Death through a lens: capturing the agonising choice of VAD
Why sign on to watch somebody die? Julian Kingma faced down his own fear of death by undertaking an extraordinary photographic assignment.
He was a great big bear of a man. Nigel Taimanu. A bear of a man with a bald head and goatee beard. He was working FIFO in the Pilbara in 2021 when he met his partner, Kath. Sparks flew, because why wouldn’t they? He was, she says, “a marshmallow inside”.
Of course he was. Those blokes, the ones with the rock-hard medicine ball stomachs? They always are.
The couple got together, and they were having a fine old time, until Nigel woke one morning with a stiff neck. He thought he’d pulled a muscle, but no. Carcinoma, the doctor said. You’ve got about 12 months. He was only 52.
What to do? Move to Queensland to be closer to his mum? That sounded like the best idea. He told Kath she didn’t have to come. He didn’t want to be a burden. She was about as likely to abandon him as she was to fly to the moon.
Nigel tried some treatment, but it didn’t work. He was in pain, and the way the cancer was growing, he worried he’d end up choking to death. He got approved for voluntary assisted dying, or VAD (the process isn’t as easy as that sentence makes it sound), and being a no-fuss kind of bloke, picked himself a date.
He also agreed, pretty much upon being asked, to have the brilliant Australian portrait photographer Julian Kingma on hand to photograph his final day – part of a year-long project Kingma was immersed in, documenting terminally ill men and women around the nation contemplating VAD to end their lives.
“When I arrived at his house, he was sitting on the front porch, giving his dog a scratch,” says Kingma. “It was the strangest thing. He got up, and I was thinking, he’s alive, but by the time I leave here, he’ll be dead. It was a hard thing to get my head around. And I couldn’t get over his courage.
“It was confronting because, like I say, he was sitting on his porch when I arrived, and he was chatting to people,” Kingma says.
“He said ‘I don’t want to do this’, but he felt like the cancer had forced his hand.
“I began to feel a bit light-headed as I went into his house, thinking he’s about to die. I was in the hallway, and I just started to cry, and he came out to me, and he cupped my head, and he was comforting me. He said, ‘It’s OK. Remember, this is what I want. And I want you here.’ I couldn’t believe it. He was consoling me.”
Taimanu had coffee and a shower before heading into his bedroom, where he got on top of the covers. He wasn’t dressed in his finery, mainly because he didn’t have much in the way of finery. No frills, no fuss.
He propped his head on a pillow and crossed his ankles. Kath lay down beside him. He gave her a kiss. “Normally with VAD the patient has to drink the medicine themselves, but he’d been having difficulty swallowing, so there was a VAD-trained GP there,” says Kingma. “The GP was having difficulty finding a vein but then he put the needle in.” Kingma took a second-to-last photograph, in which Taimanu’s eyes were wide open. In the next, they were closed.
“I’m not a religious person, so it’s hard to describe what happened, but he’d absolutely left the room,” says Kingma. “He was there, and then he was gone.” His soul had left his body?
“A soul, I don’t know, but something definitely happened. There was no pain, no struggle, he just drifted away.”
Why sign on to watch somebody die? What else lingered behind Kingma’s tears for Nigel Taimanu? A year on from that death, Kingma is strolling through the centuries-old cemetery overlooking the beach at Bronte in Sydney’s eastern suburbs, trying to answer the question. It has been raining and a fierce wind is tearing through the spiky grass between the graves.
“I remember when I first heard (as a child) that everyone dies, how shocking that was,” he says. “I remember thinking: but wait, won’t it be painful? Horrible? Everyone else seemed to be – not OK with it, but accepting of it. And I couldn’t accept it at all.”
There had been no particularly awful deaths in his family; indeed, Kingma’s own parents, wife and children are all still alive.
“I think I had a lot of anxiety in general, and then for some reason it fixated on death,” he says. “I just remember being terrified.”
Kingma, who is 55 and looks 35, says he was “probably a bit more sensitive than the average kid. I was quiet. I wasn’t sporty. I liked drawing and photography.”
He was barely out of his teens when he landed a job at the old broadsheet Herald afternoon newspaper in Melbourne. His first solo job, as a cadet photographer, was Melbourne’s Queen Street massacre in December 1987. Eight people had been shot dead by a lone gunman, who then threw himself out of an 11th-floor window and splattered himself on the road.
“That was awful,” he says, “and later there were car accidents, where people were still in the cars.” He was barely out of his 20s when he was sent to cover the massacre in Port Arthur. Like everyone, he wonders if he ever got over it. All those cheerful people, sitting down for cups of tea at the Broad Arrow Cafe. All those magnificent nurses, shouting down the corridors of the Royal Hobart Hospital, “More blood, we need more blood!”.
“There was no trauma counselling in those days,” Kingma says. “You worked for newspapers, you saw death. I have never been a big drinker, but a lot of people drank.”
Kingma steered himself away from breaking news and towards magazines. The pace was more relaxed, but the work was often no less traumatic. He spent weeks on a children’s cancer ward, photographing tiny patients with bald heads, watching as they gripped the sheets, clutched their drip lines and cried for their parents.
He had small children of his own at the time.
“I developed this idea that death is either sudden, horrible, painful, violent, or else you have to suffer,” he says. “And maybe because I was already an anxious person, I also developed this unhealthy fascination with it.
“I would have nightmares, thinking ‘I don’t want to die. I just don’t. But I have to. But I can’t.’ It was leaving me so stressed.”
