whether nursing home care in all its forms is appropriate (the charming and ever-efficient Willow Wood in this instance). This is something that many of us have had to experience or are going to have to, at some stage of our lives. Liv, the mother, is very well drawn indeed with all the variability, difficulties and moments of insight that one has to expect in this situation (she can support her herself with a mean hand at poker). Amsterdam once again plays the ‘what if’ by introducing an experimental medical intervention which might (and does) at least temporarily spectacularly reverse her symptomology.
If that wasn’t enough, Evan is a gay man who has played the game but has now found himself falling into a ‘throuple’ with very definite benefits. Amsterdam handles the sex scenes quite capably without, I would think, turning straight readers off – they might even be interested and intrigued! The reader senses his growing emotional attachment to Lon and Simon and theirs to him. This is another layer of his existence with which he needs to come to some kind of terms. His homosexuality in no way dominates the story line but remains an essential part of his thinking and developmental process.
Needless to say, there are problems that arise and take the storyline in unexpected directions leading to a part resolution for Evan (you make up your own mind). I must say I appreciated the ‘scenery’ along the way. We are exposed to several deaths and the persons involved are well sketched so that we understand well their motivations, even when they are covert, and how they experience their final moments. In a world of hospitalisation it has become increasingly less likely that individuals experience death close-up and has probably contributed to a kind of dissociation in many of our minds. This book does an excellent service of intriguing and entertaining the reader while bringing them into contact with many of the issues about which it is useful to acquaint ourselves before decision time arrives for us.