In August 2017, British Columbia’s Adam Ross fulfilled his choice to die with dignity — the last option left to free him from a prolonged, untreatable pain condition. He died alone, without anyone’s assistance, taking care to minimize the burden on the people he loved. His story reveals how much work still needs to be done to ensure that Canadians have fair alternatives in the face of unbearable suffering.
This is Adam's deeply moving and articulate departing letter to his loved ones.
Dearest family and friends,
As many of you know, I’ve been struggling with my health for quite some time and my experience of the world has become too difficult for me. I just do not wish to bear the pain I feel inside any longer. So with careful thought and consideration, I’ve decided to let go of my body. Pain is such a personal experience, something we can only try to describe, but the true depths of which can never fully be understood by another. I will, however, still try my best to explain my journey through this, in an attempt to help you understand why I decided to be free of my suffering. It’s not meant to sound like a convincing argument, it is just my story, my truth, fully and completely, the way I experienced it.
My injury occurred in the spring of 2010 and I’ve felt broken inside ever since. At the time I was having problems with my shoulder from the heavy weight training I used to do and so I went to see a physiotherapist. Along with exercises for shoulder rehabilitation, he also explained that I had a ‘hyperkyphotic’ spine and wanted me to correct my poor posture with other exercises for my upper back and neck. Like all things at the time, after the discovery of a problem, I went into fixing it as quickly and as efficiently as possible. So I flew into my rehab program, much too forcefully than I should have been on my body. One of the exercises in particular, where I was rolling up and over a ball to help fix my ‘rounded thoracic spine,’ gave me a lot of grief. My back was cracking and popping during this exercise and I started to have a lot of pain. My condition was worsening and after a few chiropractic adjustments that summer, without improvement, I continued to decline. By the time I went back to dental school that fall, it felt like a fire had been lit at the base of my neck on the left side and all of the muscles of my neck and upper back were in spasm. The pain was like nothing I had ever experienced in my life and I knew something terribly wrong was going on inside of me.
Over the years since then, I’ve had no improvement in my pain. I’ve had MRI’s and x-rays of my neck and back, which show nothing much of significance. I’ve been in and out of pain clinics and I’ve tried everything possible to help alleviate my pain. My diagnosis at onset was chronic ‘Myofascial Pain Syndrome,’ characterized by multiple muscle trigger points or knots and similar to a whiplash injury. Unlike the knots from muscle overuse that can be treated with conventional therapies, in Myofascial Pain Syndrome the nervous system becomes sensitized and the pain persists or worsens. For a neck and back injury, practicing Dentistry proved to be especially challenging, but despite my pain I continued to try and lead the life I had worked so hard to achieve. I would work all day in a lot of pain, often cry myself to sleep and then wake up with extremely stiff, knotted and sore muscles the next day and do it all over again.
'The toughest of all places in the world to be'
In January of 2016, I stopped working. My student debts were at a manageable level and my pain was too much for me to continue. The pain was becoming more widespread with knots and stiffness also in the muscles of my arms and legs. But, with the promise of relieving myself of the postural stresses from dentistry, I had hope, although little, that I was going to be able to get a handle on my pain. In about August of that year, my muscles started twitching. Slow at first, then it got pretty serious. So I received a new MRI of my brain and spinal cord, and was referred by my doctor to see a neurologist for a new diagnosis. On top of my neck and back pain, I now also have what’s called ‘Cramp-fasciculation Syndrome’, a muscle condition characterized by pain, stiffness, knots, twitching and cramping. I get shooting nerve impulses to various muscles sporadically throughout the day, causing them to twitch and remain knotted. They do not function properly anymore and give me a lot of pain. The syndrome is idiopathic, meaning they don’t know what causes it, although sometimes there is an auto-immune component, but I tested negative for these antibodies. Either way symptoms remain the same and there is no cure. All they can offer is medications to help relieve these symptoms, but this has been unsuccessful for me. The pain persists and medications are not taking it away.
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So here I find myself, in a place where I do not wish this life to end, but with a health condition I cannot bear to be living with. The toughest of all places in the world to be. All that remains is the hope that my condition improves, but it’s been seven long years with chronic pain and it is clear to me now that my health cannot be restored. After all the treatments I’ve tried and doctors can offer, I still struggle through my days in overwhelming pain, and I can’t find any relief from it. Due to its severity, I just cannot tolerate being inside my body any longer. I don’t want to die, but to be free of the pain that I am condemned to live with I have no other choice.
'I tried my hardest'
I have, however, had to come to a place of acceptance with what has happened. I’ve still been given such an incredible and enriched life, thanks mostly to the time I spent with all of you. I’ve been through hardships for the lessons I had to learn, but my journey in this life has filled me with happiness. In the end of course I wish things were different, but I am not bitter that my health has robbed me of my life. My pain has allowed me to fully understand what truly matters and I feel more love with the world around me, than I ever have before. Unfortunately, the miracles I witness each day are not enough for me to choose to endure this much pain. I’ve accepted this unfortunate circumstance and I know I’m certainly not the first, nor will I be the last person, to take their life because of an unbearable internal experience. I know now because of the hand I was dealt, it is ok sometimes, this is just a part of the human condition. Truthfully, I’m satisfied that I tried my hardest to save my life. Also, in the process of doing so, I’ve come to a place where I’m spiritually at ease with my mortality. Too early I know, but it is time for me.
I know what I have done will create so much sadness, and for that I am truly sorry. I have gone free from my pain, but I leave you all with more to carry. A burden that crushes me knowing I caused it and as I’ve contemplated my death over the past while, it is the biggest reason for my sorrow. I don’t want to hurt my loved ones in this way, but I just do not have the strength left to hold on through this pain any longer for you. Some will be upset with me, but if you coped with what I do each day, you would find peace in knowing that I am no longer suffering so. Of course, I imagined dying in a different manner, as it should be our right to choose when and how we would like that process to go, especially when you live with unbearable incurable pain that will not take you from this world naturally. But, like so many other aspects in this life, the human race has far to go in this regard. There are no words to describe the unfairness of these circumstances, but I’ve come to believe we are not separated, in life and in death, we are one.
So I am going to go peacefully now, but I will be with you always and I hope our journeys bring us together again. Oh how we will laugh. I love you so much.
Your son, brother, uncle and friend,
P.S. Always remember...revenge is best served to someone’s toothbrush. That was meant to be a joke, it’s ok you are allowed to laugh at my funeral. I know, everyone will grieve in their own way, but I can only hope that my funeral isn’t too much of a sad and depressing affair. You all know me and so you know that I would prefer if you celebrated a life, rather than mourn a death. I’ve had an amazing ride so try and have fun, laugh, and share stories of the times we spent together. Nothing brings people closer than loss, so be closer.
Dying With Dignity Canada is immensely grateful to the Ross family for sharing Adam's powerful story and letter. To read Adam's full story, please click here.
You can also find Adam's story in DWDC's 2017 Annual Report.