The Switzerland Schedule

Emerging Writer Series

Every two weeks or so I am publishing an essay from an emerging writer. This week, “The Switzerland Schedule” by Robin Williamson. Robin is a British author based in Riverside, California, where she is completing her MFA in Creative Writing at UC Riverside. She is the author of an as-yet-unpublished memoir, Things Bad Begun, and is at work on another, The Silent Part. An excerpt of The Silent Part is forthcoming in Joyland. Find Robin on Twitter at @authordrw.

---

We spent one month as a family—all of us, for once, in one place—before she did it, or before we all, together, did it, because in the end my mother’s death, or the "alleviation of her existence,” as the "SWITZERLAND Schedule" called it, was something of a collective deed, a family undertaking.

The "SWITZERLAND Schedule" was a document my father sent us the week before the act, while we were still in Spain, where my parents had been living for almost a decade, and where my father now lives alone, bereft of the pulleys and walkers and scooters that once populated the apartment. From a practical standpoint, the "SWITZERLAND Schedule" was a redundant document, listing, as it did, dates and actions we all, by this point, knew too well. It existed for psychological, not logistical purposes, in particular for my father, who was coping or perhaps failing to cope with recourse to a businessman-like fastidiousness. It was something he had revived from his professional years, manifesting in to-do lists aplenty, the crowning achievement of which was, of course, the “SWITZERLAND Schedule.”

On 25th January 2020, so the document relayed, my brothers and I would take Swiss Air flight BR3128 from Valencia to Zürich, then take a taxi to the town of Pfäffikon, about one hour away. The following day, an ambulance would take my mother to Alicante airport so that she could fly, by air ambulance, along with her caretaker and my father, to Zürich, before joining us, by ambulance, in Pfäffikon. My brothers and I would stay in an Airbnb, while my father, my mother, and my mother’s carer would stay somewhere known as the Blue House, a building with walls of corrugated iron that looked like it ought to have been in a warehouse district or down at the docks. On 27th January 2020, the document read, my mother would "proceed with the Dignitas assisted suicide." The motto of Dignitas, the non-profit society that facilitated the suicide, is: "To Live With Dignity. To Die With Dignity.”

“After taking Sodium Pentobarbital,” reads a letter we received from Dignitas, “the person will fall asleep within two to five minutes, slipping into a deep coma.” A luxurious death, if there can be such a thing. “Only after the person is completely unconscious does the Sodium Pentobarbital affect the respiration, which becomes weaker and finally stops.” Once asleep, it would take my mother between twenty minutes and one hour to die.

A few snatches from my memory of our arrival in Switzerland: My brothers and me taking a long walk around the pristine lake that neighboured the otherwise dull town of Pfäffikon, enjoying the clear air and the snowy peaks that hovered in the distance. Our awkward silence and grimaces when, in a bar, some locals asked why we had come to their town; us then telling them that we were here, in fact, for a business conference. My eldest brother and me chain-smoking by the lake. My eldest brother and me getting a preparatory glimpse of the Blue House, which was just around the corner from our hotel. We had been joking for weeks about the Blue House, comparing it to the Black Lodge in Twin Peaks, a kind of portal domain between two worlds and a realm of dreamlike mystery, a place where people disappear. It emerged on an empty street opposite an emptier football field in a town that had a general air of desertion, a hybrid of cargo container and house, my legs became stiff, as if the Blue House itself was repelling them. I couldn’t take a step further. My eldest brother, meanwhile, went back to his hotel room to vomit. During our next smoke break, he told me he had until that point avoided really acknowledging why we were here.

None of these activities were contained in the “SWITZERLAND Schedule.” How could they have been? These spontaneous events slipped into the gaps of the rigid timetable. The inevitability was almost impossible to face, the kind of inevitability that made one wish one could slow down time, delay things indefinitely, simply with the force of one’s will. Or if not delay, jump ahead, skipping the critical moment, to simply get to the other side of it. It was the kind of inevitability that one remains trapped in. Every time I lit a cigarette, I felt as if, through the encompassing buzz of smoking, I might at once prevent my mother from dying at all and at the same time get the whole thing over with.

