New FEN Coordinator (An Update)

(Jim Van Buskirk is a long-time advocate for the right to die on one’s own terms, exit guide, coordinator, and speaker with Final Exit Network.)

My involvement with Final Exit Network (FEN) has been both a slippery slope and crash course. It  started when a regular attendee of the Death Café I had been co-facilitating for several years invited me to witness her exit. I barely knew about the organization, but was mightily impressed with the expertise and patience of the guides. I immediately came home and joined. After an article I wrote about my experience wound up on the cover of the Winter 2018 FEN newsletter, the warm response was gratifying. Apparently folks requested multiple copies, and I sent it to my friends and colleagues in an effort to increase awareness of FEN’s services.

In the midst of attention, I contacted the lead coordinator, Ann Mandelstamm, with whom I began communicating regularly. At one point Ann invited me to consider coming on board as a regional coordinator. We met briefly in my backyard garden while she was in the bay area visiting family. Armed with a notebook filled with forms and guidelines and everything I’d need to know, she encouraged me to give it a try. I realized the only way to determine whether this was a good fit was to get my feet wet. I agreed to start by taking over Texas, Colorado, New Mexico, and Arizona, with the caveat that I could bail at any point.

I was barely in the proverbial saddle when the messages started coming in. Several all at once. Before returning calls I wanted to have enough time to hear the prospective client’s story completely and to explain FEN services. Suddenly my schedule, which had felt fairly flexible, was full of demands.  So of course, whenever I’d set aside 45 minutes to phone a client, I only reached their answering machine. Initially I was overwhelmed by the combination of time management, discretion (to the point of paranoia) and the heartbreaking stories I heard. I relied on Ann’s support and encouragement. Over the course of many phone calls and emails, her humor and pragmatism was wonderfully grounding. “Lordy, Lordy.  Arizona hasn’t been so busy in months. Someone must have heard there is a new sheriff in town!”

In the first two days I spoke with a 19-year old in Arizona with many ailments and no support system. Then with a 42-year-old fellow in Colorado, whose fortitude in recounting his heartbreaking situation had me in tears when I hung up. A retired pharmacist in Colorado called on behalf of his best friend’s wife suffering in the final stages of ALS.

A few days later, a 92-year-old veteran sought support in Arizona. At the end of the call her daughter expressed her appreciation, saying she could see from her mother’s face how much more comfortable she was having gathered this preliminary information about FEN’s services. After the challenges of dealing with these disparate (and desperate) people, I could see the benefit in helping folks who have left such little hope. I was concerned that I was saying the right thing, and that the folks on the other end of the line were who they said they were. Knowing about FEN’s previous legal problems, I certainly didn’t want to be the target, or cause of, any further entanglements.

I was so green, I had to double check with Ann to make sure to whom prospective clients sent their applications. Colorado mailed his personal letter and medical records to me forthwith and suddenly “Not only are you getting your feet wet, but I am betting you are damp up to your knees!!” Ann generously offered to act as the interviewer, which simplified the next step in the process. I can’t emphasize enough her kindness and compassion, for this neophyte and for the prospective clients. When I read Ann’s report, I wept again. She’d captured beautifully his untenable condition.  Ann walked me through the steps of assembling his case file, which I successfully sent to the chair of the Medical Evaluation Committee (MEC), using a new encrypted email account acquired specifically for this purpose. Success is sweet and sad in this situation, empathy as much a liability as anything else.

In the midst of all this came a message from a member who was having trouble with the online procedure of having her employer match her membership dues. Since Ann was my go-to gal, she forwarded my query to Julia, who called to tell me how she’d sorted out the situation. We had a long, convivial conversation, reinforcing my growing suspicion that FENers are a rare and brilliant breed.

Shortly thereafter, I went through the same procedure with the woman in Arizona. I didn’t realize how time-consuming it would be to assemble the personal letter, the medical records, and the interviewer’s report, then scan them for the MEC, meanwhile keeping the client apprised of each step. Eventually her case was accepted for Senior Guide assignment as well. In my first few weeks I had successfully shepherded two appreciative clients through the process. It was a challenging “trial by fire,” and fortunately the pace diminished, a little. Only now, months later, do I recognize a confidence and comfort level as I educate clients on their options, involving FEN services. I am connecting immediately and intensely with people I would otherwise never encounter. Their profound gratitude for the work we FEN volunteers do makes it all wonderfully rewarding.

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The above was originally published in FEN’s Fall 2019 newsletter. Now — three and a half years later — I have the opportunity to revisit my coordinator role. Not much has changed, really, having survived my intense initiation. I have gotten much more comfortable with explaining the various options. Ann and I estimate that approximately 85% of the callers we never hear from again, despite my emphasizing that they should feel free to call me if I can offer any additional support. They are all extremely grateful for an empathetic ear and have sustained some solace by understanding their options. I have expedited many more applications, most of which have been approved by the MEC. I am happy to report that I continue to find this position extremely rewarding, and am delighted to have become friends with Ann and with Carol, former head of the MEC. When a friend once confessed, “Jim, I don’t think I could do what you’re doing,” I immediately blurted, “I don’t think I could not do what I’m doing!” And I realize I am composing this coda in the very same spot on the patio where Ann and I first met years ago.