Nine months ago, doctors told Zeporah “Zebbie” Geller her nagging back pain was terminal lung cancer. It was likely she had just months to live, even with treatment.
Zebbie Geller didn’t cry. She accepted that chemotherapy and its side effects would not allow her to live the independent, busy life the grandmother and retired teacher had so carefully cultivated, her son, Paul Geller said.
She wanted to plan her death — down to the final moments.
Would her family help her die?
“There was a 100 percent agreement on all of our parts. Nobody was talking anybody out of it,” Paul Geller said, sitting with Joanne, his wife of 33 years, at the kitchen table in their West Orange home earlier this week.
Wrapped in a blanket and curled up on the family’s leather couch, Zebbie Geller, 80, swallowed the pill and liquid cocktail the state of New Jersey now allows doctors to prescribe for their terminally ill patients.
On Sept. 30, surrounded by her two sons Paul and David, her daughter-in-law Joanne and her sister Diane, Zebbie peacefully died about 90 minutes later, the Gellers said.
“She lived with dignity and wanted to die with dignity,” Joanne said.
Although there won’t be a precise count from the state Department of Health until next year, Zeporah Geller is undoubtedly among the first people to die using New Jersey’s new medical aid in dying law.
Joanne, a 56-year-old teacher, and Paul, a 58-year-old clothing manufacturer, said they are a private family, but they want to share their experience with the law they so fervently support in the hope that it reduces the stigma surrounding the right to die.
“I would not want this to be misconstrued that we are trying to talk others into doing it. This is something we talked about for years and years,” Joanne Geller said. “We want this too. If you are uncomfortable with it, don’t do it. But it’s a really humane option.”
They also wanted to warn patients about the time-consuming obstacles they faced carrying out Zebbie’s wishes.
Zeporah "Zebbie" Geller, center, at her granddaughter Erica's wedding at Maplewood Country Club in 2016. Paul Geller, left, and Joanne and granddaughter Jordana stand by Zebbie's side. (Photo courtesy of the Geller family)Photo courtesy of the Geller family
We called 40 doctors
The law has a minimum 15-day waiting period between the time the patient must make two verbal requests to die and one written statement before two doctors agree to assist with the process.
The Gellers started making calls to doctors in July after her treating physician declined to take the lead.
“We called every doctor we could think of, our friends’ doctors, every doctor that we knew,” Paul said.
They found the names of doctors who publicized support for the law before it passed. Those doctors also declined.
“Everyone was lovely. Everyone was sweet," Paul said.
But the chorus of noes seemed endless, he said.
Some physicians said their hospital had not yet enacted a policy telling them what to do. Others said they supported the idea but were not yet ready to take on the responsibility, he said.
They called at least 40 doctors to find the two they needed who would review her medical file and attest Zebbie met the qualifications: terminally ill with six months or less to live; of sound mind and able to request verbally and in writing the wish to die; physically able to ingest the lethal prescription without assistance.
In the middle of their search, an orthodox Jewish physician in Bergen County challenged the law because he said it violated his religious beliefs and his oath as a healer. A judge granted a restraining order on technical grounds but a state appellate court and the state Supreme Court overturned it two weeks later. The court challenge delayed the law from taking effect from Aug. 1 to Aug. 27.
“I was pretty sure that it would put it (medical aid in dying) out of reach for her," Paul said.
The Gellers are not a religious family, Paul said, declining to comment specifically on the legal challenge that almost stopped them from honoring Zebbie’s wishes. “We in no way feel others should do this if it violates religious or ethical beliefs, but they should not be able to prevent others from doing this." he said.
The process of dealing with doctors and hospitals was “tedious” and “frustrating," the Gellers said. “I’m sure there are tons of legal and ethical and other things that need to be worked out but they need to be worked out quickly,” Paul said.
In every state with an aid in dying law, patients have struggled to find physicians willing to help them, said Matt Whitaker, director of integrated programs for Compassion & Choices, the national nonprofit that works to pass and implement death with dignity laws. The organization founded Doc2Doc, a hotline for physicians to get advice on what to expect, he said.