As unpleasant and difficult and tiresome as it was, much of that month leading up to the event was a kind of idyll. For one, my mother was still alive. And it had been so long since we’d been together as a family. Or the last time ever, depending on how you look at it. I see this period in summary in the image of a family around a television. My father, my brothers and me are spread across the sofas, beers for us, red wine for him. My mother is beside a sofa, sitting on her scooter, a glass of scotch just within reach. An ordinary family in ordinary times. It was the month before COVID-19 went mainstream. We would joke, afterwards, that my mum had seen the pandemic coming and thought, "Fuck this, I’m out." Her timing was impeccable. Nothing like the “SWITZERLAND Schedule” could have been carried out amid the pandemic, and she was so dependent on carers who would have been rotating from client to client that, while she still may have got her final wish by other means, it would have been drawn out, agonising, and—worst of all—quarantined. She had been lucky, also, to get to Switzerland in time. Bureaucratic issues—in particular, for reasons I could never quite understand, the local government in Spain repeatedly asking for more proof that she was, in fact, alive at all—almost led to delays that risked sustaining her life until the start of the lockdowns.

*

My mother’s symptoms may have appeared a few years before I was born, when she had been working as a chemist at a large oil company. I've never been able to nail down the details. Did she go numb? Have tremors? Unexplained pains? Whatever happened, I only know that her employer suspected her lab work was behind it. Fearing liability, they transferred her over to IT, which is where she met my father. Is it safe to say, therefore, that if she had not developed this illness, which went on to ravage her body for two decades, then I would not exist?

My mother received a formal diagnosis when she was thirty-eight and I was only three or four, when all of us were living in Singapore, where large oil company had posted my father—a “hardship posting” as it was, believe it or not, known back then, meaning he got paid more for the supposed sacrifice. She had secondary progressive Multiple Sclerosis, which occurs when the immune system attacks a fatty material called myelin, which itself forms a protective sheath around nerve fibres. She woke up one day paralyzed in her legs, unable to stand. Steroid treatment allowed her to walk again, but the disease continued to develop. By the time I was fifteen, it was severe enough that she and my father decided to tell the family. We were on holiday in Spain, and my father gathered my brothers and I around our villa’s kitchen table.

“We have given this a lot of thought, and we have decided it is important that we tell you this,” he began. The tightness around his eyes expressed a sternness that was, I imagine, a shield for the sorrow that lay beneath. He only revealed the news after some grave prevaricating, and I felt irritated, impatient— stop being a drama queen dad, hurry up and spit it out! “Your mother,” he told us, “has multiple sclerosis.” Whatever that was.

I carried on with my day like any other on that trip, going swimming, having some beers by the beach. No discernible changes darkened my mood. Looking back, I ask: Had he failed to explain the disease? Had I glazed over as he spoke? Or listened without either grasping or processing the gravity of what he had shared? Or perhaps, somehow, I simply didn’t care? Beneath the apparent nonresponse, a part of me must have sensed the gravity of the revelation, but I had no inkling of the way this news, this disease, would become the dominant shaping force in my coming of age.

*

Many years later, when I was in my early twenties, travelling abroad—believing that I was finding myself in India—my mother woke after a nap, like that day in Singapore, with no feeling in her legs, unable to move them, their connection with her brain seemingly severed. For good this time? She didn’t know, but she had to suspect the worst. Like those tales of mothers who lift cars to save their children, she gathered a preternatural strength in her upper body; rolled onto the floor; dragged her body, her legs trailing behind, all the way to the bathroom; grabbed the diazepam she used to manage her symptoms; then after taking the time, presumably, to remove them one by one from its foil, swallowed several packets worth. My father was due to go out to dinner that evening, but for some reason, perhaps just on a whim, decided against going. Had he gone to the dinner as planned, then this story would have ended here.

In one of the many conversations I had with my mother after her attempt, I asked her whether it would be appropriate, desirable, or ethical for her to try again and how it would affect the rest of us.

She said, “I am afraid that, when I die, if I keep declining this way, you won’t remember what I was like when I was healthy.”

