One Last Thing for Mom

I am about to kill my mother. I am looking for a way to put this off as long as possible, and so I start watching an episode of the TV drama “The Americans.” Today, Keri Russell, playing a Russian agent, is spying on a State Department official by posing as a nurse for his terminally ill wife. The agent is a stonecold murderer, but she feels sorry for the official, whose attempts to help his wife kill herself with morphine have left her in a gasping, notdead limbo. So Keri Russell finishes the job by shoving a paintbrush down the woman’s throat and holding a plastic bag over her head.

This is not a good time to be watching this particular scene.

Right now my mother is in bed across the hall, in the endgame of Stage 4 lung cancer. She is nearly 83, she has had enough, and she is ready to die. More specifically, she is ready to have me help her die. I can see her point. An unsentimental, practical person, she has for years been preparing for the moment when death would become more alluring than life. We have talked about it since she received her diagnosis about three months ago and declared that she intended to forgo chemotherapy.

“I would rather die than lose my hair,” she said airily to the startled oncologist, before terrorizing the hospital physiotherapist by snapping: “I could be dead in three months. Do you really think it’s go- ing to make a difference if I get out of bed and walk around?”

So she went home to die. She was her regular funny, astringent self.

“Just put a pillow over my head,” she would say, only half joking, when I saw her each evening. “Am I dead yet?” she’d say in the morning, genuinely annoyed that terminal cancer was refusing to adhere to her imagined timetable.

Gradually, the illness took hold, the inevitable became less abstract and the jokes stopped. Mom had vivid dreams of death so awful that she could not bring herself to describe them. She became too weak to leave her bed, more of her independence seeping out each day like air from a balloon. Her world closed in.

Lung cancer is a frightening illness. In its final stages, it can make you feel as though you’re drowning, or suffocating. A formidable pharmacological stew of medications can help to suppress the symptoms, but no pill can take away the pain of waking up each day and remembering all over again that you are about to die.

I know what I’m supposed to do, because she has told me many times. One of the stories passed down as gospel in our tiny family is about how my late father, a doctor, helped his own mother at the end of her life. Her cancer was unbearable. “So he gave her a big dose of morphine to stop the pain,” my mother has always told my brother and me, as if reaching the end of a fairy tale. “It had the side effect of stopping her heart.”

As it happens, I have a big dose of morphine right here in the house. I also have some hefty doses of codeine, Ambien, Haldol and Ativan that I’ve cunningly stockpiled from the hospice service, like a squirrel hoarding for winter. In my top drawer are more than 100 micrograms worth of fentanyl patches — enough to kill her and several passers-by.

But I am not a trained assassin. I am not a doctor. I am not very brave. I’m just a person who wants to do the most important thing that her mother has ever asked of her. I’m also a resident of New York State, where assisted suicide is illegal.

Mom has taken to drifting off in the middle of crucial sentences. “It’s important to remember the …” she announces. “The one thing I need to tell you is …” But in coherent moments she looks at me with a clarity that shreds my heart. My strong mother. “Oh, Sarah,” she says. “I’m in so much pain.”

So it’s time. I begin counting up the drugs. But then I watch the bungled assisted suicide scene in “The Americans” and I see how easy it is to get wrong. Often patients develop a tolerance for morphine, Keri Russell is saying in her guise as hospice nurse, explaining why the higher dose did not kill the dying wife.

How much is the right amount, I wonder, a morphine bottle in my hand. What if Mom chokes, vomits, falls into a half- dead limbo, wakes up and yells at me? I have no problem with the idea of committing murder on behalf of a dying person you love, but I can’t ask anyone else — the health aides, my brother — for help, since I don’t want to implicate them in my crime.

Panicked, I go online and start calling end- of-life organizations. The people are endlessly compassionate, but no one will, or can, tell me what dosage to give, or how to give it. I try to talk to one of the hospice workers, but she threatens to report me to the police. “We are not having this conversation,” she says.

Oh, yes, we are. She tries another tack. “If you do this, you’ll never forgive yourself,” she says. Actually, I tell her, I’ll never forgive myself if I don’t.

But I can’t do it. I can’t do it. I promised, but I can’t.

Families are complicated and mother- daughter relationships are perhaps the most complicated of all. I’ve had a lifetime of feeling unable to get anything right with my mother.

“Mom,” I say finally. I don’t want to bring this up. It’s so late, and she’s so weak and she’s drifting in and out and why didn’t we consider this particular eventuality before, the one where I lose my nerve. But. One thing you can do, I tell her, is to stop eating. We’ll make you comfortable. We’ll give you so many drugs that you won’t even know.

About 20 minutes later, she emerges from her drugged state. “I’m ready,” she says clearly, “to fall asleep and not wake up.”

The next day she wakes up. This is how incompetent I am. “You swore this wouldn’t happen, Sarah,” she says, her voice vibrating with fury. “I’m so sorry, Mama,” I say, crying as I drip more narcotics into her mouth with a syringe.

She lies in twilight for a few days. But sometimes her eyes open in a panic and dart around, full of fear. It feels as if everything has become very primal, requiring an instinct for improvisation I don’t have.

So I do what has always soothed me. I pick up “Charlotte’s Web” and read the last two chapters — aloud, this time — the ones where Charlotte dies after living her singular, stylish life, and three of her chatty spider babies build little webs in the corner of the barn so they can stay with Wilbur the pig.

I always cried when I read this part to my daughters, years ago when they were small, and I cry again as I read it to my mother.

You are not alone. You’ll live on, the way Charlotte does, through your grandchildren and their children. It’s O.K. now. You can go.

As I put the book away, I see that her eyes are closed, finally, and that her breathing has evened out, so that it is shallow but calm.

It takes one more day. There are, it turns out, many different ways to help someone die.