‘After’ by Nikki Gemmell

Nikki Gemmel’s memoir ‘After’ opens with her identifying her mother Elayn’s body in the morgue. The rest of the memoir works backwards, attempting to understand Elayn’s unexpected suicide and its fallout. In short sentences reflecting her unsettled state of mind, Gemmell depicts the moment police arrive to tell her something was wrong, her initial treatment as a suspect in her mother’s death, and her family’s reactions. Elayn had been living with chronic pain, probably as a result of a lifetime of wearing high heels, which had been exacerbated by an operation on her feet. Gemmell examines her own love-hate relationship with Elayn, whose typically Australian ‘flinty’ resolve was at times inspirational and at others isolationist. She gradually realises the complexity of Elayn’s experience and intentions, including how Gemmell ignored Elayn when she spoke about euthanasia and Elayn’s likely opioid addiction fed by ‘doctor shopping’. Gemmell sets out her own arguments for legalising assisted dying and euthanasia, reproduces a conversation with Philip Nitschke who knew Elayn as a member of Exit International and supplied her with his Peaceful Pill Handbook, and evidences public support for the cause by reproducing a series of heartfelt reader responses to her newspaper columns about Elayn. The latter includes her now friend Helena who, unlike Elayn, is open about her intentions and can afford a planned death with Dignitas in Switzerland. The book ends with Gemmell emerging from the turmoil of initial grief and accepting her mother’s decision as a complex mix of rationality and emotion.

Elayn’s death and the publication of ‘After’ both occurred as Australian states were considering legalising voluntary assisted dying. Gemmell’s high-profile story was part of the national conversation on the topic, in part because she worked hard to publicise her mother’s story. The book is emotionally raw and depicts the complicated reality of family reactions to suicides encouraged by groups like Exit International. Although she advocates for legalisation, Gemmell sometimes seems unsure whether she believes her family’s experience would have been any easier with the time to say goodbye that assisted dying would have allowed, or whether the grief of dealing with the aftermath of a relative’s suicide, assisted or not, is always deeply distressing. Her arguments for legalising assisted dying consequently sit alongside demands for improved suicide prevention, pain management and opioid control. Notably, Gemmell depicts Elayn’s identity as bound up with her early modelling career and the book explores how Western norms of control, epitomised for some women in expectations of beauty and style, can seem unbearable if chronic pain or disability mean you can’t live up to them. Gemmell finds solace in kintsugi, the Japanese art of highlighting repairs in ceramics, in a way that obliquely questions her mother’s high standards of presentation. Gemmell’s story also features in an impassioned edition of the documentary series Australian Story with additional interviews with Elayn’s GP (who a year later was still so shaken by Elayn’s actions that he cries when recounting his experience), a chronic pain specialist and a Sydney branch of Exit International.