On the morning of Thursday, April 12, 2007, Wye Hale-Rowe watched out the window of the plane as U.S. Airways Flight 180 descended into Phoenix. She surveyed the landscape that unfolded on the ground below—blue swimming pools, elevated freeway interchanges, and a flat grid of streets studded with slender desert palm trees. When Hale-Rowe left her apartment in Aurora, Colorado, that morning and drove twenty miles by taxi to the Denver airport, the air had been frigid. In Phoenix, however, the temperature was expected to climb to seventy-five degrees. But Hale-Rowe wasn’t a snowbird, the local term for retirees who flock to Arizona in the winter and stay through spring to enjoy the weather. Her trip to the Valley of the Sun would be short. She was there to help Jana Van Voorhis commit suicide.
Jana was fifty-eight years old, never married, and without children. As a young woman, she wanted to be a nurse, but had worked instead for a couple of years on the night shift as a legal transcriptionist, a position secured for her by her mother, who was friends with the firm’s founding partner. Hale-Rowe was seventy-nine, a great-grandmother and a retired family therapist who had grown up in a Mormon colony in Star Valley, Wyoming. She was also a volunteer with Final Exit Network, a national right-to-die organization based, at that time, in Marietta, Georgia, with members and volunteers across the United States. Hale-Rowe had been active in the right-to-die movement for more than a decade. She had achieved the status of Senior Exit Guide, not because of her age but because of the number of suicides she had attended. The Network has a name for these suicides: They call them death events. At the time of her visit to Phoenix, Hale-Rowe had been to nearly twenty of them. She and Jana had never met.
Frank Langsner, who was eighty-two, picked up Hale-Rowe at Sky Harbor Airport. Born and raised in New York City, Langsner was a retired professor of health and physical education at Morgan State University in Baltimore, and he now lived in Scottsdale, Arizona. He and Hale-Rowe had met once before, in December 2005, at an Exit Guide training program in San Francisco, at an airport hotel called the Inn at Oyster Point. Over the course of two and a half days, Langsner and sixteen others learned about the laws regarding suicide in the fifty states and practiced the steps required to help others achieve what the Network calls self-deliverance. Langsner had been brand new to the organization. A friend had told him about it. He agreed with the group’s mission, and he was sympathetic to people who were dying or in pain, so he signed up. Hale-Rowe was an instructor at the program.
On February 13, 2007, two months before Hale-Rowe’s arrival in Phoenix, Jana had written a $50 check to Final Exit Network. Four days after that, Harry Lien, a Network First Responder, contacted Jana. A tall, bony man with a stooped back, Lien had for thirty-three years taught fourth grade in Arlington Heights, Illinois. Now he lived in Green Valley, Arizona, a retirement community about twenty miles south of Tucson. He kept busy as a hospice volunteer, helping to feed and dress those who were nearing the end of life. He also volunteered with Final Exit Network. With Jana, his job was to conduct an intake interview over the phone.
According to Lien’s notes, Jana reported that she was suffering from porphyria, a rare blood disorder that causes severe abdominal pain, light sensitivity, and seizures. Because of these symptoms, the condition is sometimes called the “vampire disease.” Jana also told Lien that she had lesions on her liver and an enlarged spleen, and that her gallbladder and silicone breast implants had been removed, the latter because they were leaking into her body. She said that she’d had a hysterectomy in 2006 and that she might have breast cancer. She reported that she’d suffered multiple head injuries and overexposure to radiation, and had ingested rat poison. She provided Lien with a list of medications that she said she was taking daily: a combination of mood stabilizers, sleeping pills, and painkillers that included Lexapro, Klonopin, Ambien, Vicodin, and Tylenol PM.
Jana told Lien that her next of kin were her sister, Viki Thomas, and brother-in-law, Tom Thomas, who lived nearby, and that they did not know of her plans to die. In the section of the intake form labeled “prognosis,” Lien wrote Jana’s response: “Doctors have said nothing.” Lien noted on a separate sheet of paper that Jana’s lack of knowledge about her prognosis was “unusual,” and suggested that the Network’s medical committee “ask her some specific questions about that.”
In fact, Jana was not dying. She did not have most of the ailments that she said she did. The truth was that she had a long history of mental illness and believed that she was physically ill. According to family members, Jana had begun to talk about suicide when she was a child. “She’d threaten to run out into traffic,” her sister Viki told me. She did poorly in school and had trouble making and keeping friends. Jana was first hospitalized in 1970, at twenty-one, and over the years, she had been admitted to the psychiatric wards of several local hospitals. Family members say that as Jana got older, her condition worsened. On May 7, 2006, her psychiatrist, Michael J. Fermo, noted in his records: “She reports having depressed mood swings, periods of irritability, difficulty shutting off her mind, especially at night, erratic sleep, low energy, nervous, socially isolative and an ongoing feeling that bugs are eating her. The patient has been increasingly becoming psychotic, claiming that roof rats have been overtaking her home, sneaking into her house, and attacking her.”
