Tuesday, October 16, 2018

Married for 66 years and terminally ill, they chose the day and died together. Their video explains.

On the last morning of their lives, Charlie and Francie Emerick held hands.

The Portland, Ore., couple, married for 66 years and both terminally ill, died together in their bed on April 20, 2017, after taking lethal doses of medication obtained under the stateís Death With Dignity law.

Francie, 88, went first, within 15 minutes, a testament to the state of her badly weakened heart. Charlie, 87, a respected ear, nose and throat physician, died an hour later, ending a long struggle that included prostate cancer and Parkinsonís disease diagnosed in 2012.

"They had no regrets, no unfinished business," said Sher Safran, 62, one of the pairís three grown daughters. "It felt like their time, and it meant so much to know they were together."

In the two decades since Oregon became the first state to legalize medical aid-in-dying, more than 1,300 people have died there after obtaining lethal prescriptions. The Emericks were among 143 people to do so in 2017, and they appear to be the only couple to ever take the drugs together, at the same time, officials said.

The pair, early members of the 1980s-era Hemlock Society, had supported the choice for years, and, when their illnesses worsened, they were grateful to have the option for themselves, family members said.

"This had always been their intention," said daughter Jerilyn Marler, 66, who was the coupleís primary caretaker in recent years. "If there was a way they could manage their own deaths, they would do it."

Before they died, the Emericks agreed to allow Safran and her husband, Rob Safran, 62, founders of the Share Wisdom TV Network, of Kirkland, Wash., to record their final days and hours. At first, the video was intended just for family, but then Safran asked her parents for permission to share it publicly.

SEE THE VIDEO: "At this point, itís rather exciting wondering what will we find on the other side."

"I think it can help change the way people think about dying," she said.

The result is Living & Dying: A Love Story, a 45-minute documentary that details the background of the Emericksí final decision and their resolve in carrying it out.

Shot mostly with handheld smartphones, the video captures the intimate moments of the coupleís preparations in their last week of life.

Charlie Emerick was a former medical missionary in India and chief of ENT at a Portland-area Kaiser Permanente hospital. (Kaiser Health News is not affiliated with Kaiser Permanente.) He was diagnosed with Parkinsonís disease in 2012, after dealing with symptoms of the disease for years. He suffered from prostate cancer and heart problems and learned in early 2017 that he had six months or less to live. In the documentary, he described his thoughts as he pondered whether to use aid-in-dying.

"You keep going, Charlie, youíre going to get worse and worse and worse," he explained to Sher Safran, in a quavering voice. "The other canít be worse than this."

Francie Emerick, who handled marketing and public relations for the hospital in India, appears vital and articulate in the video. Her daughters, however, say that her energy was fleeting and that it masked years of decline following multiple heart attacks and cancer.

ALSO TRENDING TODAY: Hillsboroughís homeless dead: Who were they? And how did they fall so far?

In the video, Francie acknowledged that she could have survived a bit longer than her husband. But, she said, she didnít want to.

"Charlie and I have a rather unique relationship in that we have done and been so much to each other for 70 years," she said.

The pair carefully followed the specifics of the law, which requires examinations by two different doctors to determine a prognosis of six months or less to live, multiple confirmations of intent and the ability of patients to ingest the lethal drugs themselves. The process takes a minimum of 15 days.

"We do want it to be legal," Francie said.

The video traces the arc of the coupleís lives. The Emericks met as college students in Nebraska, married on April 4, 1951, and spent years in the 1960s as medical missionaries in Miraj, India. Dr. Emerickís career took them to Southern California and then to Washington state, to India and ultimately to Oregon, all while raising three girls. In 2004, they moved into an apartment in a retirement community in Portland.

Thatís where the Emericks died on a cloudy Thursday last spring, six days after a family celebration that included their children and grandchildren ó and, at Francieís request, root beer floats. The gathering was happy, but bittersweet, family members said.

"There were moments that they expressed great sadness at the goodbye that was coming," Marler recalled.

The Emericks sought help from Linda Jensen, a veteran team leader with End of Life Choices Oregon, a nonprofit agency that supports people seeking to use the stateís Death With Dignity law.

"They were pretty well informed," said Jensen, who has assisted with dozens of deaths in 13 years. "What they wanted to understand was what a planned death really looks like."

The video includes a meeting between Jensen and the Emericks two days before they died. It would be nothing like dying on TV, she told them.

"You do not lose control of your bowel or bladder. You do not gasp for breath," she explained. Instead, she said, they would simply go to sleep.

The Emericks went over the plan: no breakfast, just pills to calm their stomachs at 9 a.m., followed by the lethal drugs an hour later.

Safran and Marler appear calm and determined as they help finalize their parentsí arrangements.

"There was a lot of grieving ahead of time because we knew it was coming," Marler said.

Some members of the family disagreed with the coupleís decision, but the Emericks were determined.

"You two have never wavered?" Safran asked her mom.

"We have not," Francie replied.

The video captured details of the final morning: Charlie saluting the camera farewell as heís wheeled down the hall, Safranís tearful last hug from her mother, Charlie and Francie clasping hands after they swallow the drugs.

"It just takes such a huge amount of internal strength and self-knowing to face that choice, to make that choice and then bring along all the people that love you and are going to miss you," Jensen said.

