ROYAL OAK, Mich. -Jack Kevorkian built his suicide machine using parts gathered from flea markets and stashed it in a rusty Volkswagen van. But it was Kevorkian's audacious attitude that set him apart in the debate over whether gravely ill people could seek help ending their lives. The retired pathologist who said he oversaw the deaths of 130 people burned state orders against him, showed up at court in costume and dared authorities to stop him or make his actions legal. He didn't give up until he was sent to prison.
Kevorkian, who died Friday at a Michigan hospital at 83, insisted suicide with the help of a medical professional was a civil right.
His gaunt, hollow-cheeked appearance gave him a ghoulish, almost cadaverous look and helped earn him the nickname "Dr. Death." But Kevorkian likened himself to Martin Luther King and Gandhi and called physicians who didn't support him "hypocritic oafs."
"Somebody has to do something for suffering humanity," he once said. "I put myself in my patients' place. This is something I would want."
Kevorkian jabbed his finger in the air as he publicly mocked politicians and religious leaders. He was a magnet for the news media, once talking to reporters with his head and wrists restrained in a stock reminiscent of the Medieval era.
His efforts put the medical establishment in knots: Here was a doctor admitting he had helped people die and urging others in the profession to do the same.
Kevorkian died at William Beaumont Hospital in Royal Oak, where he had been hospitalized since May 18 with pneumonia and kidney problems. He probably suffered from a pulmonary blood clot, according to friend and attorney Mayer Morganroth. Before his death, nurses played selections of music by Bach.
Despite Kevorkian's relentless efforts, few states made physician-assisted suicide legal. Laws took effect in Oregon in 1997 and Washington state in 2009, and a 2009 Montana Supreme Court ruling effectively legalized the practice in that state.
L. Brooks Patterson, a former prosecutor and the county executive in Oakland County, Mich., where Kevorkian assisted in a number of deaths, described him as an "affable guy" but said his tactics hurt his cause.
"I don't think he was the right ambassador to represent the issue," Patterson said. "It was the law be damned with him. The issue would have been better debated in a more serious arena than in the back of Jack's van. ... It was a sideshow. Helping people commit suicide in the back of a van is not dying with dignity."
Those who sought Kevorkian's help typically suffered from cancer, Lou Gehrig's disease, multiple sclerosis or paralysis.
He catapulted into the public eye in 1990 when he used his machine to inject lethal drugs into an Alzheimer's patient. He typically would leave the bodies at emergency rooms.
For much of the decade, he escaped legal efforts to stop him. His first four trials, all on assisted-suicide charges, resulted in three acquittals and one mistrial. Murder charges in Kevorkian's first cases were thrown out because Michigan had no law against assisted suicide. The Legislature wrote one in response. He also was stripped of his medical license.
Devotees filled courtrooms wearing "I Back Jack" buttons. Critics questioned his headline-grabbing methods, which were aided by his flamboyant attorney, Geoffrey Fieger, until the two parted ways before the 1999 trial in which he was sentenced to prison.
"The issue's got to be raised to the level where it is finally decided," Kevorkian said during a broadcast of CBS' "60 Minutes" that aired the videotaped death of Thomas Youk, a 52-year-old man with Lou Gehrig's disease.
He challenged prosecutors to charge him again, and they obliged with second-degree murder charges.
Kevorkian acted as his own lawyer. In his closing argument, he said some acts "by sheer common sense are not crimes."
"Just look at me," he told jurors. "Honestly now, do you see a criminal? Do you see a murderer?"
Kevorkian's ultimate goal was to establish "obitoriums" where people would go to die. Doctors there could harvest organs and perform medical experiments during the suicide process. Such experiments would be "entirely ethical spinoffs" of suicide, he wrote in his 1991 book "Prescription: Medicide — The Goodness of Planned Death."
"It sometimes takes a very outrageous individual to put an issue on the public agenda," Susan Wolf, a professor of law and medicine at the University of Minnesota, said in 2000. The debate he engendered "in a way cleared public space for more reasonable voices to come in."
In a rare televised interview from prison in 2005, Kevorkian told MSNBC he regretted "a little" the actions that put him there.
"It was disappointing because what I did turned out to be in vain. ... And my only regret was not having done it through the legal system, through legislation, possibly," he said.
Kevorkian was freed in June 2007 after serving eight years of a 10- to 25-year sentence. His lawyers said he suffered from hepatitis C, diabetes and other problems, and he promised in affidavits that he would not assist in any more suicides if released.
Tina Allerellie became a fierce critic after her 34-year-old sister, Karen Shoffstall, turned to Kevorkian in 1997. She said Shoffstall, who suffered from multiple sclerosis, was struggling with depression and fear but could have lived for years longer.
Kevorkian's intent "has always been to gain notoriety," Allerellie said in 2007.
In 2008, Kevorkian ran for Congress as an independent, receiving just 2.7 percent of the vote in the suburban Detroit district. He said his experience showed the party system was "corrupt" and "has to be completely overhauled."
He said he first became interested in euthanasia during his internship year when he watched a middle-aged woman die of cancer. She was so emaciated, her sagging, discolored skin "covered her bones like a cheap, wrinkled frock," Kevorkian wrote.
On June 4, 1990, he drove his van to a secluded park north of Detroit. After the Alzheimer's patient, 54-year-old Janet Adkins of Portland, Ore., met him there, he inserted a needle into her arm. When she was ready, she flipped the switch that released a flow of lethal drugs.
He later switched from his device to canisters of carbon monoxide, again insisting patients take the final step by removing a clamp that released the deadly gas to a face mask.
Kevorkian's life story became the subject of the 2010 HBO movie, "You Don't Know Jack," which earned actor Al Pacino Emmy and Golden Globe Awards for his portrayal of Kevorkian. Pacino paid tribute to Kevorkian during his Emmy acceptance speech and recognized the world-famous former doctor, who sat smiling in the audience.
Pacino said during the speech that it was a pleasure to "try to portray someone as brilliant and interesting and unique" as Kevorkian and a "pleasure to know him."
Kevorkian himself said he liked the movie and enjoyed the attention it generated. But he doubted it would inspire much action by a new generation of assisted-suicide advocates.
"You'll hear people say, 'Well, it's in the news again, it's time for discussing this further.' No, it isn't. It's been discussed to death," he told The Associated Press. "There's nothing new to say about it. It's a legitimate, ethical medical practice as it was in ancient Rome and Greece."
Kevorkian's fame also made him fodder for late-night comedians' monologues and sitcoms. His name became cultural shorthand for jokes about hastening the end of life.
Even admirers couldn't resist. Adam Mazer, the Emmy-winning writer for "You Don't Know Jack," got off one of the best lines of the 2010 Emmy telecast.
"I'm grateful you're my friend," Mazer said, looking out at Kevorkian. "I'm even more grateful you're not my physician."
When asked in 2010 how his own epitaph should read, Kevorkian said it should reflect what he believes to be his "real virtue.
"I am quite honest. I have trouble lying. I don't like people who lie."
Fieger believes Kevorkian would have taken advantage of the option he offered to others, had it been available.
"If he had enough strength to do something about it, he would have," Fieger said Friday. "Had he been able to go home, Jack Kevorkian probably would not have allowed himself to go back to the hospital."