Rachel’s story: My sister was able to have the gentle, dignified death she wanted

When Rachel Williams’ sister, Natalie, was diagnosed with late-stage cancer at the age of 55, she knew she wanted two things: She wanted to stay at home, surrounded by the love and support of her family, and she did not want to needlessly prolong her suffering. Despite resistance from doctors and some family members, Rachel — who has asked that her and her sister’s real names not be used to protect their family’s privacy — never wavered in her commitment to making sure Natalie was able to access her choice of a medically assisted death.

My smart, dynamic 55-year-old sister Natalie was diagnosed last summer with stage 4 cancer. She was given a few months to live and offered palliative care. The diagnosis hit her and us like a thunderbolt. Always active and full of life, Natalie was a loving wife and the affectionate mom of three grown kids. She had a rewarding job and was excited about the upcoming birth of her first grandchild. It seemed impossible that she would lose it all in just a few short months. Her one wish was to be at home, and we all arranged our lives, jobs, and schedules to help make that possible.

The palliative team did their best to care for Natalie’s physical and medical needs, and we adjusted to this new “normal,” hoping with all our hearts that “months” meant “many months.” But with each passing week, we could see the illness progress rapidly, and Natalie’s pain getting worse. We cried a lot, but we also hugged a lot, and told each other all the important things. My sister let us know she wanted to die at home, surrounded by her loved ones, and we agreed to help make that possible.

Natalie faced the end of her life as she had lived: realistically and with no desire to prolong the indignities, or the agony. Our family had experienced several deaths over the decades, as our parents and then our in-laws passed away in different hospital rooms. The final stage always involved days, sometimes weeks, of watching them suffer, waiting for the inevitable to happen. My sister didn’t want that and asked me to get more information on medical assistance in dying (MAID). I contacted Dying With Dignity Canada staff members, who were very helpful and put me in touch with the MAID care coordination service. From there, we were immediately connected with a registered nurse who handles MAID cases.

Natalie loved travelling and always talked about the glaciers she and her family saw while on an Alaskan cruise. (Photo credit: Andrewman327/Wikimedia)

Natalie was afraid she would suffer a medical crisis and end up in hospital before the assessment process was complete, but everyone on her MAID team went out of their way to make sure things would be in place as soon as possible, and that all our questions and concerns were fully answered. The MAID doctors, nurses, and everyone we met, treated Natalie and the rest of us with the utmost respect and compassion. However, we were surprised to find that support for MAID was lacking in much of the rest of the medical community.

Two of Natalie’s doctors tried to dissuade her after she expressed her wishes. One stressed that her life “had meaning to the end,” implying that Natalie was throwing it away if she chose a medically assisted death. Another presented what he thought was a better alternative, which involved dying in a hospice after several days of receiving larger and larger doses of morphine. Our family is not religious and to Natalie and many of us, these reactions and suggestions seemed nonsensical, but even among some of our family members, Natalie’s choosing to die on a certain day was a difficult concept to come to terms with.

Natalie knew that not everyone could be told of her plans. Elderly relatives with deep religious beliefs were not informed, so the truth had to be kept from most people outside of our close family circle. Natalie picked her death day carefully, based on how long she thought she could bear the pain without huge doses of morphine, while ensuring it would be a date after her new grandchild was born.

During Natalie’s illness, she loved looking out the window and seeing the small wildlife that visited her garden — from the squirrels and chipmunks scurrying past, to the birds at the feeders. (Photo credit: Geoff Clarke/Wikimedia)

But what is it about humans that we’re willing to accept something if it happens by chance, but not when it’s a well-thought out action? Some in the family wondered why it had to be that day and not another — why couldn’t she wait one more week, or two? Most of this was kept from Natalie because we did not want to distress her, but at the time it hurt me deeply, mainly because I was the one driving the MAID bus that we were now all on. I was the one who made all the phone calls, who arranged the various appointments, who acted as the in-between. Natalie had asked me to help her with this important task and I did it with all my heart. Although no one said anything directly, it was clear some were uncomfortable with that role. Now, several months later I have a better understanding of the powerful emotions of love and loss that were causing us to bump into each other like that.

On the day of Natalie’s death, we were all with her. We spent the morning doing what she loved best, holding hands with Friends playing in the background. The nurse who came to put in the IV ports was warm, friendly, and efficient. The doctor was the same. From the moment we met him and saw him interact with Natalie, we knew we were in good hands.

After being at the bedside of several loved ones who passed away, I can truly say that none of those deaths were as gentle, dignified, or emotionally healing for the family as my sister’s passing. We are all so thankful we live in a country that granted Natalie the ability to choose to die on her own terms, to be with us, present and alive to the last, instead of having to face a prolonged agony, alleviated only by higher and higher doses of drugs. I will never forget saying goodbye to my sister as she went to sleep, in the arms of her husband, surrounded by everyone who loved her best.

Dying With Dignity Canada is immensely grateful to Rachel Williams for sharing her beloved sister, Natalie’s, story. We are grateful that Natalie was able to have the peaceful, gentle death she wanted and that she was surrounded by love until the very end.

(Header photo: Natalie loved long walks and hikes.)