Jana was especially close to her mother, and when her mother died on July 15, 2006, Jana’s mental health began to deteriorate further, according to Viki and Tom. On February 2, 2007, Jana called Dr. Michael S. Roberts, the Phoenix oncologist whose office she had phoned ten times a week for eleven and a half years, to say that she was ill and bedridden. When Dr. Roberts called her back, Jana told him that she wanted to be moved to hospice, which is where her mother had died. Jana had recently been to Dr. Roberts’ office complaining of two different types of blood infection: bacteremia and toxemia. She believed that the latter was caused by Mexican people bringing pesticides across the border.
“Clearly, at this point I don’t think any further testing would benefit her unless there are symptoms or more objective evidence,” Dr. Roberts noted in Jana’s file. “This has been discussed with Jana frequently.”
Having completed the intake interview for Final Exit Network, Lien went to Busy Bee Printers and faxed the form to the Case Coordinator, Roberta Massey, at her home in Cherry Hill, New Jersey. In turn, Massey faxed the intake form and other materials sent to her by Jana to the Network’s medical director, Dr. Lawrence Egbert, in Baltimore.
A retired anesthesiologist and Johns Hopkins University professor, Egbert was then seventy-nine years old. A slight man with prominent ears, Egbert pedaled around Baltimore on a bicycle decorated with bumper stickers that said “Bikes not Bombs” and “Don’t Waste Our Future, Recycle.” He considered Jana’s application. It included a surgical pathology report from 2005 that confirmed Jana did not have cancer, as well as a typewritten list of diagnoses and doctors that Jana had prepared. Not a single ailment was life threatening. All were treatable. The oldest and longest-running diagnosis on the list, dating to 1970, was for anxiety and depression. The notes indicated that Jana had been under the care of the same psychiatrist for twenty-five years.
Also included in the records faxed to Egbert was a copy of a handwritten note from Jana to Massey, on a sheet of personalized stationery decorated with a pair of Raphael’s winged cherubs.
Having hard time getting medical records . . . Could you talk to one of the doctors to come to Phoenix to help me. The pain is unbearable.
Jana Van Voorhis
Egbert didn’t go to Phoenix. Nevertheless, he approved Jana’s case, although he did express reservations: On the bottom of the intake form, Egbert wrote in red ink, “Accept 3/2,” for March 2, “but stay alert.” He underlined the last three words for emphasis.
With Egbert’s approval in place, Massey assigned Langsner and Hale-Rowe as Jana’s Exit Guides, and Hale-Rowe bought a plane ticket to Phoenix. Both Guides were given a copy of Jana’s intake form, but it was not the form marked by Egbert with the warning to “stay alert.” Egbert had done his job by vetting the case, and now it was time for Langsner and Hale-Rowe to do theirs.
From the airport, Langsner and Hale-Rowe headed directly to Jana’s residence, a two-bedroom townhouse on East Hazelwood Street, the second-to-last house on a cul-de-sac in a Phoenix subdivision built in the late 1960s. A blue sticky note fixed to the front door greeted the pair when they arrived: “Frank and Wye, I put paper towels out for you to wipe shoes.” Jana had recently remodeled her home and removed its white wall-to-wall carpeting, believing it to be infested with bugs. She had replaced it with laminate flooring, but continued to insist that guests go barefoot. Langsner, however, had tired of the practice after meeting with Jana at her home several times already, and he and Jana had reached a compromise. A roll of white paper towels waited for Langsner and Hale-Rowe on a side table in the entryway. Instead of taking off their footwear, the two wiped the soles of their shoes, crumpled the towels, and walked through the narrow hallway into the main part of the house.
Jana was waiting for them. Five-feet-four-inches tall, pretty, and a little bit plump, with a round face and brown hair that hung to her shoulders, Jana was dressed that morning in a muumuu. She spoke with a high-pitched, girlish voice, and her skin looked rough, as if she had spent too much time in the sun. On the left side of her forehead, a pair of adhesive bandages formed an X over the spot where she’d been compulsively picking at her skin.
Jana was a lifelong resident of Phoenix. Her grandfather, Walter Wesley Knorpp, and great-uncle, Charlie Stauffer, had been co-publishers of Arizona’s two largest daily newspapers, The Arizona Republic and The Phoenix Gazette, and the Van Voorhis family enjoyed the social status afforded by this legacy. Before Jana’s mother died, she had set up a trust from which money was regularly deposited into Jana’s bank account. In addition, Jana had a bookkeeper to balance her bank accounts, a landscaper to care for her small outdoor space, and a maid to clean her home, which was well appointed. Woodblock prints of nature scenes by a German-born artist, Gustave Baumann, lined the hallway. In the dining room, a crystal chandelier was suspended above a glass-topped, six-seat table set with two silver candlesticks and tall white tapers. In the great room, a nearly six-foot-long oil painting of an oak forest in autumn hung in an ornate frame above a white sofa with a pink floral pattern. And in the master bedroom, Jana had assembled the tools she needed to die.
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This story was written by Jaime Joyce, a recipient of Columbia University’s Lynton Book Writing Fellowship. She is the author of ”Moonshine: A Cultural History of America’s Infamous Liquor”.
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