I responded readily, at the time, with a confident “of course not, of course I’ll always remember you at your best, I’ll make sure of it.” But now I find myself, another decade later, attempting to write about her—trying to at once skip over memories and rush to her final moments and at the same time to prevaricate, to delay and indulge and meander in order to keep it at bay—I find myself unable to narrate how her symptoms developed in the years after my father’s revelation, simply because I cannot sufficiently access in my memory what she had been like before. Not even do old photographs allow me to imagine it, despite how vivid, in those images, is the evidence of her health. Nor through the old emails I still have (because her personality, her capacity to speak with confidence and enthusiasm, was also a victim of this disease) am I quite able to conjure a moving picture of who she was before. The door to that particular theatre is shut. I only remember that not long after we learned about the disease, her symptoms became more obvious. Was this because they were getting worse—more theatrical—or because she was putting less effort into hiding them, or were we simply becoming more attentive to what had been in plain view all along?

*

My mother had thick, curly brown hair, which we described, in reference to an in-joke whose origin I have lost, as big. She had a large smile that bent boomerangs between her nose and lips, revealing perfect white teeth, concealing her black and gold fillings layered inside. Even in photographs from the later years, where behind closed doors she faced relentless pain, she is almost always smiling. This is how the world saw her, her friends, my father’s friends, my friends, my brothers’ friends, everyone outside of our family: She was someone who took the illness in her stride, whose strength of will triumphed over the conditions of her illness. She was the “good” kind of sick person. The strong, stoic sick person. The steely, courageous sick person, not one to let the dark forces of pain and disability get the better of them. The kind who doesn’t inconvenience others with their suffering, who doesn’t draw their attention to their own fragility and mortality or to the fortune of their present health. The world saw her this way because she offered just enough calm for them to imagine her this way, not because she didn’t express her misery at all. People saw her this way, in other words, because they wanted to. The misery was easier to ignore, write over, or dismiss.

The woman I knew was still every bit as witty and charming, but her illness had taken the depression that formed in her late teens and set it in stone. She was in pain—severe, persistent, unpredictable pain. You cannot therapize your way out of this kind of pain. You cannot brush it off. You cannot just will yourself into the more positive attitude that some—including myself, so often—would encourage her to take. You can’t just meditate or improve your diet or say affirmations or decide one day to look at things another way. From this kind of pain, suffering is guaranteed; to frame it as avoidable if only one takes the right course of action puts an impossible burden on the sufferer, posit a failure where there isn’t one, and offers a moral judgement on something that has nothing to do with values. I wish I had understood this while she was still alive.

To whom am I speaking here if not myself? Listening, deeply. Always there. But always trying to nudge her along, to flip her script, as if I could persuade away her suffering. And while I sometimes find myself regretting my behaviour, I recognise also that I was not equipped—how could I have been?—for the ways she would confide in me, the tears, the terror, the despair, from as early as those teenage years that followed my father’s announcement. Perhaps from earlier still.

*

Multiple sclerosis can cause a wide array of problems, ranging from severe cognitive impairment to localized physical paralysis. My mother suffered intense chronic pain throughout her body, slow deterioration of the use of her limbs, numbness, spasms, jumps (painful involuntary movements in her body, more singular and dramatic than the spasms), and the loss of various bodily functions, about which I will, out of respect, not speak any further. The scariest part of the disease was the combination of its unpredictable progression in the mid-term and its inexorable march towards worst-case scenarios in the long term. Interrupted by brief periods of remission, a pain in the leg would, over the years, transform itself into a consistent limp, then to the need for a walking stick, then a stroller, then regular periods of rest for any on-foot excursion, until eventually a wheelchair and a scooter would become necessary. Losing the ability to walk had been, for a long time, my mother’s greatest fear. Avoiding this fate was more or less the primary motivating project of her life for the good part of a decade, leading her to continue on foot in extreme pain—always lagging behind a family who could never quite learn to temper their pace—for the latter part of those years, while intermittently investing in kale-only diets, keto diets, electric shock pads, and, for a brief, almost happy, period, Rhonda Byrne’s The Secret—a book that says you can simply think your desires into reality—which my mother was, in the end, despite her best efforts, too wise to follow. It crushed her almost entirely when she had to accept, later on, that she could no longer walk. Gardening had been her most beloved hobby. She would spend hours, I know, even if I struggle to picture it, kneeling among the rhododendrons in our garden, dirt on her shirt, clippers in a gloved hand, in some kind of contentment—as much contentment as depression can allow. By the time she lost her mobility, the spasms interrupted every few minutes rather than across hours or days.

