On March 6, 2017, Adam Maier-Clayton logged on to Facebook and pressed the button to go live.
“Can anyone hear me?”
Someone commented that they could hear just fine, and Maier-Clayton adjusted the angle of his laptop. “We’re going to have a very important discussion in just one second,” he said. He leaned forward so that his face, which was uncommonly beautiful—angled and severe, like it belonged to a sculpture—was close to the camera. Behind him, his viewers could see light-blue walls and a tidy hotel-room bed. “Up front, I’m going to say you don’t have to worry about anything in terms of . . . . Uh, you’re not going to see anything bad.” By this, he meant that he would not kill himself on camera. He worried that, if he did, Facebook would take down the video, and he wanted the video to live on after his death and go viral. Instead, he would kill himself afterward.
“Okay. So, yeah . . . I’ve planned this out intricately. I’ve planned everything from the last song to the last meal . . . . But, yeah, it’s weird to be in this position. I’m twenty-seven years old and I never ever thought that something like this would happen to my life.” Maier-Clayton said that he had ordered poison from China and that it was resting a few inches from his keyboard. That was good, he said, because otherwise he would have had to jump off a building or something.
As he often did in his Facebook and YouTube videos, Maier-Clayton started with a run-through of his afflictions: generalized anxiety disorder, obsession, depression. “OCD is a demon,” he said. “Some people are dealt genetic cards that are going to make their existence sheer hell. And I am absolutely one of those people.” But, soon, he shifted to politics because, really, that was the point of the exercise. If he was going to kill himself, his suicide was going to be political.
“This whole idea that mental health should never qualify for medical assistance in dying is simply primitive,” Maier-Clayton said. “It puts physical illness, especially terminal illness, on a pedestal. And it ignores other illnesses . . . . It’s bullshit, okay?” People like him, he said—people with long and tangled histories of mental disorder and psychiatric treatment—had been “screwed over” by the Canadian government when they were excluded from accessing the country’s assisted-dying law. Maier-Clayton said that was wrong. He blamed prime minister Justin Trudeau. “If someone can’t get better, scientifically, and they have been suffering and they want out . . . ” He threw up his hands. “What’s the issue? It’s not your life. It’s theirs . . . . I’ve said it a gazillion times.”
At the start of his livestream, Maier-Clayton warned that he planned to talk for a while because he had a lot of concluding things to say. Soon, an hour had passed, then another. Maier-Clayton talked about therapy and its failures. He talked about psychiatric science and its failures. He talked about how great it felt to be sharing everything he knew. At times, his voice had a hyper edge to it, but most of the time, it was flat and studiously formal. “I’m very, very sick,” he said. “There’s no cure. I have no future.” He had wanted to work at a bank or a hedge fund or a Fortune 500 company. He had wanted to own skyscrapers and be a financial-industry baller. But, instead, his mind had gone to war with his body—and, now, here he was.
“There’s so much beauty, even in this room,” he said, almost two and a half hours in, when his voice was starting to crack. “I mean, look at this light switch. Electricity.” After a few minutes, he cried a bit and said he hoped his mom and dad would be okay. He said he didn’t want to hurt anyone.
And then he signed off.
A nine-hour drive northeast, in Ottawa, Adam’s mother, Maggie, sat in front of her laptop. She couldn’t look away from the screen. “I didn’t know if it was real,” she told me later. She grabbed her phone and tried to call Adam’s father, but he didn’t pick up.
Back in Windsor, Graham Clayton was midway through delivering a lecture to his fourth-year economics class at the University of Windsor. When the police officers knocked on the door, Graham told his students that he would be back in just a minute and then stepped into the hallway.
“Do you know where your son is?” one officer asked. No. “When was the last time you saw him?” Yesterday. The two cops told Graham that they had traced Adam to London, Ontario, but that they hadn’t found him yet. He seemed to be at a hotel. They said something about Facebook. Graham told the officers that he didn’t know what Adam was planning to do that day but that he had been threatening “rational suicide” for months on social media.
“One day,” Adam had told him a few months earlier, “you’ll get up and I’ll be gone.” “When you can’t take it any longer,” Graham had said, “don’t hang in there for me or for anybody else.” Graham thought his son had fought for long enough. They were both tired.
