Romeo and Juliet This: Jim and Angie's Journey to Dignity Day
- 1 day ago
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Some stories are entrusted to us, not just told to us. This is one of those. Jim and Angie asked me to share their journey, not for sympathy, but so that others facing similar circumstances would know that international travel for voluntary assisted death is an option. They also wanted to be clear: this choice was right for them. It may not be right for everyone, and they honored that too. They simply wanted people to know they had options, and that whatever choice feels right for you deserves to be honored just the same.
Jim was 69. For years, he lived with severe seizures that stripped away pieces of his life. During his last major episode, he shattered his shoulder and needed a full shoulder replacement. His episodes had broken his ribs and required heavy medications. He lived every day in fear of what the next seizure might take from him. He hadn’t driven a car in years.
Angie was 74. She had lived with ulcerative colitis for decades, alongside a list of other diagnoses that had become part of her daily reality. The chronic pain and debilitating symptoms had worn her down in a way that only decades of illness can. As she put it, she was exhausted and done with treatment, doctor's appointments, and medications.
Jim and Angie had been married for over 40 years. When they first reached out to me, they didn't soften the request. "We've been together our whole lives," they told me. "We won't risk one leaving the other behind. We won't risk having a medical event that makes us no longer able to make this decision or self-administer the medications. And we won't be warehoused. So we're going to Romeo and Juliet this s***; will you help us?"
They had no children. Jim had a half-sister in Tennessee he'd had limited contact with over the years, but she wasn't someone who could travel with them. Pegasos, the Swiss clinic that had approved their request, requires every patient to have an escort. Without family to fill that role, Pegasos suggested they find a death doula instead.
I'll admit, I hesitated. This was the first time someone without a terminal diagnosis — meaning a prognosis of six months or less if a disease is left untreated — had come to me asking for help hastening their death. I told them I needed time to sit with the request.
Here in the U.S., Medical Aid in Dying, or MAiD, is legal in 14 jurisdictions, 13 states and Washington, DC. Even where it is legal, the requirements are narrow. A person must be over 18, of sound mind with the mental capacity to make the decision, able to self-administer the medications, and have a prognosis of six months or less to live. Jim's seizures and Angie's ulcerative colitis, however debilitating, didn't clear that bar. There was no six-month prognosis. There was only a lifetime of suffering that had become, for them, unbearable.
Switzerland's requirements are different. To pursue voluntary assisted-death there, a person needs only to be of legal age, 18 or older, and mentally sound enough to make the decision. There is no requirement to prove a terminal prognosis, and no requirement to prove suffering to any particular standard. Pegasos requires a meeting with a mental health professional to confirm decisional capacity, and ensure the choice isn't being made hastily. They confirm the person seeking to end their life has to agree to self-administer the medication, and that there isn't an underlying, untreated mental health condition that might benefit from support before taking this final step.
For Jim and Angie, those less-strict requirements meant the difference between having a choice and having none at all.
While I was sitting with their request, I was also caring for another client, a woman I'll call SS. I'd worked with her for nearly two years, watching her move from independent living, to assisted living, to full-time hospice care in a beautiful, very expensive retirement community in Rio Rancho. SS had no family left. Her husband had died years earlier and left her with more than enough to be well cared for. She had chosen this facility to live out her final days. She had hired a death doula, me, to help her plan and to hold the hard conversations. But what she didn't have was someone there every single day, advocating for her, making sure she was actually being cared for the way she deserved.
During my last visit with SS, she had developed a stage four pressure ulcer. She wasn't adequately medicated to stay pain free and calm. I stood in her room with her hospice nurse, changing bed linens, adjusting the lights, putting on soft music, lighting artificial candles, doing everything we could to bring her some peace in a system stretched too thin to give her the care she needed and deserved on its own. After several hours of a different environment, a different energy in the room, adequate medication, and clean, dry linens, SS died peacefully.
It was in that room that I decided to go to Switzerland with Jim and Angie.
I couldn't offer them what SS didn't have either. I couldn't say, "I will take responsibility for caring for you and advocating for you until your last natural breath." I couldn't fix a system that too often values the corporate dollar over the well-being of our elders. But I could hold their hands. I could walk beside them on their final journey, leaving this world in a way that was meaningful to them. I could hold space for their decision, while holding space for my own unfolding around the experience.