In that final month, this January that contained, as I have said, more joy than perhaps we felt it should have, she was taking prescription morphine daily, which was, at this stage, like laying a thin blanket on a stone bed. It was hard for us to parse the effects of morphine from the effects of cognitive decline from the effects of the fact that she now knew of and was having to wait for the relief of death to come. She could barely speak, struggled to put together full sentences, had committed herself more or less to saying “I love you” whenever any of us would say it to her. Since she could watch TV, we watched, as a family, Ballers, a series in which Dwayne “The Rock” Johnson, whom all of us loved—and whom my mother found irresistibly sexy—worked as a financial manager for American football players. In each episode either The Rock’s clients’ antics or industry shenanigans would create the most impossible, intractable, irrevocable problems; and in each episode, he would solve the impossible, using charm alone, in a few simple sentences to his primary antagonist. Picture my father, my brothers, and I spread across the sofas, beer bottles and wine glasses strewn around the room, with my mother on her scooter beside one of the sofas, a glass of scotch in her hand. An extraordinary event hovers on the horizon.

We also watched The Good Place, a philosophical comedy set in an afterlife that doesn’t seem as good as its title suggests.

“If I get to go to The Good Place,” my mother said, after finishing an episode, “I hope I’ll get to see The Rock’s bare ass.” It was only because she had such an unflinching and assured resolve around her decision to die that we could watch the show and laugh. She never got to see the show’s finale, which aired only a few days after she died.

*

Her only other commitment at this time was smoking, which she had only taken up recently, bringing my eldest brother and me with her, as a kind of defiant rebellion against all the fad diets and promises from charlatans. She preferred to smoke rolling tobacco, but she was insufficiently dexterous to roll her own, so either my eldest brother or I would roll a dozen or more cigarettes each day. She would get through them individually with great difficulty but as a whole with great ease, always having one of us accompany her to regularly re-light the cigarette, which she barely had the strength to then keep firm between her fingers or lips. The new habit was obviously terrible for her health, but it was also hard to blame or judge her, and I for my part enjoyed these smokes we had on the balcony—despite or perhaps in part because of the effort involved in transporting her there—since they allowed some time for us to just be together, to look upon the same night sky in the face of the utter opposition of our present realities, even if we spoke little..

Which brings us to the moment I have been at once avoiding and accelerating towards, the moment of my mother’s death, our enactment of the “SWITZERLAND Schedule,” together as a family.

After her first suicide attempt, once she had recovered from the post-Diazepam haze that had her speaking like an oracle in a misty cave, she tried to blame her attempt, in a private conversation with me, on a urinary tract infection.

“You must understand,” she said, “they mess with your mind.” For reasons I can’t remember, she and I were sitting on the bed in my eldest brother’s old room in the house in which I grew up.

I wasn’t having it.

“It is not the fact you tried to kill yourself that is hardest,” I replied. “I understand it, believe it or not.”

Her face twitched, a movement so minimal that any attempt I made to interpret it would reveal only my fears.

“It’s more that you had to do it in secret,” I said.

Another twitch. Had I hit a nerve, touched upon something that should remain unspoken? Or was the twitch merely a physical effect of her illness?

“You went behind our backs,” I said. “You tried to kill someone we all love so much, and we didn’t get a say. You were alone, dying alone; and we were alone and ignorant.”

She just shook her head and gazed as much through me as at me. Tears welled up in her eyes.

“If you really want to do this,” I added, “I just wish you could do it with us by your side.”

Was this a dangerous thing to say? Was it true? Did I realise that my wish might actually come true?

She replied that she didn’t want to die anymore. She repeated her claim about the urinary tract infection, that she just wasn’t thinking straight. Her attempt, she told me, had shown her how much her death would hurt the people she loved. She honestly hadn’t realised this, she told me, had thought we would all feel relieved, that she was lifting a burden from our collective shoulders.

