October 10, 2003, 9:02 a.m.
Pre-Mortuarial Medicine

The last few weeks, there have been a bunch of stories in the EuroPress about the talented Mr. Death — his charm, his empathy, his sense of mercy. Some of them have made me think of poor Jean-Dominique Bauby. You may remember him; many certainly do. He was the editor-in-chief of the French edition of Elle who suffered a stroke in December 1995 and woke up three weeks later unable to move a single muscle, save one. His only means of communication was to wink his left eyelid. That, my friends, is an ironic literary device if ever there was one. So he wrote a book — English title: The Diving Bell and the Butterfly: A Memoir of Life in Death — blinking it out a letter at a time, from his hospital bed. As he wrote, trapped in a motionless body, he realized that even if all he had to work with was the flutter of an eyelid, "There is so much to do. You can wander off in space or in time, set out for Tierra del Fuego or for King Midas's court. You can visit the woman you love, slide down beside her and stroke her still-sleeping face. You can build castles in Spain, steal the Golden Fleece, discover Atlantis, realize your childhood dreams and adult ambitions." The book was published in 1997. Two days later, Bauby died. But his astonishing book continues to give cheer to those who face life's ultimately impossible odds.

Bauby lived his last months looking at the ceiling of room 119 in a grand asile maritime built in 1869 by Napoleon III's wife, the Empress Eugénie, in Berck-sur-Mer, a chilly and channel-facing fishing village. The empress's new hospital was intended to give care to old fishermen and a few widows of the sea. They certainly needed the shelter; although a home to sailors for much of its history, Berck has never had a harbor, at least until they opened the hospital. When they did, the old men and women moved in and spent their days sadly watching younger men empty their nets onto the broad beach below.

Now, the doctor in charge of the institution was a kindly gent, a friend to the town's more creative types. He liked his patients a great deal — admired them, even — and thought it might boost morale a bit to have a painter come in from time to time and make pictures for the amusement of them all. So he persuaded a local artist, the remarkable Francis Tattegrain, to come for a visit, meet some of the old folk and see what he thought might be possible.

Tattegrain took one look at the faces that had been baked for a lifetime in the stiff, salt air, quickly set up his easel and soon began making small portraits of the hospital's elderly inmates, some of whom no doubt preceded Jean-Dominique Bauby in room 119. The result: a remarkable series of canvases, all the same size — small, maybe 6x9 or less — with the name of the sitter and a few notes, such as a nickname or a pithy quote, scribbled across the top of each. It was a project that took him to the end of his life, in 1915, and beyond: His friend and fellow Berckois, Charles Roussel, picked up the task until there were 92 little portraits, each the same size and scale, now hung in two even rows around three walls of the small closet-sized room dedicated to the collection.

To see them, you have to wander down a passage in the back of the Musee de Berck, a converted gendarme station on a dull street in a grim, downmarket beach town overshadowed by its only slightly ritzier coastal neighbor, Le Touquet. These towns on La Manche are resorts for the truly desperate. Coalminers on holiday built Berck's boardwalk, such as it is. Its modern claim to fame is a kite festival. But it's worth finding the pictures. By walking off the street, through the museum and finally into the room you are treated to an unusual experience; you find yourself the subject of intense scrutiny, with all these salty characters surrounding you with their half-toothed grins, their cartoon-like noses and their dark, lively eyes staring at you like you're a pile of fidgety whiting. On your way out, you nod as you pass another, slightly larger portrait, this one of Victor Ménard, the doctor who was so dedicated to his charges that he arranged to give them more life than they ever bargained for.

That was then, as they say. The most-famous medical man in Berck these days is Frédéric Chaussoy, the doctor in charge of the Berck hospital's intensive-care unit. His fame comes from his decision to kill one of his patients, a very unhappy man named Vincent Humbert.

The doctor, like the vast majority of French citizens, believes in euthanasia. M. Humbert, was the victim of a traffic accident that left him a deaf-mute with just one functioning limb and some marginal eyesight. He asked to die and the doctor obliged him. When Dr. Chaussoy made his decision, he wasn't acting on whim: Humbert's refusal to live the life of a profoundly crippled man had been featured in the pages of Liberation and other French newspapers for some time — in fact, for a year or so, ever since the Humbert had sent a well-publicized letter to Jacques Chirac asking the president to relax the French law forbidding euthanasia so he could die "with dignity."

The story in Liberation gives all the tragic details: Unwilling to live after the accident, Humbert begged his mother to kill him. She tried, by pumping a megadose of barbiturates through his IV after granting a series of media interviews explaining in advance her reasoning. But all that did was put him in a coma — and into the Berck hospital. There, Dr Chaussoy pulled the plug on Vincent Humbert the day before his book — in English, I Ask the Right to Die — was to be published. Humbert's book, like Bauby's, has gone on to become a French bestseller, although I suspect to a different cohort of readers. A report in l'Humanite on the doctor's involvement explains how the case has quickly become a political issue for the Left, as all good, high-profile, dramatic episodes do. A follow-up in the same paper shows the growing sentimentalization of the euthanasia "debate." It's highly unlikely that either Humbert's mother or the doctor will ever spend a minute in court.

