Peter’s story: A medically assisted death, completely on his own terms

In this moving tribute, the sons of Nova Scotia’s Peter Blakesley describe life after their father’s melanoma diagnosis — and how the choice of an assisted death gave Peter the chance to die in a manner that, he felt, preserved his dignity and agency.

This is the story of Peter Herrick Blakesley.

Peter elected for and was awarded the ability to be the master of his own destiny – to steer his own ship, as it were. Peter was afflicted with an aggressive and excruciatingly painful case of melanoma that rendered his quality of life absolutely miserable for the final six to 12 months of his life.

Peter and his wonderful wife of 59 years, Kathleen, retired to Nova Scotia’s Annapolis Valley in 2010. Living only 20 minutes from immediate family, they enjoyed many family Sundays, holiday suppers, and Christmas visits. Out of the blue in 2013, Kathleen succumbed to the effects of a massive stroke.

In the ensuing few years, Peter soldiered on with a positive spirit, but suffered from some falls, separated shoulders, stitches and resulting bruised pride. During related medical examinations, a follow-up examination of suspicious skin lesions was conducted. These lesions were identified as malignant and confirmed as melanoma, leading to invasive and disfiguring surgeries.

Snapshots from Peter’s life (From L-R: Peter as a young man; Peter, a proud Royal Navy man, in Malta in the early 1950s; Peter and his wife, Kathleen, at a black tie affair in 1958; and Peter with his sons Neil and Martin in the early 1960s.)

Medical follow-up struggled to keep pace with the rapid, aggressive spread of Peter’s melanoma. Peter and his sons attended several appointments at the Lower Sackville Cancer Clinic and the QEII Dickson Building in Halifax. Consulted oncologists offered options (some experimental) to address Peter’s medical situation in an attempt to improve his quality of life. Family inference of collective medical diagnoses concluded that Peter’s melanoma was terminal.

In short order, Peter’s quality of life plummeted and pain elevated to excruciating levels. He could no longer lie down to sleep, and instead spent nights upright in a chair or recliner. Pain dictated that he could no longer sit in his car as passenger or driver, inhibiting his mobility. Peter became increasingly frustrated with his progressively diminished quality of life. Once energetic, he became indifferent — things that had once brought him great pleasure such as photography, fine cooking, reading, talking, and debating with close friends and family no longer interested him. His life sphere contracted to his small kitchen and living room.

Throughout his progressive physical demise, Peter maintained his mental faculties — quick and sharp-witted — and was always ready to offer his opinion, perhaps needing to feel that he held a firm grasp and control of his affairs. It was these aspects that he feared losing the most.

Peter and Kathleen’s wedding day in England on July 17, 1954.

In one poignant oncology appointment, the resident oncologist asked Peter a question that appeared to galvanize him: “Peter, what is your understanding of your current situation?” After a pause, Peter responded that he thought this was “the most insightful bloody question I’ve been asked in ages.” Peter responded that he was in his 90th year and had lived a good life. He married a wonderful, loving wife, had four sons — each of whom he was proud — and enjoyed an engaging and diverse career. He wished for nothing more and saw no point in the future.

Presented with a range of medical options — none apparently productive — he expressed with the utmost clarity and conviction that he no longer saw the point in continuing life and would be happy to end it in a manner that preserved his dignity, agency, and most importantly, the control he desired throughout his life to the very end.

• Learn more: Get the facts on Canada’s assisted dying law

Peter and Kathleen, Deep River, 1980s.

In navigating Peter’s pursuit for medical assistance in dying (MAID), it was inferred by family members and friends that some healthcare professionals are reticent to endorse MAID procedures, perhaps due to personal beliefs, or because MAID is a relatively new medicinal concept, or because it conflicts with long-standing, traditionally ascribed medical ethics. One medical professional involved in Peter’s examination offered that the medical profession, in general, hasn’t kept pace with the broadened societal acceptance of MAID and related legislation.

• Encountering barriers to accessing MAID? Click here for support and resources

Peter experienced this reticence firsthand when one oncologist said they simply wanted to “improve [his] quality of life,” when in retrospect, it was evident that Peter was already terminally afflicted. This observation of these healthcare professionals is not intended to be judgmental, far from it. There is enormous respect and gratitude offered to the wonderful and caring medical professionals involved in Peter’s diagnoses and treatment. It is offered as supportive insight from experience to those who may become involved in a MAID situation.

Peter and Kathleen on the Fundy shore, circa 2011.

Following appropriate MAID protocols and resulting approval, Peter’s MAID wishes were honoured at 8:45 a.m. on December 18, 2018. Peter was weaned from his pain-reducing medications three days prior, so that he was lucid for his final affirmation immediately prior to the MAID procedure. Capacity at the time of the procedure is a requirement in the current federal law.

Despite the howling snowstorm outside, Peter’s final morning in his hospital room was very peaceful. Tim, the attending son, observed, “My wife and I spent 20 to 30 beautiful minutes with my father prior to the final procedures. I read him final letters his grandsons sent him, struggling to get through them. He consoled me. I showed him his Christmas cards. I thanked Dad for everything he had done for me.

Dad’s family doctor arrived at 8:30 a.m. and had a nice discussion with Dad, discussing recipes — a spark in his eyes reappeared! The anaesthesiologist arrived a few minutes later and kidded with Dad for five to 10 minutes, talking about the challenges of Christmas shopping and the mirth surrounding John Cleese. The anaesthesiologist then asked Dad if he was ready for his procedure. Dad replied an emphatic, “Yes.” The anaesthesiologist advised he was going to give Dad a needle to put him to sleep, then a needle to make sure he stayed asleep. Dad’s family doctor positioned herself at the foot of Dad’s bed, rubbing his feet until he passed, she weeping. The entire scenario was absolutely serene, heart-warming, and comforting.”

Peter with two of his sons in November 2018 (From L-R: Peter with his youngest son Simon; Peter with his son Tim.)

Being the son attending the final MAID procedure, I offer that it’s surreal to discuss, schedule and participate in a loved one’s departure; it’s relatively new for our society. Reassurance and comfort can be gained in the knowledge that the recently departed went on their own terms, in control. Had Dad not elected for MAID, an oncologist engaged in Dad’s medical situation suggested that Dad could have spent months, perhaps even a year, in a palliative hospital bed waiting for “the inevitable,” as medical imagery confirmed that the melanoma had yet to metastasize in any of his organs.  That scenario would be extremely wearing for Dad and loved ones alike.

The support, care, and friendship afforded to Peter by his many friends in the local community was beautiful. Dad and I (and his friends) could engage in frank and honest discussions about MAID in the months leading up to his death. As difficult as it may be for some, we encourage frank and honest discussion between terminally afflicted persons and their families and friends. As in many things in life, communication is key.

Dying With Dignity Canada extends heartfelt thanks to the entire Blakesley family for sharing Peter’s story. We are grateful he was able to access his choice of a medically assisted death and that he was surrounded by love until the very end.

(Header: Peter’s final photo, taken by his son Simon Blakesley. All photos courtesy of the Blakesley family.)