Two letters cross the great divide

B ecause physician-assisted suicide is a subject that far too often divides families and traumatizes the best of friends, perhaps there is something to be gained in eavesdropping for a moment on a conversation about life and death between total strangers.

Caleb Heppner is a retired child-welfare administrator in Salem with terminal cancer, Rebekah Puddington a high school freshman in rural upstate New York. They will, most likely, never meet in person, but their paths crossed one night last October.

Bekah was watching the nightly news with her father, a social studies teacher, when Heppner appeared on "The NewsHour with Jim Lehrer." Heppner, 57, was diagnosed with lung cancer in 2003 and the virulent lesions have reached his spine.

Heppner spoke about the agony of watching his own father die, painfully, of leukemia. He spoke about chemotherapy and fear. And he expressed his moral reservations about suicide and his belief that "assisted suicide" is a misnomer, a phrase that does not appear in Oregon's Death with Dignity Act.

Bekah Puddington listened carefully. She is a straight-A student and the oldest of five children. She has Tourettes syndrome. And, said her mother, Patrice, "She's the kind of child that when the Lord places something on her heart, she follows through with it."

Hi! First of all, I wanted to tell you that you don't know me and the reason I'm writing to you is because I saw you on the news a few days ago . . .

I'm sorry your dad died such a painful death. I'm also sorry that you are suffering from cancer as well. I can only imagine what it must feel like. My name is Bekah, and I am 14 years old. You and I have something in common; we both have something wrong in our bodies, and we are both humans who need healing. Even though my problem is Tourettes syndrome, just a disorder and not a terminal disease, it is still difficult, especially for me as a teenage girl.

Well, I didn't write to tell you of my personal troubles; I wrote to tell you of the one who is able and willing to deliver me from them. His name is Jesus Christ.

You see, two or three summers ago, Jesus healed me completely of my Tourettes. They came back, but I believe that Jesus is going to heal me again and already has; I just haven't seen the effects of it yet. Hoping for what you can't see, it may seem insane, but it's not and it's called faith.

Jesus can heal you too Mr. Heppner, but even more wonderful than that is if you believe in Him and confess that Jesus is Lord, then after you die you will go to heaven to be with God . . .

So, I'm pleading with you Mr. Heppner; life is precious -- don't take yours . . . The Bible says that in heaven, the streets are made of gold, and that God wipes away every tear . . . Please get a Bible and find out more about Jesus. Hopefully, I'll meet you in heaven someday. And if you choose to believe -- then congratulations! There is a party in heaven when you do.

Not knowing how to reach Heppner, Bekah mailed the letter to The Oregonian in late November, where it fell into the hands of Kathleen McDonald, our office manager. She tracked down Heppner in Salem, and when he wrote back to Bekah on Dec. 11, he sent McDonald a copy of the letter, which appears below in a slightly condensed form:

Thank you for your thoughtful letter . . . It is really amazing how many people heard about my story and how many different reactions I have gotten to it. There are a couple of things I thought you might find surprising about me. The first is that I am a Christian, and the second is that I do not approve of suicide.

Let me start with suicide. Suicide is generally understood as a lonely death where someone who is depressed has tragically taken his or her own life. In Oregon, the medical process called "physician-assisted dying" is not defined as suicide, but as a medically approved process for a patient who is already dying and would like assistance in hastening the process. The death certificate of a patient who has died in this way does not list suicide as the cause of death . . .

Now I know that this may cross a line that is just not acceptable to some people. I completely understand. I love life so much and believe that it is so sacred that I would not approve of anyone prematurely taking their life (even if their disease was pretty rough) if there was still the opportunity for quality life . . .

I really cannot tell you if I will find myself in a situation where I am suffering so much in my last hours that I will request medication to hasten my death. My daily prayer is that I will be able to die peacefully and naturally with my family and friends around me.

Now, about being a Christian. I am 57 years old and have been a Christian for many years. The older I get, the more I am amazed at how wide God's grace is. I believe God is much more understanding of the human condition than we realize and probably would not hold it against a dying patient to seek help in hastening the dying process.

I have found the story of Jesus' death very interesting, viewing it as I do now from the perspective of a person who will not live long because of cancer. Jesus said that God had given him the authority to lay down his life and to take it up again (John 10:18). I wonder if that is something God grants to us as well. When the medical community extends life far past the point nature intended, is this a gift of God or is it not . . .?

I really value your prayers and those of my friends and family. Already many of the prayers have been answered. When I was first diagnosed in November 2003, the doctor estimated that I would have about 9 months to live. Here I am, enjoying a third Christmas with my family. I cherish each day and know that life is truly a gift of God to be carefully guarded.