Compassion & Choices also has held numerous seminars with New Jersey physicians and hospital groups, Whitaker said. But when the law is this new, reluctance is common.
“They are unsure about whether they are allowed to participate, and if they do, what it looks like and feels like. There is a learning curve to get people up to speed,” Whitaker said.
No major physician organization has endorsed aid in dying laws, which also exist California, Colorado, Hawaii, Montana, Maine, Oregon, Vermont, Washington and the District of Columbia. This spring, however, the American Medical Association and the Medical Society of New Jersey acknowledged that some physicians choose to support the practice to reduce patient suffering.
Compassion & Choices does not share a list of willing doctors — it would be impossible to keep an up-to-date list, and some doctors may not want their support disclosed without their permission. But it does share with patients aid in dying policies adopted by hospitals in their state, Whitaker said.
Zeporah, 'Zebbie' Geller and her granddaughter, Erica, in 1992. (Photo courtesy of Geller family)Courtesy of Geller family | For
Whitaker advises patients who are “even remotely interested” in using the law to start having conversations with their doctors sooner than later. It could take a month at least to find a doctor and make the office visits, he said.
“They should start their steps early, in a way that doesn’t add extra stress in their last weeks and days,” he said.
It took two months to find willing doctors, the Gellers said. That worried Zebbie, who only reluctantly moved from her adult-community home in Marlboro to the Gellers’ house in Essex County in August, her son said. If they waited much longer, she might need to move to a hospice facility.
And that was definitely not part of Zebbie’s plan.
“She was very funny - and a control freak”
The idea of being a patient or the object of pity was abhorrent to her, the Gellers said.
Only Zebbie’s family knew she was terminally ill, Joanne said. She said her mother-in-law would tell friends: “I have a situation I’m dealing with."
Widowed about seven years ago, Zebbie lived alone and kept a busy social calendar with friends and spending time with family. She enjoyed long walks on the beach and reading, exchanging books with her four granddaughters. She loved watching movies, especially musicals like Chicago, her daughter-in-law said. She was 80 but looked and acted many years younger. Joanne smiled as she described how Zebbie “danced her heart out” at their older daughter Erica’s wedding two years ago.
The Gellers affectionately describe Zebbie as sarcastically funny, edgy, and “a control freak,” a quality Joanne said she admittedly shares.
On the morning of Sept. 30, hours before her death, Zebbie insisted on writing a check to the homeowner’s association to pay her fees through the end of the year. She cancelled her New York Times and TV Guide subscriptions.
“She made it as easy for us as she could,” Joanne said.
In the afternoon, the hospice nurse had come to check on Zebbie, who had been feeling weak and throwing up all morning. Morphine and an oxygen tank were already part of her regular regiment. The hospice nurse suggested moving a hospital bed into the living room.
" I’m ready, let’s do it,” Zebbie said in her final request after the nurse left, her son Paul recalled.
The Gellers picked up the prescription that Saturday night, Joanne said. On Sunday, Zebbie visited with her granddaughters — Erica in person and the others by video-conferencing. Her sister, Diane Fromhartz and her son, David, were there.
Paul Geller and his wife, Joanne Geller, seen in their West Orange home, said they helped fulfill the wishes of Paul's mother, Zebbie, to end her life months after receiving a terminal lung cancer diagnosis. She is believed to be among the first people in New Jersey to use the new medical aid in dying law.
Zebbie laid on the living room couch, the lights dimmed, Joanne said. As the pharmacist had carefully explained, she first took an anti-nausea pill and waited about 30 minutes, Paul said. Then she drank the fatal mix of apple juice and digoxin, a cardiac drug that slows the heart. Another 30 minutes later, she took a sleep aid. She died about 20 minutes later, he said.
At her request, Zebbie’s funeral was held graveside. She wanted to be buried with one of her favorite Snoopy stuffed animals, and she was.
“I think she is very heroic,” Joanne said. "I spoke at her funeral and said, ‘You were the bravest woman I knew.’ "
“She knew how she wanted to live. She knew how she wanted to die,” she said. "The only tears I saw were when she expressed she couldn’t believe what she was doing to our lives. If that’s not bravery, I don’t know what is.”
Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio.