The national news story about the battle over whether a Florida woman should have her feeding tubes removed and be allowed to die reminded me one of the stories that meant the most to me during my career in journalism.
It was in October 1990 and I was only a few months into my job at The Carthage Press. Because city/courthouse reporter Pat Halvorsen had the day off, Managing Editor Neil Campbell assigned me to cover the hearing on whether Nancy Cruzan should have her feeding tube removed. It was a story that meant a lot to me since I had known Nancy when we were both teenagers. It was several years later that she was involved in the car accident that put her into what doctors called a "persistent vegetative state." Her parents, Joe and Joyce Cruzan, had to go to court to try have their daughter's feeding tube removed. The case went all the way to the United States Supreme Court, where it became the first right-to-die case ever decided by our nation's highest court. In a 5-4 ruling, the justices said there was a right to die. Unfortunately for Nancy's family, they still had to prove that their daughter would not want to have heroic measures taken to keep her alive.
The upstairs courtroom was packed at the Jasper County Courthouse that Thursday morning. I felt like one of the big shots sitting in the jury box with reporters from The New York Times, the Kansas City Star, Associated Press, two network sketch artists, and my favorite...the good looking female reporter from Channel 3 in Springfield. I sat in that jury box, and as I later told my classes, I saw exactly the same things the other reporters were seeing in exactly the same way. Fortunately, I was saved by lunch.
When I returned from lunch, even though there were still 20 minutes before testimony was scheduled to resume, the jury box was already filled, including the seat by that cute reporter from Channel 3.
So I sat behind the Cruzan family and their lawyer, William Colby.
I noticed that one of Nancy's nieces, high school freshman Miranda Yocum, was drawing on a sketchpad with just as much skill as the highly paid professionals in the jury box. I began to concentrate on her. I ended up writing both a generic story on the courtroom testimony and a feature on the little sketch artist. The feature won several major state and national awards and taught me a valuable lesson about following the pack, one I hope I will never forget.
Three years ago, on the 10th anniversary of Nancy's Dec. 26, 1990, death, 417 magazine in Springfield commissioned me to write a story about the effect Nancy had on our society. I sent the editors the story on time, sent several follow-up messages, but never received any money and the article was never published.
This is the article I wrote for 417:
REMEMBERED ON 10-YEAR
ANNIVERSARY OF HER DEATH
By Randy Turner
The words are simple ones, but to those who followed the ordeal the Cruzan family went through after a 1983 automobile accident left Nancy in a persistent vegetative state, those two words have a significant meaning.
The words are etched in her tombstone in a cemetery just outside of Carterville. They can be interpreted in more than one way. It could be a thank you to the U. S. Supreme Court, which made it possible for Judge Charles Teel to render the Dec. 12, 1990, decision that ended what remained of Nancy’s life. It could be a thank you for all the people who fought to make those decisions possible…people like Nancy’s parents, Joe and Joyce Cruzan and her sister, Chris White, the nieces she loved, Angie and Miranda Yocum, or the attorney, Bill Colby of Kansas City, who fought all the way to Washington, D. C. and back for Nancy’s right to die.
Tuesday, Dec. 26, will mark the 10-year anniversary of the end of a saga that began on a county road just outside of Carthage and ended up gripping the nation.
Nancy Cruzan made the most of the quarter of a century that she “lived.” She was vivacious, outgoing, looking forward to every day. My encounters with her were brief and both came when we were teenagers. When my baseball team played in Carterville, one of the highlights was the Cruzan sisters, whose laughter and joy of life came across to everyone they met. I only met her a couple of times, but she made enough of an impression that I, like the others who knew her, was shocked when she was robbed of her life at such an early age.
On Jan. 11, 1983, Nancy had worked the late shift at Schreiber’s Cheese Plant in Carthage. She was driving east on Elm Road and was only one mile from her home when the accident occurred. There were no weather conditions that would have explained why she lost control of her car. It ran off the left side of the road, hit some trees and a mailbox, then swerved back across the road and went off the right side, going through a fence, overturning several times and coming to rest on its top. She may have fallen asleep, authorities speculated.
By the time CPR was administered to her, her brain had already been deprived of oxygen for about 14 minutes. About six minutes is all it takes to cause permanent brain damage. She was left in what doctors called a “persistent vegetative state.” The cerebral hemisphere of her brain, which controlled her thinking and her emotions no longer functioned. All she had left were physical reflexes.
Nearly five years into that existence between life and death, Joe and Joyce Cruzan asked Judge Teel if they could remove the feeding tube that was attached to their daughter…the only thing that was keeping Nancy alive. Teel warned that someone could bring legal charges against them unless they petitioned to have it done legally. The Cruzans filed the motion in Jasper County Circuit Court and that began the long legal battle. Testimony at the circuit court level was provided by people who said that Nancy had indicated she would never want to be kept alive by artificial means. She had worked for a time as the Stapleton Center in Joplin caring for a retarded three-year-old boy who had to be forcefed. During a conversation with other workers at the center, Nancy indicated if she were in that situation, she would want to have the plug pulled.
Teel granted permission to have the feeding tubes removed, but the decision was appealed by the Missouri Attorney General’s office, which had taken an interest in the case, and it was sent to the Missouri Supreme Court, which overturned Teel’s ruling. The Cruzans and their attorney, Colby, took the case to the United States Supreme Court. It was the first time the Supreme Court had ever considered a right-to-die case.