By then, Adam had become, in his own words, “the most visible right-to-die activist who stands up and represents mental illness.” He was a poster boy: the face of a political push to expand Canada’s aid-in-dying law to include patients who suffer from psychiatric disorders but are not terminally ill. In a May 2016 Globe and Mail op-ed, Adam had written that “physical illness and mental illness can actually induce the same amount of pain. The only difference is the pain in a physical illness has a physical pathology. In a mental illness, the pain is called psychosomatic pain. To the patient, it feels exactly the same.” Suffering was suffering, he wrote. Why should mediocre technocrats in Ottawa get to privilege one kind over the other?
After finishing his lecture, Graham waited for his students to leave the classroom and then drove home, away from the unlovely urban campus and along the river separating Windsor from Detroit. Eventually, the phone rang: it was Adam. The police had found him at the hotel room—and, in a panic, he had flushed his pentobarbital down the toilet. He had lost his chance. “So he’s okay,” Graham said softly, hanging up the phone. His grey moustache twitched and his eyebrows unfurled. “I don’t know where we go from here.” He took a breath. “It’s a no-win situation here. I lose my son or I watch my son suffer.”
Adam had been a careful baby. When he was a toddler, Maggie wondered if she should cover up the electrical outlets in her house with childproof plastic covers, like other mothers did, but she didn’t need to. Adam knew not to touch. He was such a good boy that his parents didn’t think much of it when, around age four, not long after Maggie and Graham had divorced, Adam started making strange noises. They were almost like animal barks. “Adam, why are you doing that?” Graham asked his son. But Adam didn’t know.
After a while, Adam stopped barking and started doing things with his hands. He had to manoeuvre his fingers in certain ways, in certain orders, over and over. When Adam started playing soccer competitively, he needed to move his fingers into just the right positions or else he wouldn’t be able to score and his team would lose—but, if he moved them too much, he would forget to run after the ball. He sometimes taped his fingers together so that they could be still and he could focus on the game.
It took a dozen more years for Adam to be given a diagnosis of obsessive-compulsive disorder and generalized anxiety disorder and prescribed his first antidepressant. By then, his teenage mind was fizzing with terrible thoughts. At parties and at school, the thoughts told Adam that he had done something wrong. More than that, he had done something wrong on purpose and then forgotten about it. The thoughts said that everyone else knew what he had done and that they were judging him for it.
Adam took the pills the doctor gave him. He said they didn’t help, though he never stayed on any given regimen for very long. He decided that, if he wanted to be normal, he would have to beat the compulsions out of himself. Adam started doing exercises with his brain. When his brain told him to do something, he refused to do it. After a while, the thoughts quieted.
In 2011, Adam moved to Ottawa to start a college degree in business management. In high school, he hadn’t worked that hard, and he had sometimes been “a dickhead” to other people, but he intended to be different now. He wanted to be the kind of person who worked all the time. His metamorphosis was quick and deliberate. “I transformed from an ignorant jock,” he told me. “I became very introspective. I wanted to be a better person.”
Adam decided that he would become a banker. Or something like a banker: a fund manager, for instance. The details of the dream were still bleary. And never mind that he was only at a second-rate college, studying for a diploma. The point was that, somehow, he would become someone with money and a nice, intelligent wife and adopted children from foreign countries. He would have nice cars, but not too many, because that would be obnoxious and also because he planned to give away tons of money to philanthropic causes.
Things were manageable, everyone would agree, until Adam got high. It was December 2012, at a frat party; Adam was twenty-three. He took a hit from someone’s bong, and then another. And then it was night and everyone was high and Adam was on the floor, curled up in the fetal position, thinking he was dying.
When he woke the next morning, it seemed to Adam that all his friends were covered in wax. They looked like puppets instead of people, or like fake people masquerading as real ones. He felt afloat—not like he was out of his body but like he was too much in it. “I don’t call it sadness,” he told me, later, of the feeling. “It’s a soullessness.” Adam didn’t believe in souls, per se, but he still felt somehow as if he’d lost his.
