What is it like to make a difficult end-of-life decision? In this powerful blog post, DWDC volunteer witness Nancy shares her journey with cancer and her choice to apply for MAID.
In 2015 I was diagnosed with a small adenocarcinoma in my right lung. I was encouraged that the high tech radiation treatment (SBRT) I was having might zap it out of existence. Unfortunately, this was not to be.
In 2016 the tumor was still active and metastasized into the pleura, causing the lining to thicken and sub pleural nodules to appear. Metastatic pleural lung disease was now added to my growing list of cancer terminology, along with non-small cell cancer and Stage Four.
In the spring of 2017, my lung specialist and I sat in a small patient room and looked at the latest CT scan. He quietly analyzed what he saw, reviewed the previous scans and said, “I wish I had better news for you.”
He then spoke about the progress the cancer was making, what I needed to consider and what to expect in the months ahead. I heard the words “hospice,” “affairs in order,” and “increased shortness of breath,” but they went by in a blur as my mind raced and I tuned him in and out.
When I was first diagnosed, I was incredulous and scared. Slowly I began to adjust to having cancer. When the tumor metastasized it was a setback, but as the cancer seemed to be slow-growing, I thought I had time to still enjoy life for a few more years. I had no symptoms other than a persistent cough and looked and felt well. I chose not to go through chemotherapy.
I left the office lightheaded and shaken with the reality that I had about a year to live. It was surreal. I knew I had to pull myself together so turned, as I always did, to what my father taught me. He was a fly weight boxer in his youth and knew that although everyone fell or was pushed down at times, it was how you got back up on your feet that counted.
“OK, kid,” he'd say. “You've had a blow. Take a minute to shake it off, then take a deep breath, throw your shoulders back and fight it through.” Well, this was certainly a blow, but at 81 I had a pretty good foundation of fighting things through. OK, then.
Deep breath. Shoulders back.
A few days later I contacted Sue Hughson, a cherished friend who, at that time, was co-chair of the Vancouver Chapter of Dying With Dignity Canada and the best possible person to help me through all end-of-life issues. She knew I was an advocate for MAID, so walked me through the process of obtaining the patient request form from Fraser Health Authority and made sure I had other necessary forms in place including an advance directive and a representation agreement.
Sue told me about the Volunteer Witness program and referred me to Alex Muir, the DWDC Vancouver witness coordinator. I knew immediately that being a witness is what I wanted to do.
As a witness, I could help others submit the MAID form request and along the way become familiar with the process, people, and settings that eventually awaited me. I didn't have to fight through the end of life – I could embrace it.
Becoming a witness has been one of the most meaningful things I have ever done in life. Although our primary purpose is to affirm that the patient's intention is to access the MAID procedure, our presence often brings a sense of relief as we complete the form and submit it to FHA. Before we leave, most patients thank us and we let them know it has been a privilege to help them. So much is expressed in those few words.
Meeting and volunteering with the other witnesses has also been a privilege. They are mentors, like-minded advocates, and most of all, dear friends who continue to enrich my life.
A big plus is witnessing in the local hospices, hospitals and facilities where MAID is provided. I have been in patient rooms and family areas, seen and spoken with the caring staff members who look after the patients. I'm now comfortable in those settings and know that when the time comes I will be well cared for by skilled and compassionate staff.
Another unexpected plus has been that as the witnesses and others involved in end-of-life issues talk so openly about death and dying; it has made it easier for me to open up to my family and close friends. Our conversations are sometimes awkward, but I can now discuss what is important about our going through this journey together.
Although I have been fortunate and have outlived the one year prognosis in 2017, my cancer has spread and I have submitted my MAID request. I had prepared and was ready. It was an odd feeling seeing my initials and signature affirming as a patient that my death is reasonably foreseeable.
Although the cancer is advancing, I can still manage my independent life and enjoy being with friends and family (as long as they don't hover, lol). My two dogs give me continual loving companionship.
I am grateful for the life I have and for the choice to end it with dignity and those I love nearby.
Deep breath. Shoulders back.