There was no funeral after the deaths. The Emericks had donated their bodies for research through a program at the Oregon Health & Science University and any remains wouldnít typically be returned for two or three years, a spokeswoman said.

In the interim, the video has become comforting and precious to the family, said Safran.

"Itís very lovely, just to hear their voices," she said.

The documentary also serves a larger purpose: helping others to understand how aid-in-dying works, she said.

Carol Knowles, 70, was a member of Francie Emerickís book club. The Emericks didnít tell other residents about their plans. Knowles said she was surprised when they died the same day ó until she saw the documentary.

TO YOUR HEALTH: Keep track of trends and new developments that affect you. Visit the Times health page.

"I thought it was brave and beautiful," she said. "You could see the care with which Charlie and Francie had made that decision."

Another member of the group expressed concern, however, saying her religion prohibited any efforts to hasten death. Knowles said she plans to take the documentary to the retirement centerís social worker before showing it more widely.

"We want to do it in a way that will not scare them or make them feel uncomfortable," she said.

Stephen Drake, research analyst for the disability rights group Not Dead Yet, had serious reservations about making the video public. He worried that presenting aid-in-dying in a positive light "changes the expectations; this romanticizes the idea of not just suicide, but a double suicide," Drake said.

Safran said she expects strong reactions ó including criticism ó for chronicling her parentsí final days. But she said the documentary honors the Emericksí belief that, if possible, everyone should have a say in when and how they die.

"We have a faith that says life is not to be worshipped," Francie said. "Itís the quality of life that counts."


KHNís coverage of these topics is supported by John A. Hartford Foundation and The SCAN Foundation. Contact JoNel Aleccia at [email protected], follow @JoNel_Aleccia.

Drugmakers to disclose prices for medicines advertised on TV

Drugmakers to disclose prices for medicines advertised on TV

TRENTON, N.J. ó Dozens of drugmakers will start disclosing the prices for U.S. prescription drugs advertised on TV. The prices wonít actually be shown in the TV commercials but the advertisement will include a website where the list price will be pos...
Published: 10/15/18
The Times 2019 Medicare Guide

The Times 2019 Medicare Guide

It has four main parts, labeled A, B, C and D. But after that, the rules can be wickedly complex. Nearly 60 million people are using it right now. And with an estimated 10,000 people reaching age 65 each day in the U.S., that number is growing fast.S...
Published: 10/15/18
Medicare opens enrollment for 2019 with insurers focused on keeping you out of the hospital

Medicare opens enrollment for 2019 with insurers focused on keeping you out of the hospital

The annual Medicare open enrollment period kicks off today, and the news is generally good for nearly 4.4 million Floridians who rely on the program. Premiums are expected to stay roughly the same in 2019, and many plans are offering expanded perks a...
Published: 10/15/18
Nurses at HCA hospitals reach contract agreement

Nurses at HCA hospitals reach contract agreement

Registered nurses from 15 hospitals in Florida owned by the national chain, Hospital Corporation of America, have reached tentative agreements on union contract negotiations. Nurses across Florida and several other states have been picketing, and rec...
Published: 10/12/18
Tampa joins growing wave of legal actions against makers and distributors of opioids

Tampa joins growing wave of legal actions against makers and distributors of opioids

TAMPA óTampa is the latest bay area government to take legal action against opioid manufacturers and distributors, charging they knowingly marketed and sold dangerous painkillers like Oxycontin, Percocet and Dilaudid."As shown below, all defendants c...
Published: 10/12/18
Breast cancer awareness: From mammograms (2-D and 3-D) and MRIs to risk factors, hereís what you should know

Breast cancer awareness: From mammograms (2-D and 3-D) and MRIs to risk factors, hereís what you should know

Jenna Johnson expects to reach a major milestone next month: five years cancer free following a diagnosis of breast cancer.The now 56-year-old executive assistant and office manager was diagnosed in November 2013, after reporting a few months late fo...
Published: 10/12/18
For many millennials, reliance on the family doctor is fading away

For many millennials, reliance on the family doctor is fading away

Calvin Brown doesnít have a primary care doctor ó and the peripatetic 23-year-old doesnít want one.Since his graduation last year from the University of San Diego, Brown has held a series of jobs that have taken him to several California cities. "As ...
Published: 10/10/18
HPV vaccine expanded for people ages 27 to 45

HPV vaccine expanded for people ages 27 to 45

The HPV vaccine, which prevents cervical cancer and other malignancies, is now approved for men and women from 27 to 45-years-old, the Food and Drug Administration said on Friday.The vaccine is Gardasil 9, made by Merck, and had been previously appro...
Published: 10/08/18
When hospice patients die, their unused opioids can be stolen. A new bill aims to stop that.

When hospice patients die, their unused opioids can be stolen. A new bill aims to stop that.

Hospice workers would be allowed to destroy patientsí unneeded opioids, reducing the risk that families misuse them, according to one little-noticed provision in the bipartisan opioids bill headed to President Donald Trumpís desk for his likely signa...
Published: 10/08/18
How one artistís heart, stilled by a fatal blow, saved another oneís life

How one artistís heart, stilled by a fatal blow, saved another oneís life

TAMPA ó The sound was faint at first, but adjusting the stethoscope helped Erika Callahan detect the thumping of a familiar heart.Closing her eyes, Callahan pretended that the sound also was coming from the same chest where she had laid her head coun...
Published: 10/07/18
Updated: 10/09/18