WEDNESDAY JANUARY 10 2001
Interview
Don't let my son die
Robert Wendland is kept alive by a feeding tube. His wife says that he should be allowed to die. His mother wants to ensure that he lives. Grace Bradberry reports
The California Supreme Court has heard some unusual cases in its time, but the latest to come before it rates as one of the most extraordinary. Pitched against each other are a wife who says her hospitalised husband’s feeding tube should be removed so that he can be left to starve to death — his suffering eased only by painkillers — and her husband’s mother, who argues that he must be allowed to live.

Seven years ago, Robert Wendland had had a few drinks over dinner when he decided to take his pick-up truck for a spin so he could listen to his new Paul McCartney tape. As he drove along the side roads of central California, with his seatbelt off, the 40-year-old salesman was making a U-turn on a motorway slip road when the truck skidded off the hard shoulder, rolling end over end.

Robert was thrown out, paralysing his right side and plunging him into a coma. For 16 months he lay, kept alive only by a feeding tube. Sometimes his body twitched and his fingers moved, and it appeared he might be fighting to live. Then he began to show signs of awareness, moving his hand or his leg when asked.

That was in 1995. More than five years have gone by and the inner world of Robert Wendland remains a mystery. On a good day, he can hold a cup, use a paintbrush and push a ball down a ramp. His right eye stares vacantly, but his left appears to track. Doctors say that he feels pain, but they do not know how much and no one knows whether he is capable of mental anguish, though one doctor who examined him wrote, hauntingly: “I hope that his level of awareness is low.”

Some experts describe him as “minimally conscious”, drifting in a grey area between coma and consciousness. Others say that he is conscious but brain-damaged. What matters more, however, is what members of his family think — and they too disagree.

When his wife, Rose Wendland, looks at her now 48-year-old husband, she sees “a shell”. For her, Robert “died seven years ago”. The man who sits in a hospital room, dressed in nappies, fed by a tube, cannot recognise her or their three children, she says.

But when Robert’s mother, Florence Wendland, looks at him, she sees a man who is still there. She detects “moods” — contentment and frustration, sadness and even affection. “I’ll ask him, can I hold his hand and he’ll give me his hand,” she says. “I’ll say, ‘Can I kiss your hand?’ and he’ll put his hand up to my mouth and I’ll say, ‘Can you kiss my hand?’ and he’ll put my hand up to his mouth and he’ll kiss it.”

Rose wants Robert’s feeding tube removed so that he can die. She says that this is what he would have wanted and is the only merciful course. Florence wants him to live, horrified at the prospect of her son dying of starvation and thirst, regardless of what steps are taken to ease his passing. This stark conflict is now a landmark case before the California Supreme Court.

While Robert’s doctors, bio-ethicists and the American Civil Liberties Union all back Rose, anti-euthanasia campaigners and disabled-rights activists side with Florence, on the grounds that allowing Robert Wendland to die could set a legal precedent that would allow relatives to “put down” Alzheimer’s patients and the severely disabled.

The battle began in 1995 after Robert pulled out his feeding tube for the fourth time. His wife took this as a sign that he did not want to live. As the legal conservator, she had the right to withhold medical treatment, including tube feeding, if she was acting in good faith based on medical advice and the wishes he had expressed. But someone at the hospital tipped off Florence who, together with one of her daughters, sought a restraining order. The case went before a judge, who denied Rose the right to remove the feeding tube.

“I don’t know at this point whether here today I am preserving Robert’s life or I am sentencing him to death,” said the clearly anguished Judge Bob McNatt.

Florence is troubled by no such doubts. Aged 78, she lives alone in a small flat in Stockton, the central California town where her son also lived. Three times a week, this frail lady takes the bus to the next town, and spends as much as five hours at a time with the second of her eight children. Her relationship with her son may now be closer than it was before the accident. Rose has said that Florence and Robert were estranged, though Florence denies this, insisting that he visited regularly, keeping this secret from his wife. To begin with, Robert’s accident brought the family together. “We all thought he’d come out of it and get better. And he did pull out of it, and got better,” adds his mother.

At around the time that Rose gave up hope for her husband, so did the hospital, ending the one-on-one therapy that he was receiving. Although he cannot walk or talk, he now takes part in group activities, painting plant pots, bowling and, soon, a game in which he will attempt to hit a golf ball through a hole. Recently he painted a picture that Florence held up on the TV show Good Morning America. “It’s like a pool of fish and then a bunch of little fish swimming around it,” interprets Florence — though to the uninvolved observer it appears entirely abstract.