I didn’t believe her. I was never fully convinced that she ever stopped wanting to die. I sometimes even wondered or feared that she resented my father, my brothers, and I, because, if not for our love, she could be rid of all this pain.

But I was always careful, in the years that followed, to avoid saying anything that would influence her decision either way. When she or my father asked me, intermittently, in the years that followed, for my thoughts about her pursuing an assisted suicide—each dip in her condition would revive the conversation—my answer was always to the same effect: I didn’t want to share any feelings on the matter. If I were to influence the decision in either direction, I wouldn’t be able to bear it once she was gone.

A few years before the assisted suicide, when I was preparing to travel again—she had made her attempt while I was abroad—I admitted to her that I was afraid she might try again.

“I promise I won’t kill myself while you are traveling,” she said.

Did that mean I needed to travel forever?

“Please don’t append your death to my actions, mum,” I said. “I couldn’t live with that.”

So I could not contribute to these conversations. I only wanted my mother to make the decision that was right for her.

I trusted that, whatever it was, whenever it changed, it would always be the right one.

*

We could do this together because assisted suicide is legal in Switzerland. We could do this together because my father had worked as an executive for an oil company and his retirement income allowed him to shoulder the costs: of the suicide itself, of the air ambulance (effectively a private jet rental), of jumping through all the legal hoops along the way. I understand that the final bill, all told, amounted to around $50,000. We could do this together because my mother had spent years thinking it through, had come to an unwavering and conclusive decision, and had the presence of mind to prove her resolve to mental health professionals along the way; and because my father, my brothers, and I all supported her decision. We could do this together despite the forces, almost exclusively driven by religious dogma, that pile innumerable resources into denying human beings’ autonomy over their own bodies. Because of all of the above, I could have the awful, agonising and inexpressibly precious privilege of watching my own mother die:

We are in the Blue House, my brother and I, with my father and my mother’s carer, all scattered around my mother, who is lying in a bed, rails on each side, her upper body on a roughly thirty-degree incline. It is around 9:00 AM, and we are surrounded on all sides—on every table a bowl—by Swiss chocolates, specifically Lindt. The bed is the only thing in the room that betrays a medical procedure; the rest of the room could be anyone’s home: a table, some chairs, a sofa, generic landscapes on the walls. The assisted suicide had been due to occur in the afternoon, but for all our obedience to the “SWITZERLAND Schedule” until this point, my mother could no longer abide to any schedule, asked if it could be sooner: after the turmoil of the flight over—flying would have been, for any other reason, an absolute no go—she has been left in excruciating pain. A doctor has already come and spoken to us, explained the law, the procedure, the importance of the right to die, and her right to say no at any time. She has taken a shot of some kind of medicine—it will prevent her from throwing up the final medicine—and we are saying our goodbyes. “The Lark Ascending” by Ralph Vaughn Williams plays—my father’s choice, although I wish it was silent—my emotions need no catalyst. She says to my father: “No woman has ever been loved as much as you loved me. Please take care of the boys.” She has words for each of my brothers that are their secrets to cherish. When I say my goodbyes, profess my love one final time, she only scowls at me. In the preceding months, I had been growing my hair, which is curly like hers; it became big while hers was thinning.

“You stole my hair,” she said, a hint of a smile behind the scrunched nose. “You bastard!” Playful daggers shoot out from her eyes.

Her final words, at least to me, come some twenty-five minutes later.

In something approaching a croak, she asks me how long she has left to wait before the medicine will take effect.

I tell her it should only be another five minutes.

“Too long,” she says. “Too long to wait.”

In these final moments, there are tears and screeching, but none of it comes from her, and it is on her I want us to focus. She remains still throughout. Her eyes eventually close. Her face appears to relax. The blood slowly trickles down the insides of her face, until everything above her nose becomes a translucent grey, like a blind is closing over her. Even the skin or flesh on her face seems to slacken. Has her nose become more crooked, or have I never really looked before? How much do we ever know someone? Who was she to all of those to whom she wasn’t mother? The thoughts we have when someone dies. The beauty of her painless face.

Life robbed her of her body.

I wish she was still here with me.

I’m grateful that she’s gone.