Lawrence Egbert: The new Dr. Death

With Jack Kevorkian gone, says Manuel Roig-Franzia, this 84-year-old doctor is the new face of assisted suicide

LAWRENCE EGBERT COMES to his cramped third-story office almost every weekday, taking calls on an old white push-button phone with a handset darkened by years of smudged newsprint and perspiration. Egbert, a slightly built, genial, and energetic retired anesthesiologist, turns to his computer, content to answer an email while I sort through a pile of plastic tubing in a lumpy white garbage bag. Once I finish untangling the tubes, I hold in my hands a curious plastic sack, about 21 inches long and 18 inches wide.

Egbert calls it an "exit hood." It's a contraption that can end a life in minutes. The 84-year-old doctor, who formerly served as a campus Unitarian Universalist minister and has taught as an assistant visiting professor at Johns Hopkins University, explains how it works. A tube connects the hood to two helium tanks, he says. He lifts the hood over his head and lowers the open end, letting go as an elastic garter clamps to his forehead. Then, he says, you release the valves on the tanks, streaming helium into the hood.

"You fill it up until it feels like a New York chef's hat," he says, stretching the hood to demonstrate. Then, he says, you pull it down and cinch it tight at the neck with a sweat band.

In those final seconds before his patients lose consciousness and die, the words they utter sound like Donald Duck, he says, imitating the high-pitched, nasally squeak familiar to any child who has sucked a gulp from a helium balloon.

Egbert estimates that he has been present for 100 suicides in the past 15 years, a figure that puts him in the same league with Jack Kevorkian, who claimed to have helped more than 130 people die. Egbert says he approved applications for about 300 suicides, most as medical director of the Final Exit Network, a loosely knit group that claims 3,000 dues-paying members. Even within his own organization, Egbert is controversial. The vast majority of the network's members suffer from painful physical ailments such as late-stage cancer, he says. But unlike the group's current leadership, Egbert is also willing, in extreme cases, he says, to serve as an "exit guide" for patients who have suffered from depression for extended periods of time.

With Kevorkian gone — he died in June — two indictments of Egbert have transformed him into the public face of American assisted suicide. It has been more than 17 years since Oregon voters passed a ballot initiative approving the nation's first assisted-suicide law for terminally ill patients. Only one other state, Washington, has legalized the procedure, and the American Medical Association remains firmly opposed.

Facing a trial that could further shape national opinion about assisted suicide, Egbert lacks Kevorkian's public relations flair — he's not one to dress in costumes — and he lacks Kevorkian's certitude. I expected to find an absolutist, a proselytizer for a cause. Instead, I encounter a man whose zeal is tempered by self-doubt.
"Once I am a true believer, that's the time I should quit," he says. "I never get used to it. I'm not used to it now."

Egbert has worked with patients who used barbiturates or morphine to speed their deaths, but he says those treatments can be hard to acquire in the quantities necessary to end life. Helium, on the other hand, is easy to get. Final Exit's patients are instructed that they can buy helium tanks at party stores, Egbert tells me. Remnants of his clients' visits to party stores lie at the bottom of Egbert's garbage bag: a pack of balloons, pink, blue, yellow, and green.

He says patients lose consciousness within 30 to 60 seconds of pulling the hoods over their faces and are usually dead within five to 10 minutes. "They turn blue or bluish — we can say gray," Egbert says. "After they're unconscious, their muscles start twitching. That's very upsetting to relatives. Some think they're trying to wrench the bag off."