Rebekah, I wish you the best with your own challenges. Often the things that we suffer help us understand what comes to others in their lives. The Bible says that "time and chance happen to us all." It is how we handle what time and chance send us that determine our character in the end. It will either make us stronger or weaker. From reading your letter, I believe that you are one of the people that will become much stronger.

May God bless you and keep you in the shelter of His enormous, outstretched wings.

Two months later, a teenager in upstate New York isn't sure what surprises her more, that she wrote her letter -- another prayer tossed to the wind and the waves -- or that Heppner wrote his. "I thought it was really cool to find out he was a Christian," Bekah Puddington said.

Two months later, a gentle man with terminal cancer spent Friday morning at a Salem hospital, drinking barium, waiting on another bone scan, fretting about insurance, pondering his choices and what they will mean for those he has touched and those who are still reaching for him.

"When you die," Caleb Heppner said, "you want people to be left with the good you did, not with a cloud over their hopes and dreams."

Steve Duin: 503-221-8597; 1320 S.W. Broadway, Portland, OR 97201 steveduin@news.oregonian.com www.oregonlive.com/weblogs/papertrail

Never posted before, so hope this works. I also don't know the excerpting rules for the Oregonian, so moderator, please change if necessary, as I have posted the whole column.

In Mr. Heppner's response to the little girl who wrote him, he says that physician assisted suicide isn't suicide, essentially arguing because it is legal. There are at least a few cases in Oregon where the people were not terminally ill and/or were coerced. In those who were coerced, certainly not suicide. However, essentially the same argument could be made for abortion, since it is unfortunately legal.

I also thought his quoting that Christ chose to lay down his life (and therefore, I take it, he can justify the same for others) was of interest. And that, to be truthful is kind of the point. Jesus, as God, had to choose to lay down His life - it could not be taken. Mr. Heppner, in his letter, is attempting to place humans at the same level as God in choosing the time and manner of death. He's also making the "quality of life" argument that leads to Terri Schiavo's death and, soon, IMHO, to ill elderly that are costly to the medical system or inconvenient to their relatives.

Very blue state attitude, IMHO.

I don't know, I didn't get the impression this man was trying to justify the process to her, I thought he was trying to explain it and his feelings, fears, and questions as well. More like thinking out loud. He did not say that he was planning on using the law, only that he didn't know what was in store for him, and what he would do when he got there.

What an incredible girl. It is so nice to see a girl her age focused on Jesus, and giving hope to others. I will say prayers for both of them.

When you are dying of terminal cancer, the compassionate thing to do is to stop the pain with morphine so that the patient can rest and not suffer more than is necessary. The purpose is not to kill, but pain treatment. The pain medicine also has the effect of hastening your death because of the amount needed to treat such intense pain.

When you get chemotherapy sometimes it kills you while trying to save you.

Using morphine or chemotherapy in these case is not suicide or assisted suicide. The intent is not to kill you; it is to treat you.

Absolutely true, and I am absolutely in support of that. My father, in fact, died of terminal cancer last fall and hospice (and morphine) were wonderful in helping him remain comfortable until he passed away.

The article, however, alludes to physician assisted suicide which is a different matter entirely. We have had both coercion and non-terminal but depressed folks involved in physician assisted suicide here in Oregon. Many more cases have been documented in the Netherlands.

My personal favorite (in Oregon)was the daughter who wanted her mother to choose physician assisted suicide. The first doctor noted the daughter, not the mother, was the advocate for it and that the mother was depressed. The daughter shopped around for another doctor who would not interfere, found one, and the mother is now dead.

I don't like suicide, as it is taking the place of God in choosing time and means of death. I, however, would not interfere with a competent adult's choice to do it.

That said, the availability of physician assisted suicide in a world of rising medical costs and lowered personal ethics is a prescription for abuse and coercion of the elderly, IMHO.

**My personal favorite (in Oregon)was the daughter who wanted her mother to choose physician assisted suicide. The first doctor noted the daughter, not the mother, was the advocate for it and that the mother was depressed. The daughter shopped around for another doctor who would not interfere, found one, and the mother is now dead.**

Good grief, what a nightmare! The doctor who killed the mother is the abortionist of the other end of life.

I have often said that Baby boomers are going to get back what they put out to their children. They put out that kids are not important as their careers and money. That children are to be managed in the least expensive way possible. If all else fails, drug 'em. In light of these left wing family values, why would not a child see her parent as an unnecessary expense and waste of breath if the parent is sick or depressed and interfering in the offspring's life and finances.

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