The next day, it was the same. Maggie brought Adam to an emergency room. And then another. The doctors said he was just high. They said he’d be fine. But, in the weeks that followed, the weird feeling stayed and the old obsessions returned. Some days, Maggie said, Adam was “extremely aggressive.” Other days, he cried and asked her to hold his hand. Adam met with more doctors, but nobody knew what was wrong with him. One said that he should see a psychiatrist but warned that, with an outpatient referral, it could take months to get an appointment. Another told Adam that this was all in his head.
Finally, there was a diagnosis. “It’s called depersonalization disorder,” Adam wrote, later, on his blog. “It’s when a human brain endures a sufficient amount of stress that it says, ‘ok soldier, that’s enough of that noise, we’re taking a break’ and dissociates as a defense mechanism. The brain literally pulls out all context, emotion, and feeling from everything you know and you are left feeling empty and foreign to everything you once knew.” There were other diagnoses too: major depressive disorder, somatic symptom disorder. Adam had never heard of somatic pain before, but he read about it on a website. “According to one theory,” the website read, “depression and anxiety are converted into physical symptoms . . . . It becomes almost impossible to tell which came first or where one leaves off and the other begins.” To Adam, the order of things didn’t really matter because his whole body hurt and his eyes burned, as if a tablespoon of acid was sloshing around in each eye socket. The obsessive thoughts grew louder and the voices that carried them more brazen. He thought that he had lost whatever chemical components make up human joy.
Adam managed to graduate from college and get a job at a local bank branch. He liked the work, but in 2014, he quit. He said his physical symptoms—the mysterious aches and the burning and the fogginess—were distracting him from his tasks and that he couldn’t focus on the clients in front of him. His fights with Maggie grew worse. One day, Adam took a baseball bat and smashed the furniture in the basement to splintered bits. Maggie sent him home, to Windsor, to live with his father in the brick house that he shared with Adam’s grandmother and her dozens of porcelain animal figurines.
Adam started seeing a psychiatrist, who prescribed him drugs. Over many months, Adam took many things: Paxil, Zoloft, Ativan, Demerol, hydromorphone, gabapentin, Wellbutrin. Adam tried CBD oil. He tried cognitive-behavioural therapy and acceptance-and-commitment therapy and mindfulness meditation. He tried rest: lying on the couch for hours of his day, watching BBC World Service and reading stuff on the internet. But nothing made him feel well again.
Adam started to wonder if there were some patients who couldn’t be helped by modern medicine—and if he was one of those patients. He wondered what doctors would do if he was. “Dad, as long as I’m alive, the doctors are going to keep trying to find something,” Adam said. “Hang in there. Let them help you,” Graham said. But Adam’s mind was already elsewhere. In June 2014, he logged on to Facebook. “After reading a few things I was curious,” he wrote. “What are peoples’ opinions on the ‘right to die.’”
In 2015, Canada’s Supreme Court overturned the country’s ban on assisted death, ruling it unconstitutional. Parliament was given one year to translate the new judgment into law and to define its practical borders: who would be eligible and who would not. Lawmakers could be as expansive as the court allowed or add additional criteria and safeguards, narrowing the dimensions of access. Adam read the text of the Supreme Court decision closely and was surprised by it. It said that a competent Canadian resident had the right to physician-assisted death if they had a “grievous” and “irremediable” medical condition that caused them to “endure physical or psychological suffering that is intolerable.”
It said nothing about terminal illness or imminent death. There was no requirement of a physical pathology at all: psychological suffering was enough. The court seemed to care less about the cut-and-dried particularities of a prognosis—how much lifespan was left, what part of the body was diseased or broken—and more about the subjective experience of the patient, who alone could decide whether their suffering was unendurable. It seemed to Adam that the court had theoretically cleared the way for an assisted-dying law that included him.
Almost immediately, Parliament and the press began debating the limits of the would-be law, in particular whether it should include people whose primary sickness was psychological. The Federal Special Joint Committee of the House and Senate on Physician-Assisted Dying heard testimony from both sides. Proponents argued that the law should be more elastic than its American equivalents in the kinds of suffering it recognized. They cited reports showing that mental suffering could, in some cases, be worse than physical pain. A large study of subjective well-being in Germany, for instance, had found that only end-stage liver disease was experienced as more severe than some mental disorders.
