Debra wanted her affairs to be in order.

Her small home was quiet, save for the beeps and vibrations coming from her late-husband David’s cellphone: alarms reminding her when to eat, when to take her medications, when to water the plants. In the mornings and evenings, there were alarms to open and close the curtains in the living room and, at regular intervals throughout the day, alarms prompting her to use the bathroom because she did not always remember to go and would sometimes have accidents. Debra imagined that David’s cellphone was David himself, re-embodied, a year after his death, and ministering to the needs of her failing body and rotting mind. “I used to be a Maserati,” she liked to say. “Now I’m a clunker.”

The neuropsychologist had used another word, which was “dementia.”

After the appointment, Debra started having visions of life in a nursing home, lost and unglued. Doctors would ignore her, and nurses wouldn’t know how to position her in just the right way so that she wouldn’t be in pain. She would forget how to think. She would forget how to chew and swallow. The other patients would cry and moan, and they would feed off one another — each patient nudging the next into ever more hysterical and demented states. It would not be a nice facility because Debra could not afford a nice facility. In Debra’s vision, things would be worst at night. “Strangers are touching me. People are going through my personal life. Touching me in a way that might be inappropriate.” If it happened, would she even know that she was being hurt?

Debra decided she didn’t want to become incapable of caring for herself.

In addition to working as an exit guide, Brian volunteered at a suicide-prevention hotline: trying to keep strangers alive for a few more hours until the crisis passed and “usually, they realize that they don’t want to die.” Brian knew how to talk a person out of it. Debra, however, had thought things through. So who were we to judge whether her cognitive decline was sufficiently severe? Who were we to say that it needed to be severe for the exit to be — what, worth it? “She doesn’t want to lose her selfhood,” Brian said. “She sees it happening.” Brian believes that nobody wants to die, only sometimes they can’t live this way.

When she was younger, she and her husband had been in a life-altering car wreck.

After the crash, Debra and David spent most of their time taking care of each other. They went out less. They saw fewer people. David helped Debra with her pain pills and swore that the wheelchair didn’t bother him one bit. He became Debra’s arms and legs. Debra tended to David through the blood clots and the heart surgery and the cancer. Debra spent hours researching his various maladies. Each time she presented David’s doctors with a suggestion for a new treatment, she felt certain that she had saved his life.

It was only after David died that Debra began to see herself as she was. The confusions and forgetting, which she had brushed aside, now lay in view. It was also after David died that Debra finally read the terms of the reverse mortgage that he had signed to cover their medical bills. Debra wondered if she would lose her home. She was stunned by how little money she had left.

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