Florence has also bought her son a game in which he fits coloured shapes through coloured holes, mirroring a game with coloured pegs that his therapists once used. “I’ll say, ‘Here’s the orange one — where does it go?’ And he’ll put it in the orange hole. Then I’ll say, ‘Here’s the triangle one’, and he’ll put it in the right hole. He always has a problem with the red one, but finally he gets it.”

“Of course, she thinks it’s childish,” says Florence. Rose would not be interviewed for this article, though she has spoken extensively to the US media, where a public battle is being fought between mother and daughter-in-law. Recently, Rose took a Los Angeles Times reporter to visit her husband. A nurse pointed out the shaped blocks, and added that Robert could do the puzzle. “A one-year-old can do that,” Rose apparently responded. “Am I happy that maybe he can recognise a nurse who has been here for two years and not his children? Not his wife? Now what does that mean? That his Mom sits there playing those blocks with him? No. It doesn’t mean anything. It disgusts me, to tell you the truth.”

Rose, married to Robert for 22 years, and her three children — Katie, 22, Kerrie, 20, and Robert, 15 — virtually moved into Robert’s hospital room for the first year after the accident. But they no longer visit regularly. Florence’s belief in her son’s cognitive abilities goes beyond anything that even the most optimistic doctors have suggested. She reads to him, mostly from spiritual books — “Cos he was always interested in the Bible”. She thinks he has some understanding.

“The other day a man walked into his hospital room and he said, ‘Hello Robert, how are you doing?’ He held out his hand and Robert took his hand. You can’t tell me that he’s semi-conscious because he hears and knows what somebody asks him.

“If we’re talking about his case, he’ll sit there and listen, he’ll take in every word. He’s not dumb. He knows what we’re talking about. Sometimes it seems like he wants to give up. He hits with his hand, because he gets frustrated that he can’t say what he wants to say. Then he gets angry. Gosh, I . . .” she then falters — “It just gets me so upset too. I say, ‘Oh Robert, if you could only talk, this wouldn’t be like this’. I’m not giving up; God performs a lot of miracles, and all of a sudden he can have Robert say a word.”

Florence is not a regular churchgoer, but her reasons for fighting to keep Robert alive are firmly religious. “The Lord giveth and the Lord taketh away,” she tells me. “The Lord could have taken Robert during any of this time. Why didn’t He? Because He wasn’t ready. When the time comes and He’s ready to take Robert, then I’ll say goodbye with the good feeling that he’ll meet his maker.”

Rose, though, believes that Robert should have met his maker already, and has been prevented from doing so by artificial medical means. But the real case she makes is that Robert would not have wanted to exist like this. “What he said was, if I could not be a father, a husband or provider, then why even exist?” she told Good Morning America.

Three months before Robert’s accident, her father died and it was Rose who had to make the decision to turn off the life support. Robert apparently told her that she had done the right thing. There was also, apparently, a conversation just a week before Robert’s accident when he expressed the view that he would not want to be kept alive if severely incapacitated. But Rose has also said that neither she nor her children can go on with their lives while Robert remains on life support. “You know, we live with this daily. Every second of the day,” she told Good Morning America.

Florence, who brought up her eight children without the help of their three fathers, does not see what is stopping her daughter-in-law from getting on with her life. “Why doesn’t she get a divorce and get on with her life? Nobody would begrudge her that. We know she’s a young woman,” — Rose is 43 — “She can’t live alone the rest of her life. I have no hard feelings against Rosie. But I will not stand by and let her put him to death.”

If the feeding tubes were to be removed, Robert Wendland’s death would be grim, according to Florence’s lawyer, Janie Siess, who conjured up a chilling picture in court. Doctors do not know how much pain he feels, so he would either be heavily medicated or put back into a coma. “The longest case on record of dehydration and starvation death is 21 days,” says Siess, who is sitting in on the interview. “That’s three weeks during which your organs are shutting down and your skin is cracking and your tongue is drying up and cracking and bleeding.”

“They put a little ice on it,” says Florence.

Three years ago, one of Robert’s doctors asked him a series of questions. He responded by pointing or pushing bars designated “yes” or “no”. The doctor asked, “Do you have pain?” Robert indicated “yes”. “Do you want more therapy?” The answer was “no”. “Do you want to die?” He did not respond.

Did Robert understand the questions and his own responses? The doctor didn’t know. In any case, the patient could not answer the one question that everyone is asking — should he live or die?

After the interview, Florence is driven into Lodi, where Robert is in hospital. No family member is available to accom- pany her. So she walks in alone, to her solitary vigil by the bedside of a son who may or may not know that she is there, and who might, or might not, agree with what she is doing.

Copyright 2001 Times Newspapers Ltd. This service is provided on Times Newspapers' standard terms and conditions. To inquire about a licence to reproduce material from The Times, visit the Syndication website.
   
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