Until recently, I never really thought about how often we, as current and former cancer patients, count down. We count the days until we have tests done and then we count the days until the appointment where we will get the test results. It’s five days, four, three, two and one until the day of surgery. One day before the first chemotherapy treatment. And the counting continues for each major milestone in the cancer journey, even after active treatment has ended.
Medical Assistance in Dying (MAID)
Now, imagine, instead of counting the days until your next milestone, there is a daily countdown to the day you will die because you know the exact date that will be. While once unheard of, with the legalization of Medical Assistance in Dying (MAID) in Canada, in 2016, this option is now available under certain conditions. Until this month, I didn’t know anyone who met the criteria and had elected to choose this option.
Death of friends without MAID
Over the years, I have had several friends die from cancer. One person, Lise, who lived in another province, went into palliative care and was no longer eating or drinking. Each day I received an email from someone telling me whether or not she was alive. Many weeks later, I received the email I was expecting. She had died. Everyone was surprised at how long she lived…possibly because she would not accept that she was dying. Lise believed she was going home and would live at least another two years.
Another friend, Rosanne, had terminal cancer and accepted that her death was near. I talked to her about the timing of my visit. I decided to let family and other friends visit her first before I went to see her. That was a mistake. I called her daughter on the morning of my planned visit only to be told that Rosanne had passed away. For me, there wouldn’t be a last visit other than my last conversation with her on the phone, which was days earlier. Years later, I still regret not going to see her sooner. I still think about her every time I hear a Swiss Chalet commercial. Swiss Chalet was our go-to spot for lunch.
Death of friends with MAID
From the perspective of being a friend to several people who have used MAID, there are pros and cons of the MAID experience. The same is true from the patient's perspective.
Patient's perspective
Now, another friend, John, has run out of options for cancer treatments. There is no hope that a cure will be found to save his life. He knows that the time he has left with his family will be far shorter than he’d hoped. He knows his health will deteriorate, but he doesn’t know how quickly. With MAID as an option, John had to decide whether he wanted to let cancer run its course or whether he wanted to control when his life would end.
Having never been in this situation, I can only imagine the conversations that John and his wife had before they made the decision that MAID was the best option for them. Knowing how much John loved his wife and children, I would assume that the biggest heart-wrenching hurdle to overcome would be saying good-bye sooner rather than later.
This feeling would have to be weighed against the quality of life for John and his family. Over time, he would become a shadow of his former self. The cancer would take a physical toll and the whole experience would be an emotional one for everyone. As his health deteriorated, he would require more and more assistance from the people around him to the point where he might worry that he had become a burden. John may have wanted to ensure that the last memory his children had of him was a good one…when dad still looked like dad.
Friends and family perspective
Having made the decisions and the arrangements, the countdown started. I was just a third party, and each day I woke up and thought about John and his family. I selfishly wished that I didn’t have to feel this pain every morning. Eventually, when I could thrust these thoughts aside, I thought of John and what I could only imagine he was going through. What was it like for him to know this was his last Monday, Tuesday and Wednesday and that the time left with his family and friends was all too quickly running out?
Personally, I don’t know if I could have made the decision to use MAID, because I don’t know if I could get over the very big hurdle of saying good-bye to my family and friends sooner rather than later. Until now, I have never thought about what I would do in the same situation. And even then, it’s one thing to decide whether or not you would want MAID and it’s another to be actually in that position where you have to weigh the importance of quality of life over the length of my life.
As for John, I’m glad that I had the opportunity to tell him that he was loved and it had been an honour to know him. It was not like someone dying suddenly and knowing that your last words were said in anger or regretting that you never told the person just how much you loved them.
Update
When I originally wrote this post (2017), John had not reached the day when he was to leave this world, I hope, and now know, he was surrounded by the people he loved, and I trust he found the peace that he deserved. I also trust that his wife and children have, with time, found some form of peace, knowing there was one less great guy in the world. At that time, John was the only friend who chose to use MAID. Since then, another friend, Roy, used MAID in December 2023. He had stage 4 prostate cancer and all treatment options were gone. For every medical problem that arose, the fix triggered another problem. There was constant pain. For details about prostate cancer and Roy's real-life story, please check my post, So much to learn about...Advanced Prostate Cancer post, which is in the Related Posts section below.