But the mood has been spoiled somewhat by the reappearance in the press of Christine Malèvre, a nurse who is trying to reverse an earlier court decision that found her guilty of killing her patients (the number is now up to seven) and sentenced her to ten years, despite the fact that she, too, had a book deal, something called Mes Aveux — My Confessions. Her defense, reported Europe 1 radio: She only killed patients either by accident or "at their request." Her embrace of euthanasia — as captured by TF1 — was a rather awkwardly timed appeal to public sentiment, coming as it did in the wake of the Humbert affair. The French press has been less inclined to sanctify Malèvre — although she did have a run as the "Madonna of euthanasia." Perhaps the slippery slope blocked their view, since the only apparent difference between those who asked the nurse to kill them and Vincent Humbert is that the people the nurse killed were terminally ill and not very good at generating publicity or book deals. Or wait! Is somebody saying that a woman who is a nurse is less compassionate than a man who happens to be a doctor?

Well, meanwhile, in Germany, a doctor who happens to be a woman is being investigated in the deaths of 76 cancer patients in her clinic. She claims they were terminally ill. When the story broke, Le Monde thought the affaire might be huge; Suddeutsche Zeitung was more aloof in its own report. The story took a few turns, such as this one in the Frankfurter Rundschau, with the clinic denying everything. But, according to Die Welt, none of that is going to wash with the prosecutors. The internist is accused of giving morphine-Valium cocktails to patients, ostensibly to relieve their pain. The relief was permanent, however, and the government is apparently going to enforce anti-euthanasia laws in the case. Why? Perhaps because Germans have already had some experience with euthanasia. In fact, the story broke as German papers, including Deutsches Atzeblatt, were carrying the news that a new online archive had been established to help relatives anxious to determine whether or not some 200,000 missing family members had been victims of Nazi euthanasia programs.

Only three nations in Europe — the Netherlands, Belgium, and Switzerland — currently allow euthanasia. Maybe that will change — except, perhaps, in Germany — since euthanasia is increasingly seen as a kind of "right," like abortion. In Italy, for example, a mother cries in the pages of Corriere della Sera for the right to kill her suffering daughter, and those who oppose her are heartless. In Spain, SER reports a new poll shows that 60 percent of doctors want euthanasia legalized. The European Commission, according to Le Monde (a free précis; the full article is now pay-only) is ready to reopen the debate. Even the local parliament of Guernsey is weighing whether or not islanders should be put out of their misery if life gets too miserable, according to this report in the Daily Telegraph.

The idea of mercy killing reflects the modern, secular European ideal, in that it asserts that man's mercy is superior to God's. Maybe one day teleology will finally be stripped of its nasty theological-philosophical taint and made into a medical specialty, like urology. Or maybe European doctors themselves will take the lead. According to this report in Die Welt, they've started killing themselves in the operating rooms. I guess if you're a guy who practices euthanasia, that's a mercy killing.

NOTES

The Euthanator won anyway. Politically, Europe — especially western Europe — is like a giant Marin County, yearning to breathe regulated air. Nowhere is this more true than in the pages of the leftwing Liberation, where the story on the California recall election carried this headline: "San Francisco dit non." English translation: "Dewey Wins!"

Ike! A rhumba! You thought the French had problems maintaining linguistic purity in the face of creeping Franglais? According to Le Monde, now it's payback time for Tio Sam, where a growing number of Hispanic immigrants to the U.S. apparently are speaking something called Spanglish and calling each other names, such as "cubonics," and "dominicanish," and my favorite, "nuyorrican."

Correction: An angry Dutch journalist has written to tell me that Abidjan is not the capital of the troubled Ivory Coast, where, as I wrote last week, the French-led U.N. mission is going sub-Saharan. Because anger always drives me to seriousness, I want to say right off: He's right. The capital of Ivory Coast is a place called Yamoussoukro. It was made the capital in the '80s because it was the hometown of a former Ivorian leader. However, all the government buildings and embassies and Chinese restaurants are in Abidjan, and everybody, including the Washington Post, refers to that city as the capital. Well. Almost everybody. The BBC refers to Abidjan as the "commercial capital," which is ironic, since the BBC is normally commercial-free. Point is, you couldn't get a dog license in the "capital" — and if the French don't improve the situation soon, you won't find many dogs there, either. He also insisted that the Marcoussis Accords — in which Villepin tried to broker a peace between the country's warring factions — "actually did work" except for the misbehavior of "irresponsible Ivorian politicians." Which I guess means the accords worked in France, because they aren't working in Ivory Coast: Last week, according to Le Nouvel Observateur, there were angry demonstrations against the accords in the south, where they're worried about Muslim-led violence. According to Liberation, this triggered angry demonstrations in the north, where the rebels, who happen to be Muslim, all live. All seriousness aside, in Holland, though, everything's cool.

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