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In the final phase

As her cancer symptoms intensify, Lovelle Svart’s decision whether to end her life comes closer.

When a friend from Portland, Maine, visited recently, Lovelle Svart went out to lunch two days in a row. Each time, whether it was the snapper with hazelnut crust or the salmon with green beans, she had to stop after a couple of bites.

“Like getting glass stuck right here,” Lovelle says, her right hand pressing her collarbone, “and it won’t go down.”

Painful swallowing is scary for Lovelle, and not just because it keeps her from eating. She also is considering ending her life under Oregon’s unique-in-the-nation Death With Dignity Act. To do so would require her to swallow — without help — the lethal drug overdose her doctor prescribed in August, at her request.

No matter how long Lovelle has had to think about it — she found out nearly five years ago she had inoperable lung cancer — the notion of dying still catches her by surprise. And no matter how much time she — a consummate planner — has spent anticipating her own death, she can’t control everything.

Intensifying symptoms, for example. Besides difficulty swallowing, they include shortness of breath, a gastric double whammy of constipation and diarrhea, weakness, and pain in the back and chest.

“I just can’t keep going, it hurts so bad,” she said. “This isn’t life.”

On a scale of 1 to 10, she rates her pain at “7 almost all the time.” It shoots to 10 when she tries to eat anything but soft food.

Until last weekend, Lovelle resisted taking morphine or other heavy-duty pain-relievers, out of fear they would make her drowsy and interfere with her clear-headedness. But as the pain throughout her chest became unbearable, she turned to morphine for relief.

Every few hours, she draws a tiny dose of the liquid into an eye-dropper and squirts it underneath her tongue.

While not bedridden, she stays in bed most of most days now and rarely leaves the apartment she rents in a Southwest Portland assisted-living center. It has been weeks since she ate anything like a meal — more than a few bites of yogurt, a slice of melon or a spoonful of black beans out of a can.

One surprise, for Lovelle, has been the accelerating pace of time running out. “I thought I’d make it to October,” she said Monday. “Now I doubt it.”

She scheduled a November visit to the dentist, even though both sides of the transaction knew she’d be unlikely to make it that far.

A second surprise: Her deepest physical fear of death has changed.

“It’s not my breathing; it’s my swallowing,” she says “It’s happening differently than I expected.”

Lovelle’s doctor warned her in early June that she probably would die within six months. That made her eligible to request what some call a doctor-assisted suicide and others call hastened death. During the 10 years since the Oregon law took effect, at least 292 terminally ill Oregonians have ended their lives by taking a prescribed overdose.

Although Lovelle filled her prescription, she had been unsure whether she would actually take the drug. She saw it as a kind of figurative tranquilizer, something she could use as a last resort if she met with unbearable pain or started gasping for breath.

But now, with her symptoms intensifying as the cancer spreads from her lungs throughout her chest cavity, she has edged toward a more resolute choice to take the life-ending drug. That possibility has evolved into a probability, she said this week.

“There’s no creativity,” she says. “There’s no fun. There’s really not a whole lot of reason to be alive anymore.”

This week, she occasionally lapsed into talking about herself in the past tense.

Her eyes are increasingly sensitive to daylight, she says, and sometimes she sees shadowy shapes — “like an animal or person” — moving across her line of sight. Even with her thinking intact, her memory is slipping, and she says she finds it increasingly hard to call up common words.

How does a self-described control freak — “that’s me,” Lovelle says — deal with the ultimate loss of control: impending death?

Partly, in her case, by continuing her obsessive planning and attention to detail. Her will is complete, her financial affairs in order, the cremation of her body arranged. Her apartment is “decorated” with yellow stick-on notes identifying who gets various belongings after she dies.

“It’s not as much the death itself; it’s really the things around it,” she says. “Like: Is everything going to work the way it should? Will all the pieces be in place?”

Including this piece: If she choose to end her life under the Oregon law, will she be able to swallow the drug? It is illegal for anyone to help the person lift the glass or get the liquid down.

From time to time, Lovelle tests herself by trying to swallow two-thirds of a glass of water in less than a minute. That’s roughly what it would take for her to ingest enough of the potion to put her into a coma and end her life.

In many ways, Lovelle’s tendency toward planning and detail are not unlike others who have requested a life-ending prescription. The typical such person has a “strong and vivid” personality characterized by “determination and inflexibility,” according to a 2003 study of doctors by researchers at Oregon Health & Science University.

Doctors reported finding such people “both challenging and likable.” They described them as “interesting, memorable, unusual, likable, amazing, passionate, eccentric and self-involved, but also as crusty, reclusive, demanding or solitary odd ducks whose views did not always mesh with the philosophy of hospice.”

Lovelle says her outspoken, personal account of her own dying, including her decision-making at the end of her life, has been less burdensome for her than for her family, including her 90-year-old mother and three siblings.

“I chose to do this,” she says. “They didn’t choose it.

“They’re going along with me. They support me, but it’s not a matter of their being real thrilled that I’m doing this.”

Don Colburn - 503-294-5124 - doncolburn@news.oregonian.com