The Court ruled that a person does have the right to die, but also indicated state courts should hear the evidence and determine if Nancy really had indicated what she would want to happen.
That brought the case full circle and the eyes of the nation were on Carthage, Mo., that day in October 1990. The courthouse square was filled with vans from all the Joplin and Springfield stations, plus stations as far away as Kansas City and St. Louis.
Since the case was going to be heard by Judge Teel once more and not by a jury, reporters filled the jury box so they could get a little closer to the judge, the attorneys and the witnesses. The national media was present, including representatives of The New York Times, The Associated Press and other metropolitan newspapers.
Three more witnesses were presented who testified that Nancy had indicated to them she would never want to be kept alive through artificial means if she were left incapacitated in an accident. One of the witnesses was a man for whom she had worked when she lived in Oklahoma City.
The Cruzan family listened attentively as the man began his testimony, clearly answering the questions that were posed to him by Colby and by Carthage attorney Thad McCanse, who had been appointed by the court to represent “Nancy’s interests.”
Joe and Joyce Cruzan were seated with Colby. In the row behind them was Nancy’s older sister, Christy White, and Christy’s two young daughters, Angie and Miranda Yocum, who at the time were students at Webb City High School. Nancy had loved those two girls more than she loved anyone else in her life.
Miranda, a ninth grader and a budding artist, had brought along a sketchpad and was drawing a courtroom scene that matched the efforts being put forth by the two professionals who were seated in the jury box. Her eye for detail was evident as she sketched Colby perfectly, right down to his suspenders and caught all other aspects of the courtroom.
As the testimony continued, Nancy’s former boss recollected the conversation he had with her, recalling that she had said she wouldn’t want to live as a vegetable because “vegetables can’t hug their nieces.”
After hearing that, Angie, the older niece, began to cry. Miranda’s face was also reddening as she put her arm around her sister’s shoulder and began patting her on the back. When the testimony ended and the hearing concluded, Miranda took her sketch to William Colby and presented it to him. Maybe the first time during the case, the attorney was able to smile. “That’s really good,” he said. “That’s really good.”
Judge Teel took the testimony under consideration and on Dec. 12, 1990, he ordered the feeding tubes to be removed. In a written statement, Joe Cruzan said, “I suspect hundreds of thousands of people can rest free, knowing that when death beckons they can meet it face to face with dignity, free from the fear of unwanted and useless medical treatment.” Twelve days later, Nancy Cruzan, whose life ended on that county road nearly eight years earlier, died.
The end did not come peacefully for the Cruzan family as protesters gathered around the Southwest Missouri Rehabilitation Center in Mount Vernon where Nancy had been a patient for several years. Even though many of the protesters were calling him a murderer, Joe Cruzan still had sympathy for them. He knew they believed in what they were doing, just as he did. On one particularly cold night, he took them hot coffee because, as he said, “No one should have to be cold.”
Nancy Cruzan died 10 years ago, but her influence is still being felt.
For a time, her sister, Christy, ran the Nancy Cruzan Foundation, helping people who faced similar situations. “I think we’ve come a long way,” she told the Associated Press in 1996. “There are a lot of caring medical professionals ready to listen to what patients want. I truly believe…because of Nan’s case…there are a lot of families that won’t have to go to court now.”
Missouri went from being behind other states in providing patients the right to control their own destinies to establishing a living will law that makes sure that what the patient wants is taken into consideration. The public awareness created by the Nancy Cruzan case made it easier for people to put into writing what they would want to have done for them medically if they should ever be incapacitated.
Missouri also now has a durable power-of-attorney law, put into effect shortly after Nancy’s death, that allows a person to name another person who will make the life-and-death decision if it needs to be made. The Cruzan case also made a difference on the federal level. The Federal Patient Self-Determination Act, primarily sponsored by former U. S. Senator John Danforth of Missouri, requires hospital officials to tell patients about their right to determine in advance what should be done and then requires the hospitals to honor those wishes.
Joe Cruzan committed suicide in 1995. His life had never been the same since Nancy’s accident. An intensely private person, he suddenly against his will became a celebrity with many sworn enemies who felt he had no right to make a life-and-death decision for his daughter.
Joyce Cruzan died in 1998. The Christmas holidays will always bring bittersweet memories for the remaining members of the family. But they do know that their sister’s life…and her death… made a difference.
Their attorney, Bill Colby, was also greatly affected by the case. He took a leave of absence from his law firm to write a book on the Cruzan case. Earlier, on the fifth anniversary of Nancy’s death, he wrote an op-ed article for The Kansas City Star, in which he said what he hoped would be the lasting impact of Nancy Cruzan and the court battle that earned her the right to die.
“The more information we provide while healthy, the more each of us communicates with our loved ones, the greater the chance that we will empower those loved ones to ask the right questions and make the decisions we would choose at the end of life.”
In that article, Colby described the call he received from Joe Cruzan the night that Nancy died. “When Joe saw that Nancy was no longer breathing, he reached up and gently closed her eyelids. As we wound up (our) conversation early that morning, I asked Joe, ‘What are you going to do now?’ He replied, ‘Well, I guess we are going to go home.’ “
(Note: Bill Colby is scheduled to be at Hastings in Joplin 7 p.m. Tuesday, Nov. 4, where he will talk about Nancy Cruzan, read from his book, and will most likely talk about the Florida case, which has once again turned the focus on Nancy Cruzan.)