Hey there, time traveller!
This article was published 16/6/2017 (313 days ago), so information in it may no longer be current.
I had expected the conversation with his widow to be emotionally difficult for her to tell.
What I hadn’t anticipated was how troubling it would be to hear.
Looking back, that’s partly because I knew them both, the husband and wife, and, of course, because of the intimate nature of the conversation about how he died. How he chose to die and how it affected him, her and the family members who were there. I’m sharing that up front because that subject matter — like medically assisted dying itself — isn’t for everyone. Which is also why — since there is still a degree of judgment associated with the right to die and recent legalization, and because the widow asked that their names not be divulged — I’ve created pseudonyms. I hope the story of James and Grace will help dispel stigma.
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It had been nearly a month since that sunny spring Saturday when the black Nissan commercial van pulled into their suburban Winnipeg driveway to take her husband’s body away. Now, Grace and I were seated across a kitchen table and she described the beginning of that end.
James had been diagnosed with terminal cancer two years earlier, when he was in his late 70s. Even then, Grace and the family had to convince him to give chemotherapy a try. But by mid-April, during an appointment at CancerCare, his oncologist told James the chemotherapy wasn’t helping anymore.
"We said, ‘What’s the next choice?’" Grace recalled.
The doctor said James could prolong his life with dialysis.
No, he didn’t want to do that. In that case, the doctor told them, the next step would be palliative care.
"I guess I’ll go to Switzerland now."
"You don’t have to go to Switzerland," the doctor said.
"Oh?" James said.
And with that they went straight home that Friday and called the number for the team that administers medically assisted dying. The following week, with James’ kidneys failing, a team consisting of a physician, a nurse and a social worker arrived at their home to assess the patient.
"It was a lot of questions about what was happening: what kind of care he was getting, why he wanted to do this, why not just get palliative care?"
"He was clear the whole way through," Grace said of the medical interview and a second one that would follow soon after with another assessment team. "This is the way he wanted to end it."
James requested that the wait period be less than the prescribed 10 days, if possible, which it is under specific medically related circumstances. It would be done in eight days for James.
"Which, as it turned out, was good. He was very, very, um..."
Grace was searching for the right words.
"Uncomfortable at the end," she finally said.
"Distressed?" I asked.
"Distressed," she agreed. "Very distressed."
I asked if it was mostly because of physical discomfort. Or emotional?
"Well, it was emotional. It was hard to know. I mean, it was very hard to know. He didn’t want people touching him. But he did like people sitting with him."
So, during the day, they all took turns. At night, Grace slept on the floor beside her husband, in the upstairs bedroom with the framed family photos and the flowers.
"Do you want me to go into the details of what happened?" Grace asked.
I said yes, although what she went on to describe still haunts me.
"So on the morning of the procedure, they came at the identified time," Grace began.
This time there was a second nurse with the physician, and a social worker, because they had anticipated difficulty putting a second intravenous site in his hand. There was a problem, which made James "very distressed." He became even more agitated after the IVs were in place and the team left the room to prepare the three medications. Grace recalled how he was trying to turn over, and was yanking at the IV lines.
Was he having second thoughts?
"No, no," Grace said.
She said a nurse returned before the others, calmed him and gently assured James it wouldn’t be much longer.
"We left the room and they asked him again if he really wanted to proceed. I knew he wanted to proceed. What he didn’t want was the discomfort."
Up to the last minute — when James signed his name to a form authorizing the procedure — the team was still checking with him. Then Grace and the family watched as the medication that would put him to sleep was injected, following by the injection of Valium. And, even though a third medication was administered, one of the nurses later told Grace that the Valium is all it took.
"He’s gone," Grace remembered saying right then.
"We were all, of course, sobbing," Grace recalled. "But so was the team. They were all crying."
In a way, James died in the most peaceful of ways. In his sleep.
There had been nothing hurried about any of it, Grace said. It was all done respectfully, carefully and compassionately.
"I found it very meaningful."
I wondered what James would have thought of how it went. How it ended for him.
"I think he would have found it very appropriate," Grace said. "And sympathetic. And he would still make the same decision."
Then she answered my next question before I could ask it. Would she do it for herself?
"I don’t know if I would do that, quite frankly. I really don’t know."
We were almost an hour into our conversation when I asked Grace if she had any regrets.
"I regret he got cancer. You know? I regret that he’s gone."
But there’s nothing about the medically assisted dying process she regrets.
"I would do it that way again," Grace said. "It was the right thing to do."
Just then, as she began to get up from the table, Grace had a final request that spoke to the end of his life, and the rest of hers, in the most human of ways.
"I wouldn’t mind a hug, though."