Suicide as Escape from Terminal Suffering

Suicide as Escape from Terminal Suffering is the rationale Ben Givens constructs after learning that his cancer is incurable: if dying will bring suffering he cannot control, he believes he can avoid that process by ending his life first. The idea is neither a sudden impulse nor a settled philosophical answer. It develops through his medical knowledge, fear of pain, and efforts to make death seem manageable, then comes under pressure from the very commitments his plan would leave behind.

Prognosis and the Future He Fears

Ben understands his diagnosis with the clinical certainty of a physician. His cancer has spread from the lining of his colon to nearby lymph nodes and then to his liver, and he believes he has only months to live. He has spent years confronting the limits of medicine in other people, but now the prognosis is his own. The possibility of hope does not persuade him: he expects the disease to progress and sees no treatment capable of stopping it.

His decision rests especially on what he imagines between the present and death. He anticipates a drawn-out decline involving severe illness, dependence, and prolonged care, ending in a nursing home. In his projection, Bill Ward, his doctor, would eventually ease that final stage with morphine. This is Ben’s fearful forecast, not an account of an outcome already reached. To him, the gap between his current life and that imagined end is the central problem: death itself might be nothing, but the process of dying could be unbearable.

Ben’s medical expertise sharpens rather than softens the forecast. He knows the likely course of advanced cancer and has no willingness to mistake reassurance for a cure. Yet his knowledge does not make the future emotionally controllable. He repeatedly has to accept the diagnosis anew, and his attempt to reason from clinical facts toward a clean, decisive escape is also an attempt to avoid living through uncertainty and decline.

A Carefully Concealed Plan

Ben organizes his intended suicide around a hunting trip, presenting it as an ordinary excursion. He tells a lie about going to Silver Peak after he returns and packs enough clothes and supplies to make the trip appear to last from Saturday through Thursday. The careful preparations give the journey a plausible public shape while concealing its intended end. He expects that Bill Ward may suspect the truth, but believes the circumstances will not make it certain; he also expects his doctor to respect physician–patient confidentiality unless an inquiry obliges him to disclose the cancer.

The plan is not only about Ben’s own death. He intends to release his dogs on the sage-covered land before dying, but recognizes that this would leave them exposed to hunger and danger. His hope that they might find another hunter does not quiet his sense that he owes them more than abandonment. His last meal, too, troubles him: he imagines it nourishing only the creatures that would consume what remained of him. These thoughts expose the cost the plan would impose on other lives, even as he tries to frame it as a private decision.

His attachment to Rachel gives the journey another counterweight. On a train journey from Mantua to Bressanone, they had promised that their ashes would one day nourish intertwined red and white roses. As they grew older, they could laugh at the youthful sentiment without relinquishing it. Ben has kept Rachel’s ashes in the hope that the promise might still be fulfilled. He wonders whether suicide would foreclose that shared future and imagines his remains scattered across the sage country instead. The rose pact makes his choice more than an escape from pain: it threatens a continuing act of love that he has preserved beyond Rachel’s death.

The Argument About Pain and Death

Ben rejects the idea that avoiding pain is cowardice. In his view, pain is indifferent to a person’s character or virtue, and enduring it does not automatically prove bravery. He has heard and sometimes offered the consolations of gradual dying: that small details become vivid, love deepens, ordinary troubles recede, and there is time to reflect. Now he questions how much he could have known about those consolations before facing his own death. He believes there are levels of suffering that can overwhelm argument, and fears that his own illness may bring him to them.

At times, he can regard death with a calm detachment. He reasons that if death is a state in which nothing is felt, then death is not the painful part; the ordeal of reaching it is. From that distinction he derives what seems to him an intelligent, rational choice: remove the anticipated pain and horror by choosing suicide. But the reasoning does not bring lasting peace. He fears that he will regret the decision, feels already estranged from the world, and experiences his present life as shadowed by the grave.

His religious understanding complicates the effort to treat death as mere nothingness. The biology he studied and practiced has not led him to reject God. He sees the body as divine and believes that something holy leaves it at death. His medical understanding can therefore support two incompatible impulses: it gives him a detailed account of bodily decline, while his sense of the body’s sacredness makes death more than a technical endpoint. The detachment he seeks comes and goes; it cannot settle that tension.

Medical Duty and the Limits of Detachment

Ben’s work as a physician had taught him both intervention and helplessness. He had often concentrated on tactical questions and held patients’ deaths at a distance, but he was not without tenderness; he knew the authority and the limits of medical care. His own diagnosis collapses that professional distance. He can imagine the future as a doctor, but he must inhabit it as a patient.

That vocation remains active during his journey. When he encounters Angel, a seriously ill orchard picker, Ben urges that he receive care at a hospital, while acknowledging that he has no stethoscope and cannot diagnose or treat him there. Catherine Donnelly helps communicate with the pickers. Their concerns include the cost of care and the possibility that identification or immigration papers could expose them to serious consequences. Emergency responders disagree about what financial assistance may be available. Ben insists that these barriers should not prevent Angel from receiving treatment. The episode does not resolve Ben’s own crisis, but it shows that his instinct to protect life and press for care persists even while he regards his own planned death as reasonable.

Pain also intrudes on his journey in immediate, less controlled ways. In a motel, unable to sleep because of pain in his side, he smokes marijuana given to him by a traveler, seeking relief. The drug brings confusion and paranoia as well as relief, and he recognizes that it clouds his ability to judge his condition. The episode offers no simple alternative to his fear: temporary relief is available, but it does not answer his questions about the illness or the future.

Recognition Without a Settled Resolution

While hunting, Ben holds a bird whose life is still warm and questions the circumstances he has chosen for his own death. He sees the plan as cruel: he would die alone in the dry sage country after killing small birds. He concludes that the shooting and the landscape are not enough to justify the journey, and that treating this final act as stoic defiance is inadequate. More profoundly, he recognizes the contradiction between suicide and the life he has lived as a doctor, husband, and father. The realization does not erase his fear of dying, but it makes clear that his plan conflicts with his understanding of himself.

Later, as his illness and exhaustion deepen, Ben continues to fear death despite having searched for a way to make it endurable. His life appears to him to alternate between fear and brief intervals of calm, when work, love, or ordinary light draws his attention elsewhere. The concept therefore remains unresolved: suicide offers an imagined escape from a future of suffering, but the novel shows the plan repeatedly meeting the attachments, duties, and recognition that make escape neither simple nor emotionally complete.