In photos from childhood, you would never guess what lay ahead.
My identical twin sister looks straight into the camera with a twinkle in her eye, an impudently raised chin, and an impossibly wide smile; she's daring the camera to try to catch her and hoping it will. I am usually next to her, head tilted to one side, eying the camera suspiciously as if hoping it will spot my flashy twin and leave me alone. The way our arms curl around each other shows the close bond, like a two-headed, four-armed being, but I am certainly the trailing end.
I could not have guessed that 25 years later I would sit in an easy chair, with her on the floor beside me, holding my hands tightly in her own, as she asked if I would, please, finally, let her go. Let her take her own life and end the pain.
From the age of 14, she'd struggled with severe bipolar disorder -– alternating between “normal” periods, where she was more depressed than you've likely ever been in your life, and psychotic periods, where she would end up in restraints, or in jail, or catatonically curled up in a fetal position for weeks at a time or strapped to a bed with electrodes in her head, losing her memories one zap at a time.
The illness and treatments had taken so much from her -– her prospects, her confidence, her security, her dignity. They had left, in return, 90 extra medication-induced pounds, sneers and glares from strangers and medical workers, and a treasure trove of traumatic memories and disappointments.
I became her roommate and care provider. When she'd begin to fade into insubstantial darkness, I'd rock her gently in my arms. While watching her face freeze into a silent scream from wracking psychic pain, I'd say quietly “The pain will pass over you like a wave. Let the wave come and go. Eventually it will be gone and you'll still be here.”
When it was over weeks later, she'd still be there all right, but she wasn't the same person. You don't go through pain like that and come back with a happy, mischievous light in your eyes.
It got so that she didn't suffer most when the depression was on her, but in the in-between times. The sun would be shining and she'd be building something she cared about when the terrible certainty of the next great storm would steal her strength and her breath away.
And after a long time of that, she wanted to die. But I didn't want her to go, or at least not in that way, not a sad death in a cloud of fear and pain and hopelessness.
After several failed attempts over a decade, she finally decided she was ready to go for good, but that I was holding her back and weakening her resolve so she couldn't pass through.
She sat me down in that easy chair, and she said, “I know you love me, and I love you more than anything in the world, but I don't want to live this life. I don't want to face another episode, I don't want to feel this pain anymore, I don't want to burden the world with it. You are the only thing anchoring me to the Earth, and I'm asking your blessing to leave. Will you please –- please -- let me go?”
It took me three days to get over the shock and settle into thinking about the question. I held a precious, suffering life in my hands, and it was begging me to kill it.
And finally I said yes.
Tortured and wracked with pain and sadness, I said yes. I couldn't say no just to save myself some suffering at the expense of my sister. So I said yes, I can let you go.
But I asked her for three agreements:
- She would do it as gently as possible.
- She would let me stay beside her so I would know she didn't die alone and afraid.
- And she would give me one last chance –- one month to run a full-page ad in the New York Times, telling our story and begging for help from anyone who could truly help our desperate case. If nothing looked like salvation to her, I said, she was free to go.
And she agreed. Thank goodness she agreed.
I never had to run the ad –- I went screaming that day to the best expert I could find and I begged him for help. He recommended the best psychologist he could think of, and she saved my sister's life using Cognitive Behavioral Therapy and PTSD therapy techniques. She taught mental strategies to undermine the pain, and strategies to cope with the fear of its return –- she had my sister keep a calendar of the number of days the pain was with her, and how many days it was not, to help her understand that the number of bad days was well outweighed by the number of good.
She taught that the suicidal impulse lasts 15 to 30 minutes and in that time you see no other options -– but if you let your body move a little, and you wait it out, the other options will remind themselves to you and the impulse will pass. She taught illness management strategies like faithfully filling your pillbox (my sister's is the size of a hardbound Harry Potter novel).
For every fear and weakness, she taught a strategy to cope and overcome.
It's now 14 years on, and I am sitting at my desk with one less kidney. My sister is now so pleased with life, so satisfied with the sunny days, that she took me up on the offer of a kidney so she could have even more time alive than her own body had left to give. And I gave that kidney with joy.
That was an epic day –- that day I could hear the falling in of Mount Doom, see the Eagles swooping in to rescue two battered, weary heroes, feel the warm sunshine streaming through breaking black clouds. And I perceived as only a faint wisp over the joyful scene, that darkest moment years ago when I was sure I was holding her, in an easy chair, at the end of all things.