He battled his terror in private, at least until Covid, when he happened upon Andrew Denton’s podcast, Better Off Dead, which made the case for voluntary assisted dying.
At the time it was legal only in Victoria. “I was listening to these people who were suffering beyond imagination, and they all wanted to end their own lives, and they were part of this campaign to make VAD legal across Australia,” says Kingma.
“But it wasn’t the arguments for or against that interested me. It was that they all seemed to believe a peaceful death was possible.”
He contacted Denton’s organisation, Go Gentle, and offered to become the official photographer for patients who were considering VAD. Denton’s team agreed to fund a project that would see him travel around Australia for two years, photographing (and later interviewing) patients, caregivers, and family members for an important book and an exhibition, to be titled The Power of Choice.
Some of the portraits are intimate (a wife threading tubes into a port in her husband’s body). Some are raw and wretched (a woman tries to stand, and collapses). Some are tender (a nurse remembers a patient who has ended their own life) and some are startling, for they show death. Some who had been deemed “eligible” for VAD were still undecided as to when they would proceed – if at all – at the time the book went to print.
Did Kingma know, when he started, that he would probably end up photographing somebody as they died? “Yes, but I wanted to know – I sort of needed to know – if it was possible to have a peaceful death,” he says.
Facilitated by Go Gentle, Kingma began reaching out to VAD doctors.
“They might say, yes, we know four people who are considering this, and we will ask them for you, and then they would call back, and say two people have said yes and I would then call the patient,” he says.
“And what surprised me the most was how vulnerable they were with me.”
The first person he met was a “lovely lady” called Sue Parker, 75, of Ballarat, who had been diagnosed with motor neurone disease.
“She was the first person I called, and the first person I photographed,” he says. “I rang her, and I said, ‘Hello, how are you?’, and she said: ‘I’m great. I’m dying on Monday!’ This was Wednesday, from memory. And she said, ‘If you’re going to take some photographs of me, you better come quick’.
“I arrived at her place on the Sunday, and she showed me where she had circled the date on her calendar, calling it her ‘used by’ date. She was laughing about that. This was all confronting for me because I hadn’t let go of any of my anxiety about death, and she’s talking about it so openly.
“She said, ‘I’m a nurse. I’ve seen this (meaning, motor neurone, which leaves a patient unable to even breathe on their own). I know what it looks like, and I’m not doing it. I’m going out on my terms. And now let’s have a drink.’
And she got me so drunk.”
Kingma took a series of beautiful photographs of Sue with her family before taking his leave. She died, voluntarily, the next day. “I called her daughter, and I asked her, ‘How was it?’ She said it happened like Sue wanted, on a daybed, in the garden, with a whiskey chaser.
“I asked, ‘Was it peaceful?’ And she said, ‘So peaceful’.”
In the months that followed, Kingma met and photographed 20 more VAD candidates, ahead of their deaths. There was Laraine Blackson, 85, whose last request for family members was “not to put the good gold cups in the dishwasher”. And there was Tony Heyns, a former cattleman, jackaroo and mango farmer, whose cancer, which started in his jaw, was eating him alive. “There is unimaginable suffering out there,” says Kingma, softly.
He discovered some themes as he sat talking to people. “They all said I don’t want to die. But I am dying, and I don’t want to be in pain, or I don’t want to choke, or I don’t want to suffocate,” he says. “They said, my anxiety levels have come down because I have this medication now, so if things get rough, I can take it.” Some talked about the drawn-out death of a parent, or a loved one, “meaning they had seen what that was like, and they didn’t want that to be them. And almost everyone said, you’re allowed to do it for your pet. Why not a human being? And I know people say, we’re not pets, and it’s not for us to decide, and I can totally understand that some people believe that, but hand-on-heart, everyone I met was making the choice for themselves.”
Besides the patients, he met some of their caregivers and Victorian pharmacist Michael Dooley, who was tasked with finding the medications that patients would take, when Victoria first legalised VAD in 2019. Dooley has said he searched for something that was both simple to use, and 100 per cent effective.
The only problem was that it “tastes horrible … whatever you think is bitter, double it, triple it … just get it down as quickly as you can. He has to take the medication into the house, and he has to check the patient’s driver’s licence,” says Kingma.
“He told me, ‘You see the photo on their ID, versus the person in front of you … and that really brings it home’.”
It brought suffering home for Kingma, too.
“The patients have pictures of how they used to be,” he says, “and when I see them, they are in so much pain. One lady hadn’t been outside for five years. I could see what they’d endured.”
The first person to ask him to be present when he died was Phil O’Keefe, who was 62 and, like Sue Parker, battling MND.
“I had photographed him a few times, and he had been on the fence about whether to use VAD,” he says. “He told me, ‘I don’t want to suffer pointlessly, but I’m not sure about VAD’.”
“And in the end, he didn’t use it. The palliative care team said there was another option.... He wanted to know, will there be pain? They said no. And that was the option he took.”
“So, are you still afraid?” Kingma has been asked the question many times since news of his project began to spread. Given that he now knows a peaceful death is possible with VAD - and also without it - does he still fear his own ?
He’s careful with his answer.
“This project is all about the patients, and their families – honouring them and the choice they have made,” he says. “But it has been a gift to me, too. There is still no part of me that wants to die, but some of my fear of death has gone, yes. But it’s given me so much more than that. It’s made me appreciate life.”
The Power of Choice by Julian Kingma (New South) is out on May 1
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