To the hardest-core advocates, the exclusion of mental illness was not just overly cautious but also ethically dubious because it privileged physical over mental affliction. For years, health care officials had been working to destigmatize mental illness, in part by disputing the notion that mental illness was the fault of the sufferer or that it was somehow less than physical pain. Advocacy groups had also challenged the perception that anyone with a mental illness was out of control or out of their mind and unable to recognize their own interests, much less act on them. They had made progress. But rejecting patients with mental disorders from an assisted-dying law would seem to communicate, “Your suffering is absolutely serious and real . . . unless you want to die, in which case it is not. In that case, we know what’s best for you.”
In Toronto, Justine Dembo, a young psychiatrist, followed the debate from Sunnybrook Hospital. Early on, Dembo decided that she was open to the broadest formulation of the law and to the possibility of one day helping her patients to die under it. To Dembo, the idea that doctors should exclude patients with mental illnesses—presumably to protect them from themselves—was born of something even deeper than stigma or fear. It was instead evidence of professional hubris and of the particular obstinacy of psychiatrists, who never seemed willing to admit that some patients just could not be helped. Oncologists and lung specialists were, by contrast, used to surrendering battles: to acknowledging that surgery had failed or that another round of chemotherapy would be pointless. But psychiatrists still believed they could help everyone. There were always more drugs and drug combinations to try and more therapy techniques to borrow from. And the treatments themselves had no obvious or preordained endpoints. Psychiatry, it seemed to Dembo, had lost sight of its own therapeutic limits. Or, at least, doctors were unwilling to acknowledge them and act accordingly.
Dembo already knew that some patients could search forever and never find anything that worked for long. In the famous Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, published in 2006 in the American Journal of Psychiatry, researchers found that around 30 percent of people in outpatient care were still symptomatic after four consecutive medication courses. Among those who did respond to treatment, 71 percent relapsed within one year. Electroconvulsive therapy (ECT), a neurostimulation technique, was shown to help refractory patients about half of the time, but some people didn’t want ECT because it needed to be administered under general anesthesia and could cause retrograde amnesia. Psychotherapy worked for some people and not for others. The same was true for inpatient treatment programs and for rarely performed neurosurgical interventions like bilateral cingulotomy, in which surgeons cut or burned part of the patient’s brain in a region that connects sensory experience with pleasant or unpleasant memories. Given this, Dembo asked, was it so irrational for some long-term psychiatry patients to conclude that their suffering would never be relieved by science?
The logical leap—that some people should be allowed to die—felt quick and almost traitorous. “In psychiatry,” Dembo said, “you really learn that anyone who wants to die is suicidal and should be treated as such and prevented from suicide. In residency training and until very recently, there was no discussion at all about whether a wish to die could ever be a rational response to any illness, let alone a mental illness.” Instead, when patients said they wanted to die, their plans were called “suicidal ideation” and taken to be proof of their sickness. Their psychiatrists, in turn, worked to subdue the thinking. That was literally the point of the job: to keep patients alive, to prevent suicide.
In 2010, a few years into her residency, Dembo wrote a searching paper about “treatment futility and assisted suicide in psychiatry.” While researching, she had learned that some countries—Belgium, the Netherlands, Luxembourg, and Switzerland—already considered mental illness a valid criterion for assisted death in limited cases.
Dembo presented her thinking at a grand rounds lecture at Toronto’s Centre for Addiction and Mental Health. She asked whether physician-assisted death could ever be considered a form of harm reduction. Some patients were likely to take their own lives; at least, this way, they wouldn’t die alone, in fear, and maybe in awful pain. After the talk, Dembo thought she might get in trouble for what she’d said. Instead, she was thanked by a few senior psychiatrists. “Don’t tell anyone I said this,” one whispered, “but I’m really glad you brought this up because I have patients who I really wonder about.”
