Too Close to Home

It's a shame that the Wall Street Journal is subscription only on the web. Readers near a newsstand however, would be well served by picking up a copy today for a beautiful, sad, difficult page one article entitled "The Choice: Years on Dialysis Brought Joe Mole to a Crossroads". Fair warning: reserve a half hour to compose yourself afterwards. This one hit me very close to home. (Internal links added.)

As the winter of 2002 approached, the only things standing between Joe Mole and the biggest decision of his life were his family and friends, his faith, and an unfinished set of cherry wood pews. Mr. Mole, a 41-year-old carpenter, was debating whether to die... voluntary dialysis quitters are often in solid mental health, and aren't usually influenced by major depression or suicidal tendencies, according to psychiatrists who have studied the issue. They don't leave family members to confront a sudden loss with little more than a suicide note. Rather, they sometimes quit treatments despite having family and friends who plead with them to choose life...

Mr. Mole had never been religious. But around the time of his mother's death and his first dialysis treatments, he attended mass at St. Brendan church with his sister Beverly Wingate, 10 years older and visiting from Cincinnati. That afternoon, he started taking instruction to become a Roman Catholic. Shortly before his April 2000 baptism, he had four toes amputated. As happens with many diabetics, the circulation in his feet had grown weak and his toes had become hopelessly infected. Mr. Mole was concerned he wouldn't be able to stand in the baptismal font, as adult converts did, because doctors warned him not to get his feet wet. "I have to get in that water," he told his sister. "Otherwise, I'm worried it won't count." Before the service, he taped a plastic bag around each foot. "Joe had bags on his feet in the baptismal font," says Father William Anderson, who baptized him. "And he was beaming."

...Inside a butterfly sanctuary, Mr. Phillips recalls spotting Mr. Mole covered with butterflies. Only one or two landed on him and Ms. Kimble. "Pam," Mr. Phillips said, "do you think they somehow know he's sick?" In January 2002, the Tomblyn Funeral Home in Elkins commissioned Mr. Mole to build and install 22 cherry wood pews in its chapel. It was one of the biggest projects he'd ever undertaken...

Nurses from a hospice-care agency came to treat him at home. One was Timothy Nulph, 43, who drove a Harley Davidson motorcycle and wore shoulder-length blond hair, a mustache and a beard. He and Mr. Mole talked about woodworking, women and how they'd ride motorcycles together when Mr. Mole felt better.

Mr. Nulph says Mr. Mole asked him what he could expect if he quit dialysis: How long would he live? What pain and discomfort might he experience? How was quitting dialysis morally different than ending your life, as Mr. Mole put it, "with a shotgun"?

Mr. Nulph says he listened without advising. But he couldn't help giving his opinion when Mr. Mole asked whether quitting dialysis was a sin.

"You're being kept alive by a machine," Mr. Nulph says he told him. "Yes, God gave us the knowledge to make the machine, but I can't see stopping something artificial as a sin."

Ms. Kimble asked Father Anderson to talk with Mr. Mole. The priest visited Mr. Mole in his room one day in June of 2003. Father Anderson told Mr. Mole that what he was contemplating wasn't suicide. Rather, it was a decision not to interfere with nature taking its course. The church didn't require him to submit to "extraordinary" means, such as a kidney machine, to sustain life, the priest said. Mr. Mole looked relieved, Father Anderson recalls.

How the church views the decision to discontinue medical treatment varies upon on the individual case, says William Ryan, a spokesman for the U.S. Conference of Catholic Bishops. "If the person simply wanted to stop dialysis to end their life that wouldn't be considered the moral thing to do," he says. "If the treatment is considered burdensome, not doing any good, useless, it may be permissible to quit in the eyes of the Catholic faith."

...That Monday, Genny Cross arrived at the dialysis clinic to find chair number 7 empty. "I thought maybe he was in the hospital," she recalls.

Mr. Mole was at home, where Father Anderson had come to give him communion. Because he was so nauseated, Mr. Mole was concerned he might regurgitate the host, so the priest broke off a speck and gave that to him. "In God's eyes," the priest said, "you're in good shape."

...At the Tomblyn Funeral home, family and friends of Robert Joseph Mole, 42, sat on the pews he'd made and bid him farewell.

Father Anderson told them Mr. Mole was handed life like a piece of imperfect wood, and through his handiwork, crafted something beautiful. He joked about a reading from the Gospel of John: "In my Father's house are many mansions." Father Anderson said, "Joe is probably up there, fixing some of them now."

A riderless Harley stood on a hill outside St. Brendan church, placed there by Mr. Nulph, the hospice nurse, as a tribute.

Two years later, his sisters say they remain haunted about how they responded to their brother's wishes.

Mrs. Wingate wonders if she should have simply encouraged him to do what he wanted. "Even now I struggle with the rightness and appropriateness" of her early response, she says. On several occasions when she has thought about her brother, she says a white butterfly with a black spot on each wing has appeared, fluttering around her before flying off. She thinks it's a signal from her brother, telling her he's well and happy.

In September, Ms. Kimble, 57, attended the dialysis clinic's annual candlelight vigil for patients who have died. She says she now regrets discouraging Mr. Mole from stopping treatments. "It was selfish on my part," she says. "I just didn't want to let him go."

There's much more. Go pick up a copy. No, the WSJ is not just about corporate moves and conservative politics. This is simply good, solid, human-interest story-telling. Unlike much of the MSM (and even the wire services) these days, this kind of piece reverberates across dozens of questions of morality and public policy without feeling the need to make didactic points about any of them. It presents facts and trusts its readers to think. And in this, there's a lot to think about.