Earlier this year, nursing student Cassie Bonstrom was in a class at Normandale Community College when the instructor asked the students if their families ever experienced an ethical dilemma in a health care situation.
Bonstrom told the class about the death of her grandmother, Nancy Jack, who was admitted to Fairview Southdale Hospital in Edina in 1989 with terminal lung failure. After Nancy suffered a massive stroke and was considered brain dead, her family agreed to have her taken off a respirator. Her doctor gave her morphine to ease her suffering as she died.
But Nancy’s death was later found to be a case of morphine poisoning and declared a homicide. Charges were considered against the doctor for an alleged “mercy killing.”
Bonstrom couldn’t answer many of the instructor’s questions about the case. But another student in the class could. Emelia Weicker Mickman was familiar with the case because the doctor facing murder charges 30 years ago was her father, James Mickman.
“She and I just stared at each other,” Bonstrom said. “I think our class just went silent for a moment.”
Bonstrom immediately texted her mom to ask the name of the doctor who treated her grandmother.
Her mother messaged back: “Saint Jim Mickman.”
Susan Jack, Bonstrom’s mother and the daughter of Nancy Jack, said she and her family had always believed James Mickman had done the right thing when treating her mother.
“I was so grateful to him, that he had done whatever was needed for her to have a peaceful death,” Susan Jack said.
But a nurse had questioned how much morphine was given to Nancy. That led to an investigation and a ruling by the Hennepin County medical examiner that she died of morphine poisoning.
For the next year, the case of Nancy Jack and that of another patient who received morphine when he was dying at the University of Minnesota Hospital were investigated by the Hennepin County Attorney’s Office for possible charges against the doctors involved.
“It was a terrifying experience,” said Sarai Mickman Brenner, the wife of James Mickman.
She said her husband “knew what he had done came from a very deeply held place of compassion for patient care.” But she was worried that her husband might be prosecuted and convicted of murder.
At the time, the couple had just had Emelia, their first child. Mickman Brenner wondered if she would have to move to Stillwater with her young daughter so they could be close to the state prison.
In the end, then-Hennepin County Attorney Tom Johnson said that while he agreed with the medical examiner that the morphine-associated deaths were homicides, he decided not to prosecute the doctors involved, saying there was no direct evidence of premeditation and intent to kill.
Lawyers representing the doctors in the two cases maintained that morphine did not cause the deaths and the deaths should never have been characterized as homicide.
“She was going to die. There wasn’t any effort to kill her,” Susan Jack said of her mother.
James Mickman continued to practice for decades after Nancy Jack died. His patients ranged from the needy in homeless shelters in Minneapolis to the sick in refugee camps in Southeast Asia, where he was a camp doctor for the American Refugee Committee.
“He loved his work,” Mickman Brenner said.
“He was a very special guy,” Susan Jack agreed.
He died in 2013 after battling a brain tumor.
Emelia Mickman said her father’s experience in hospice care fueled her interest in nursing. “His death was just so peaceful,” she said. She hopes to work in hospice, palliative and end-of-life care once she gets her degree.
Mickman Brenner said both she and her daughter did hospice volunteer work after her husband died. Bonstrom’s father, Unitarian pastor Harlan Limpert, also is a leader in an interfaith group seeking to expand end-of-life options for the terminally ill.
When Nancy Jack died, Bonstrom and Mickman were too young to grasp details about her death. After the class, “we just gave each other big hugs,” Bonstrom said. “It was just overwhelming.”
“It felt like kismet. A strange and beautiful experience,” Mickman said. “It feels like we’ve been living these parallel lives this whole time.”
Since then, they’ve become friends and their families hope to meet.
“I definitely feel like there’s a deeper connection knowing this history we had,” Bonstrom said. “Just to find a connection that runs so deep between my family and Emelia’s family is really special.”