But, beyond the Toronto conference room, some psychiatrists were growing alarmed by the discussions playing out in Canada. Critics argued that patients with the most severe mental illnesses—the ones who were most likely to qualify under an assisted-dying law—were, by virtue of their conditions, not able to make decisions about matters as grave and permanent as death. They noted that the very fact of severe depression could distort the way a patient understood their prognosis, making them more likely to anticipate failure and interminable suffering. Because the patient’s ability to reason was corrupted, their lethal longings could not be accepted as rational, much less be carried out by an acquiescent physician.
The most ardent detractors argued that assisting in the death of a psychiatric patient was akin to collaborating in an irrational suicide. To help such a patient, they said, would be to confuse the very symptoms of mental illness—a desire to die, despondence, fear of treatment, a parched sense of meaning—with rational thinking. It would be to recast the existential dread of a sick person into an expression of free will.
Some believed that the existence of an expanded law would itself hurt patients. The thinking went that, if an already fragile patient was given the option of assisted death, they would give up on life sooner, especially if their own doctors took their request seriously and, in doing so, seemed to validate the fact that their case was utterly hopeless. The very process of evaluating the patient’s request could, in other words, influence the course of their mental illness and make it worse. An expression of interest in assisted death could become its own self-fulfilling prophecy.
Others condemned the proposal on more practical grounds. They admonished Canadian politicians for even considering such an expansive law given the state of mental health care in the country. “The fact is many mentally ill people live in terrible conditions of poverty and exclusion,” wrote Canadian psychiatrist John Maher in a later paper. “Are we pushing people towards wanting death and then perversely offering a legal path to that end? Shame on us if we are.” Some imagined a dystopian future in which time and resources and expectations were diverted away from mental health care and put toward the ultimately less expensive work of helping patients die.
It seemed obvious to Dembo that she could never know with complete certainty that any given patient was incurable. Anyone could be a one-in-a-million outlier, and some seemingly hopeless cases did take turns for the better. People improved. But what was improvement anyway?
A patient might move up a point or two on a depression scale, in a way that a professional could measure, but still feel dreadful every day. The way it looked to Dembo, many psychiatrists were treating patients who had no reasonable prospect for substantial improvement while enjoining those same patients not to give up hope that their hideous suffering might end. Was that morally correct? The bioethical consensus in other fields of medicine seemed to be that it was unethical for doctors to offer false hope. But some psychiatrists seemed ambivalent on the point, maybe because they believed that mentally ill patients needed hope in order to get better. That hope had its own therapeutic properties. “We thus find ourselves in a paradox in which hope is vital for recovery but may also lengthen lives of unbearable mental anguish,” Dembo wrote in a 2013 paper. “What is an ethical therapist to do?”
Dembo started to imagine ways that her thinking could be converted into professional medical standards. Under her ideal formulation, a patient who was eligible for assisted death would have to demonstrate chronic suicidal thinking as opposed to fleeting suicidal moods. They would also be subject to a waiting period of several months or even years after their request for death. They would have to have tried a certain number of evidence-based treatments, including medications and therapy, to make certain that their illness was unresponsive to them. The law would require that a patient had tried. Still, Dembo thought, no law could demand that a person try everything and anything. Even a patient with a severe psychiatric disorder had the right to say no. To say enough is enough.
Adam Maier-Clayton was the first patient to ask Giovanni Villella, a psychiatrist in Windsor, about assisted dying. It was the end of 2015, and Canadian parliamentarians were still formulating their aid-in-dying law. Adam had met Villella at the emergency room, where he’d gone in a moment of pain-racked panic, and Villella had agreed to see him in his private practice. Canada’s universal health care system covered psychiatric care, but the waiting times to see specialists could be long and the visits could be limited, so some patients paid privately instead. Adam’s father said he would pay. One day, Adam asked the doctor whether he thought that assisted dying should be an option for people who were sick like he was, in a mental way. Villella looked straight at him. He knew that he could never physically help a patient to die. He was a religious man, and the act went against his faith. But he also didn’t think that people who wanted assisted deaths were asking for anything wrong. In Villella’s experience, a small fraction of patients—7 or 8 percent, maybe—were largely resistant to treatment. Fundamentally, he agreed with Adam that those patients had the right to a peaceful end. Only, Adam was so young. There were still things to try.