The journey
In early April, my husband Luke and I met Jim and Angie at the Atlanta airport. From there we flew to Amsterdam, then on to Basel. In Basel, we took a cab to Rhoderis, a tiny hamlet tucked into the Swiss hills, home to the Pegasos clinic. There isn't much to the village: a small hotel, a dairy, a handful of small businesses and homes, all backed by beautiful forest. The clinic itself is attached to the hotel where patients spend their final day or two before what Jim and Angie chose to call their Dignity Day.
The day before, I led them through a guided meditation, releasing any burdens they might still be carrying and filling them instead with love, light, and gratitude for their human experience.
On the day of the medication administration, a nurse came to the hotel to guide us on a two-minute walk to the attached clinic. After the paperwork was sorted, consents reviewed and signed, and passports copied for the record, the staff gave us time alone in the room. The space was simple, Scandinavian in design. Inside, a queen-sized adjustable hospital bed faced picture windows and glass French doors that opened onto rolling Swiss hills. We lit a candle, played music, and called in the Seven Sacred Directions, blessing and consecrating the space where this sacred transition was about to take place.
Jim and Angie had asked for an anointing ritual, the kind where an essential oil is placed on different parts of the body along with a prayer or words of gratitude for all that part of the body had offered throughout a lifetime. In this ceremony, they anointed each other, lovingly placing the oils on one another's bodies, thanking each other for their years together. Angie said it felt like a vow renewal of sorts, and I couldn't resist joking that they were heading off on one heck of a honeymoon. It brought a moment of laughter and lightness to us all.
When they were ready, the nurse returned and started their IV lines. Jim and Angie lay side by side on the bed, holding hands, and together opened the lines to self-administer the medication. Angie left this world within about three minutes, with a deep, glorious, audible sigh and a smile across her face. Jim had the gift of witnessing his wife's passing in what looked, from the outside, like pure bliss. Then he turned to me, slight concern at being left behind in his eyes. I took a deep breath with him, reminded him he was okay, loved, and not alone, and he closed his eyes and took his final breaths. Within five minutes, both of their bodies had ceased to function.
There's a practice I offer to any client who is interested and willing. I ask them to choose a very specific, very clear sign, something they'll send once they've arrived safely on the other side, so I'll know.
The night before their Dignity Day, over dinner, Jim and Angie announced their signs. Jim chose a goat. Angie chose a cat. Luke and I laughed and told them a goat was a solid choice, since an unexpected goat would get anyone's attention, but a cat felt almost too common to ever be sure it wasn't just a coincidence. So the four of us settled it together: a cat and a goat together, or better yet, a cat riding a goat, would be undeniable. That would be Jim and Angie saying hello.
Three days after they died, Luke and I were walking through a beautifully manicured Zurich suburb when we came across an oddly out-of-place cardboard cutout, a little girl riding a goat, attached to a concrete retaining wall. I pointed it out to Luke in surprise, and he started to say, half joking, "Now if we see a cat in the next ten seconds..." and an orange tabby cat walked out from behind that very same wall. We stood there and cried, and held each other. Luke accepted it immediately as their sign. But even with everything I've witnessed in this work, my inner skeptic crept in. The goat felt undeniably specific. The cat, on its own, still felt like it could be explained away.
So for the next week, I found myself quietly asking Angie, in my own mind and heart, for something I couldn't question. Something undeniable.
A week to the day after they died, Luke and I took a double-decker tourist bus to see the tulips at Keukenhof. We were seated apart, and I ended up next to a delightful older woman named Joann. After some easy conversation, I told her what I do for a living and why we'd come to Switzerland. She lit up and said, "Oh, then you won't think this is weird at all," reached into her purse, and pulled out a small Ziploc bag. Inside were cremains. "This is my husband, Jim," she said. "I take him everywhere with me and sprinkle a little so he gets to see all the places I travel now."
I hadn't told her my clients' names. I kept that to myself and let the conversation continue. A few minutes later she said, "You know, I really like you. I'm going to give you one of my rocks. I paint them and give them to people I like." She pulled out another bag, this one full of small painted stones, dug through it deliberately, and pulled one out. "This one!" On it was a small painted cat, with a halo and angel wings.
Joann had literally been carrying Jim in her purse, and she handed me an angel cat.
I couldn't hold back my tears at that point, and when I told her the whole story, she teared up too. She took it as a sign that her own Jim was letting her know he was okay too, that she wasn't alone, and that we're all more connected than we know.
The number of "coincidences" it would take for this story to unfold exactly as it did is, I think, its own kind of answer.
Jim and Angie wanted their story told because they believed, deeply, in the right to choose. Not for everyone to choose the same thing, but for everyone to have the choice at all.
This is beautiful, thank you for sharing <3