To Cry Inside, by Lesley Martin (Penguin)

 A daughter gives her mother an overdose of morphine. The mother does not die. The following night, the daughter places a pillow between the two of them and presses her mother to her chest until she stops breathing. The daughter is tried and convicted of attempted murder on the overdose charge, and is sentenced to fifteen months’ imprisonment. A crime is committed, and justice is done.

Such a summary of the Lesley Martin case is both accurate and utterly misleading. In this book, Martin powerfully conveys what happens in this country to an honest person whose compassion and integrity leads her to contravene an unjust law. Her account is all the more powerful for the space she allows for hostile voices: her own sister’s victim impact statement, for instance, or the judge’s summing up of the case.

What was most apparent to me after reading this book was that human behaviour is subtle and various, and that the law that regulates it is blunt and indiscriminate: a bulldozer chasing a rabbit. Lesley Martin’s mother was dying of rectal cancer. Martin’s actions shortened a pain-wracked life by a day, perhaps days: in the not-so-compassionate words of the palliative care nurse assigned to her care, “Your mother is not so bad. She could last several days on the flesh she’s carrying.”

In a grim trial, alleviated by moments of pure farce that make Boston Legal look like realism, Martin was found not guilty on the charge of smothering her mother with a pillow. A jury is not required to give its reasons, but presumably this verdict was reached because of the difficulty in proving intent, and because asphyxiation/suffocation was not identified as a cause of death. That left the morphine charge. This was more complex than it might seem, as accounts of precisely what happened varied. Martin walks us through this complexity, and reveals why there were differing accounts. She also explains how she came to be in the position of giving her mother a morphine overdose – a mother whom no one disputes she loved dearly.

Martin packed up from the Gold Coast and came home to New Zealand when she heard her mother was sick. Her early life is summarised in the first chapter, with a writer’s eye for what’s relevant: her first marriage, for instance, is dismissed in two sentences. But even such summary description is revealing: a solo mother, she qualified as a nurse and completed various postgraduate nursing qualifications; she obtained her commercial pilot’s licence; she spent a year nursing in Saudi Arabia. She also trained to become a counsellor with Lifeline Australia. Not exactly the profile of a murderer, one would have thought.

As a registered nurse, the care of her mother fell solely on her until the final days, when palliative care was also provided by her mother’s GP and the local hospice. The administration of morphine at such a time, as anyone who has witnessed the dying of someone from terminal illness will know, is common practice. Dosages are high, inducing the so-called “double effect” of relieving pain but also shortening life. This kind of euthanasia happens in hospitals and hospices around the country every day, but no one is ever likely to be prosecuted for it.

Lesley Martin’s mother knew she was dying, and she commented on the irony that, whereas we euthanase animals that are dying in pain, we are far less humane when it comes to people (Martin’s first book alludes to this in its title, To Die Like A Dog). She asked her daughter not to let her die slowly and miserably. A promise was made, and kept. But how was the 60mg of morphine Martin was accused of giving her mother administered? As a single dose? Or in several doses over time (which would be indistinguishable in intention from the “double effect” dosages commonly administered in palliative situations)?

Martin attributes the differing accounts to what psychologists call “cognitive dissonance” (she uses the plainer expression “crisis of soul”). She had made a promise not to let her mother die slowly and in pain, yet her mother was doing exactly that. She had made a promise that she wanted to keep. She did not want to kill her mother. These contradictions can lead a person to provide differing accounts: Martin wanted to believe that she had kept her promise to her mother in her last hours, and one account supports this; she did not want her mother to die, and another account supports that. If this sounds like psychological gobbledegook for lying, consider that criminals in the dock tell lies to avoid incrimination. The account that swayed the jurors was the account represented in Martin’s first book, of one dose of 60mg. It was that published account that led to Martin’s arrest, and ultimately to her conviction – but it differed from other accounts that suggest several doses.

This is where the story becomes truly astonishing. If Martin had never published her first book, she would never have been arrested. There is a strong sense, here, that everyone wanted the case to go away, but publication of this first book – with that incriminating detail of a single 60mg dose of morphine – made what followed inevitable. Martin did not want the case to go away. She was convinced that what she had done was compassionate and right, and that if one is dying of a painful illness, then the choice of the manner of one’s death is profoundly private, and not a matter for the law.

The law still disagrees. Martin served seven and a half months in Arohata Prison (of which she provides a vivid and moving evocation) for a crime that is carried out covertly in New Zealand every day of the week. When my grandmother, senile and in hospital but physically quite well, aspirated food into her lungs, doctors said that in a few days she would develop pneumonia. They could administer antibiotics to head the pneumonia off – or not. They didn’t, and a few days later, my grandmother died. I mentioned to a friend that I was reviewing this book, and was told that that very day, an acquaintance of hers with a terminal illness was being offered the option of “floating away” on morphine. It’s covert, it’s behind closed doors, and it’s illegal, but dying people all over the country are exercising a fundamental right, and humane doctors, nurses and families are helping them.

In poll after poll, New Zealanders have said that voluntary euthanasia should be legalised, and a Private Member’s Bill was narrowly defeated in 2003 (ironically, on the same day Lesley Martin was arrested) by one non-vote and an abstention. Yes, such legislation is fraught with dangers. Yes, it will require careful drafting, so that elderly people are not killed off by inheritance-hungry relatives. But justice is not being done, and the Lesley Martin case is proof of that. For honouring a promise to her mother, Martin lost her home, her livelihood, her freedom and her marriage. Her face looks calmly at the reader from the cover, her eyes direct and steady. “What would you do?” is her unspoken question. Well? What would you do?

Christchurch Press

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Tim Tweets