Adam followed the doctor’s instructions and took all his recommended medications. He tried one drug, then, when he decided that it wasn’t working, he weaned himself off it and tried something else or had something added to the mix. Overall, he thought the drugs made him only 5 percent better, which wasn’t better enough.
The only thing that ever dulled the pain was exercise. As often as he could, Adam would drive to a gym in a nearby strip mall. He would lift heavy things until he could feel nothing but the normal burn that muscles were supposed to feel when they were put to extreme use. The pain from exercise cancelled out the other pain, for a while. Sometimes, Adam would look at himself in the mirror and think how wild it was that he could feel as bad as he did without having physical marks on his skin. No matter how much he lifted, the pain would find him a few hours later. So would the thoughts. When the thoughts were in his mind, Adam could act frantic, almost feral.
In October 2015, Adam started a blog called Outpatient Memoirs. In early posts, he wrote about how hard it was to see people he knew go to work every day and build lives for themselves. In other posts, he described the business ventures that he had planned to start before he became sick and second rate. In his narration, they were not frustrated hopes or sidelined dreams but a stolen future. “A life of mediocrity or worse is not worth living,” he wrote.
In early 2016, Adam told his father that he was planning to commit suicide. He explained that, for years, he had hidden just how bad he was feeling. But, now, he was scared that he would “reach a point where I can’t take it anymore.” He promised his father that he would keep trying for another twelve months, but after the twelve months were over, he couldn’t promise anything. Graham cried.
After the conversation, Graham decided that there was nothing for him to do but support his son. Adam didn’t seem depressed in the “down, down” kind of way. He seemed clear-headed. “Which is more important,” Graham asked me, “that you don’t give up on having your child with you or that you take mercy on your child?” Adam’s mother, Maggie, was less accepting. When Adam told her what he intended to do, she sobbed and begged him to mail out a sample of his hair to have it analyzed at an American lab. Maggie thought Adam’s body may contain something toxic that was messing with this mind.
Adam started writing on his blog and on Facebook about the assisted-dying debate. The more he posted, the more random people friended him. Some sent messages to say that they related to his words and were suffering too. Those strangers got Adam thinking that maybe he could become a kind of public activist, with a YouTube channel and 10,000 Facebook followers—and then that he could use his influence to lobby on behalf of mentally ill people across the country. He could change the law and then he could die under it.
In June 2016, the Canadian government finally introduced its aid-in-dying legislation. Bill C-14 was, by all accounts, far more liberal than any equivalent American law, since it did not require that patients be within six months of natural death. Still, when Adam read through the text, he felt wrecked. It would never apply to him. In the end, legislators had excluded mental illness from their eligibility criteria.
Adam sent an email to Ellen Wiebe, a Vancouver family-medicine professor and women’s health practitioner who had spoken publicly in support of assisted death and whom Adam had read about online. He asked her to review his medical files, and she agreed. The two talked on Skype a few times, and Wiebe could see that Adam was sad, but she felt that his sadness was a reasonable reaction to his illness and his situation. That summer, after the full text of Bill C-14 was published, Wiebe told Adam what he already knew: that he was not legally eligible. But, even if he had been eligible, she said, she still would not have agreed to help him die, “because I still see you as someone with potential.” He was so young. There were still things to try.
Adam bought a little camera and started filming lectures for YouTube. While filming, he wore muscle shirts or tight V-necks. To anyone watching, he didn’t look sick: he looked like a movie star. He warned his viewers that he would probably end up crying a lot on camera, but he rarely cried. More often, he got angry, lashing out with manic energy at unnamed haters who allegedly didn’t believe that he was sick, or who told him that the nothingness of death would not bring him peace, or who said he owed it to his future self to stay alive.
Journalists got in touch, and soon, Adam was doing radio and newspaper and TV interviews. “If I kill myself,” he told a reporter at the Toronto Star, “I’ll be proud.” In December 2016, Vice described him as “the face of mental illness in the ongoing right-to-die debate.”
As Adam spent more time online, he saw less of his old friends from high school and college. On Facebook, the messages from strangers kept coming. He texted with strange women who offered to hook up with him in Toronto and Hamilton and Ottawa. He skyped with a man in Australia who wanted to film his death so that the video could be uploaded afterward and go big on YouTube.
