The Easy Way Out by Steven Amsterdam

Paperback reviewed by Susan Osborne

This novel is unlikely to appeal to everyone although we should all read it. It’s about assisted suicide, one of the great moral dilemmas of the twenty-first century Western world where medicine has advanced in leaps and bounds but not the ethical framework for dealing with its unintended consequences. Steven Amsterdam’s sharp, funny novel explores this conundrum through Evan, a nurse whose mother has recently been diagnosed with Parkinson’s disease.

Evan is about to administer his first lethal dose to a builder riddled with cancer. Teddy’s family are with him: his wife not quite holding things together and his daughters not quite believing what’s about to happen. As a nurse on Mercy Hospital’s assisted suicide programme, a pilot project made possible by the enactment of a new law, Evan is closely monitored, part of a strict protocol carefully designed to protect all parties. His first assignment is a little bumpy but all is smoothed out in the debrief. After work, as he does every day, Evan visits Viv in the nursing home where a new treatment appears to have transformed her from the waspish, distant woman he knows and loves into the garishly made up, life and soul of the party. On one of Evan’s ‘assists’ he oversteps the mark, offering a little too much in the way of help, putting both himself and his boss in an untenable position. Soon he’s working off-grid, stepping over the line into unregulated territory, convinced that his vocation is to help those who want to be helped. Meanwhile, Viv moves out of her nursing facility, shrugging off his offers of help and urging him to find himself a life. Despite his relationship with Lon and Simon who have invited him into their lives and into their bed, the only support he’ll allow is from the roommate he met during Viv’s brief commune days. When Viv’s stabilisation dips into a disastrous decline, Evan is faced with a choice.

The Easy Way Out is an extraordinarily powerful novel, made all the more so by the knowledge of Amsterdam’s own work as a palliative care nurse. No axes are ground here: Amsterdam explores the dilemmas that surround this vexed question with compassion and humanity, leavening it all with a darkly sardonic humour – gallows if you like. Both Evan and Viv are sharply drawn. Evan’s lonely mission and its emotional fallout is painfully believable while Viv is wonderfully acerbic – Evan imagines her fury at being called ‘feisty’, that over-used cliché applied to women who speak up for themselves at a time when that’s something she can no longer do. It’s a smart, though-provoking novel that pulls no punches from its hard-hitting opening chapter to its surprising end. I was reminded of Atul Gawande’s Being Mortal as I read it – we all need to have conversations about our old age and decline, stop ducking the issue and pretending it won’t happen to us. And if our country decides, as some already have, that we must find a safe and secure way to legitimise assisted suicide we need to think carefully about the burden we place on those charged to assist. This is a brave novel – wise, funny and gripping. We should do Amsterdam the courtesy of giving it careful consideration.