A legacy of love and compassion
Professor Arnold Gillespie was a driving force behind the push for a voluntary assisted dying law in South Australia. When he became terminally ill, he applied for VAD himself. Here, Arnold's wife Debra tells his story.
When somebody you love is in intolerable pain, there are no words to describe the relief that comes knowing that help is at hand.
To put things into context, let me tell you a little bit about Arnold.
Arnold was Associate Professor of Obstetrics and Gynaecology at the University of Adelaide until his retirement in 1999. He worked in Gynaecology at the Royal Adelaide Hospital from 1974 until 1999, heading the department during those years. Whilst working there he saw significant pain, suffering and lack of dignity in much of the work he did, particularly when dealing with gynaecological oncology.
This was one of the driving forces behind his dedication to achieving VAD for everyone. He worked on the South Australian Voluntary Euthanasia Society (SAVES) and then Voluntary Assisted Dying SA (VADSA) committees as Vice President from 2013 to 2019. The only man during that period, or since, to work on committee.
At Arnold’s funeral, Francis Coombe, President of VADSA said
“The beauty in Arnold will always be with us. A legacy of love and compassion, of intellectual rigor, tenacity and high achievement.”
Arnold’s focus moved from committee to the VADSA Task force, which is the strategy arm of VADSA, working to support the VAD bills presented to the SA parliament – incidentally, there were 17 bills presented between 1995 and the passing of the current law.
He was a founding member of Doctors for AMA Neutrality on VAD. This group later morphed into Doctors for Assisted Dying Choice, of which he was the National Convenor for 15 years. In that time, he oversaw the growth of the organisation from a small splinter group to – and I quote – “…a medical advocacy powerhouse that has played an important role in promoting the adoption of VAD legislation in every State of Australia.” That quote from Dr Richard Lugg a long time Doctors for Assisted Dying Choice Committee Member.
Arnold also became involved in developing the educational program that today’s South Australian VAD doctors undertake before being able to assist patients at the end of their lives.
He would be the first one to tell you he had a good life and he lived it to the full, particularly in his retirement. We spent three years travelling the UK, Europe, and Scandinavia in a motor home, making friends and memories along the way.
Whilst we were away Arnold worked for a short time in a women’s clinic in north London. The clinic had been established along the lines of the RAH Women’s Health Centre that he established many, many years before. He was always a strong advocate for women and women’s health. The London clinic’s founder had visited the RAH and was in awe of the centre and was determined to establish something along similar lines for women in London.
Coming home from our travels in 2002, we again got itchy feet and we then played grey nomads and travelled Australia for another couple of years.
Arnold loved life. He loved work. And he loved us, his family.
In November 2022 he contracted osteomyelitis and septicaemia and was hospitalized. It took a while, but he eventually came home, albeit considerably weaker and still in considerable pain.
A series of further medical complications, including a particularly rare sarcoma, continued to make his life difficult, such that a few days before he took his final trip to hospital, we sought assistance for help with voluntary assisted dying.
Before he was able to have his first VAD visit at home, he had a fall that resulted in two pelvic fractures, and he was back in the Royal Adelaide Hospital. Here a different team became responsible for Arnold’s VAD care. Chloe, Mandy, and the team were kind, caring and thorough, confirming that Arnold fulfilled the criteria required, and in particular that he was mentally competent to make this decision about his life.
The only way that I can tell you about the joy that he felt after being approved by the second doctor were his exact words. After sobbing with relief, he suddenly smiled the best smile I had seen in a very long time and said, ‘You bloody beauty!’ Not something I had ever heard him say before.
The dictionary describes relief as “a feeling of reassurance and relaxation following release from anxiety or distress”. But it was so much more than that.
Where previously there had been fear of the unknown, fear of the prospect of ongoing pain, fear of dehumanising lack of dignity and a basic fear of what happens next, we both had an immediate feeling of calm and for the first time in a long time, we felt positive.
Arnold had something to look forward to – relief from both physical and mental pain.
He wasn’t afraid of death, in fact due to his health status, he welcomed it. That perhaps sounds a bit macabre - but when ongoing intolerable pain is all you see before you, it isn’t macabre at all. It is a feeling of lightness, of almost wellbeing as strange as that may sound. Arnold’s change in mood was palpable. This change, coupled with evident relief was commented on by several.
Our experience on the day. Our family is a blended one and the children (all aged over 45) were given the option of being with Arnold at the time. Two of the three came but the third did not feel able to be there at the end. Arnold respected this and they said their goodbyes the day before.
Arnold always said he wanted his life celebrated, and we were determined to follow through on that. He wanted French champagne and Pringles (for which he had recently acquired a taste) and about half an hour before we were due to have the VAD team meet with us, we toasted his life and he talked to us about how grateful he was for the wonderful life he had lived, thanking us also for the parts we had played.
He was so very aware that he needed to be fully competent to give the final agreement to VAD and to that end he had taken little to no pain relief over the previous 24 hours. Reading the pain on his face was almost overpowering for me. His emaciated body and his tenacious mind were each struggling so very hard to radiate peace and calm for us.
At the appointed time the team arrived and when Chloe was ready, she called in the witnesses. Arnold chose to have hospital witnesses rather than place that task upon friends and he was extraordinarily thankful for their service.
There was no hesitation in anyone’s mind that Arnold not only understood the procedure and was capable of giving his consent to it but, true to his life’s work, he was also able to further educate all about VAD. The answers he gave were full of passion and knowledge. Not answers that would be heard very often by most witnesses. The witnesses confirmed Arnold’s competence with regards to consent and left the room, with Arnold’s unending thanks.
With most of his family around him, we hugged, kissed and then held hands as Chloe delivered the medication. Arnold’s oesophageal spasm negated oral medication. As he was telling us how much he loved us all he slipped away to the peace that he so desperately craved. It was a beautiful death. It was a death he wanted, and he never wavered in his decision. His racked body and mind were at rest.
Chloe, Mandy and the VAD team here at the RAH cannot be commended highly enough for their care, concern and dedication to their work.
As a family we knew that it was the right thing. No, we didn’t want to lose him. Yes, it has left a very vacant space in our lives, but it is what Arnold wanted and the family agree that without doubt it was the best thing that could possibly have happened to a man so dedicated to the cause of helping those in distress at the end of life.
Arnold and I shared many journeys in our lives together. We journeyed all over the world. We had a rifle with bayonet fixed pointed at us in Moscow, we climbed inside the great Pyramid of Giza, in Botswana we were charged at by a bull elephant and we travelled to North Cape in Norway to watch the sun NOT go down on the longest day of the year. So many journeys.
This, Arnold’s last journey, was one of joy and pain but one that I was grateful to make with him. To share with the man I love, the most distressing times physically and emotionally, knowing that he was able to end life with some dignity still intact.
Only last week there was another assisted death in my family. I have been a professional animal trainer for more than 20 years, and dogs are a major part of my life. My old girl told me her time had come. As she slipped away from me with the help of her wonderful caring vet, in the arms of the human who loved her, I could not but help make a comparison.
For so long we have been able to help our family pets shuffle off the rigours of pain and suffering. Because of the work undertaken by people like Arnold, various committees and organisations dedicated to the cause of VAD, by Chloe, Mandy, the team here at the RAH and other medical professionals dedicated to the cause, this gift of VAD should be treasured, nurtured and the privilege never underestimated.