Graham watched his son move silently around the house. He worried about how many hours Adam spent on Skype and Facebook every day, talking to people across Canada and Asia and Latin America and everywhere else about their problems. Adam tried to respond to everyone, but each day, he fell short. “You can’t carry the load on your shoulders,” Graham said. “It’ll break your back.”
One day in December 2016, I asked Adam if there was any universe he could imagine in which, over the next few months, something may start working for him “to the point that you no longer think about ending your life?”
He paused. “My hope is surely very little.” For a while, he had thought that ketamine injections could help him, but in October, he tried them three times and said they didn’t work. It was clear, he said, that no grand pharmaceutical gesture would make the pain go away—or help his obsessive-compulsive mind to slacken. If he did get better, it wouldn’t be better. It might be like being able to talk to a woman for an hour without clenching his jaw because his chest hurt so much. If his life right now was a negative ten, it might become a negative seven. It might become slightly less of a joke, but it would still be a joke.
On January 1, 2017, Adam logged on to Facebook and announced that his “insurance policy (a lethal compound) had cleared customs.” He was vague about the particulars. He had connected with Exit International, a right-to-die advocacy group, then had met some people online who offered to help him get pentobarbital. A few weeks later, he posted a picture of a medicine jar. He claimed that it contained sixteen grams of the drug and that it had come from China. “No noose, no skyscraper, no blood, no traumatizing innocent bystanders, just sleep,” he wrote.
On April 14, 2017, Adam left his house in the middle of the night and drove down the expressway in the dark. “I am my own savior,” he had written on Facebook. “Always have been. Always will be.”
When he turned off the freeway, he checked himself in to one of the cheap motels lining Huron Church Road. When he got inside, he ate two pieces of raisin bread and a muffin and drank a glass of milk. He left letters by the door. One was addressed to the building manager, and in it, Adam apologized for taking his life in the motel.
When the police arrived at Graham’s house to tell him that his son was dead, he did not invite them inside. They spoke on the front porch. Then Graham called Maggie. Neither knew exactly how Adam had gotten the drugs. In the notice of death that they published online, Graham and Maggie wrote that Adam had “died of rational suicide after suffering from an exotic neurobiological illness with no known cure.”
“My son died all alone in a hotel room,” Maggie said at the funeral. “My son deserved to die with dignity. With his family and friends beside him, in his own comfy bed.”
On April 17, 2017, Adam’s final Facebook post was quoted at the top of a Globe and Mail op-ed titled “The Mentally Ill Must Be Part of the Assisted-Dying Debate.” In another op-ed, published two days later, journalist Sandra Martin wrote that “Canada’s assisted-dying laws must be open to those with mental illness.” Online, the CBC ran an article about Adam that included a photo of a teary Graham, wearing a tweed jacket and staring vacantly into the distance. Alongside the text of the article, editors placed a sidebar with the phone numbers of local anti-suicide crisis lines: “Help is available.”
Around that time, I travelled to Windsor to speak with Graham again. He led me into the living room. Occasionally, he told me, he still got calls about Adam. Strangers would reach him at home or at his office: they called from around the world to say that Adam’s videos had been meaningful to them. Some said, “I’ve got a son that’s going through this right now. Your son’s stuff helped me understand.”
Before his death, Adam gave Graham a list of all his email and social media passwords. In the last few months, Graham had started logging on and sifting through the digital detritus of his son’s life. He was starting with the Facebook messages.
“Why?” I asked.
“Well, it’s part of his legacy, isn’t it?” From what Graham could tell, Adam had spent hours a day corresponding with people who were lost and hurting. What was amazing, Graham said, was how often Adam had urged people to keep trying. To slow down. To stay alive.
If you or someone you know is having a suicide crisis, please call the Canada Suicide Prevention Service (1-833-456-4566), which offers 24/7 support. There is also Kids Help Phone, the First Nations and Inuit Hope for Wellness Help Line, and 1 866 APPELLE (for Quebec residents).
Excerpted and adapted from The Inevitable: Dispatches from the Right to Die by Katie Engelhart. Published by St. Martin’s Press, March 2, 2021. Copyright © 2021 by Katie Engelhart. All rights reserved.