How One Man Chose to Die in British Columbia

by | Oct 28, 2019 | End of Life

Earlier this year, I was talking with some folks about my now completed book, an assisted-suicide family thriller called When I Killed My Father. One woman, A—,  told me that her father had died recently after choosing a medically assisted death that is now legal under Canadian law. I asked her if I could call her and ask her more about the experience. She said yes.

In the United States, there are eight states and the District of Columbia that have medical-aid-in-dying laws. Oregon has had the law for 25 years. The British Columbia law is similar to those laws in U.S.  jurisdictions, except in two significant ways. In the U.S., the person who wishes to die must be diagnosed with a terminal disease, and have six months left to live. In British Columbia, however, anyone who has a “grievous and irremediable medical condition causing suffering that is intolerable to the patient” may qualify. 

The other major difference is that in the U.S., the patient must self-administer the prescribed drugs, whereas in B.C., a doctor may also administer the drug. 

How did your father’s death and decision to die come about?

My dad was two weeks shy of his 88th birthday. He enjoyed robust good health for 86 of those 88 years. In the last year, his health declined rapidly. He spoke frequently about how tired he was of the medical intervention — all the stuff he had to do every day to manage multiple chronic conditions.

I didn’t know if he was aware that medically assisted death is legal in Canada. I talked with my sister about bringing it up. She was in agreement.

So I said to him, did you know this law in Canada allows you to end your life legally? He was not aware the option was available. 

How did you bring it up? 

My dad was organized. He had made his will a good ten years ago. He started talking to me about his bank accounts, his will. His financial affairs were in order. His funeral wishes were known. His death was not a taboo subject in our family.

It was probably in the course of talking about his health. He said he was tired of doing all “this.” He didn’t specifically say he wanted to die, but it was implied, and had been implied a number of times before.

In that last year, he had moved into a senior residence. It was a nice retirement home. He didn’t have to cook. He didn’t have to snowblow. We were moving forward. We all expected he might live into his nineties like his parents did.

Q: What happened then?

He was interested, but we didn’t talk about it pertaining to him, only generally.

I asked him if he remembered Sue Rodriguez, who had ALS and sued the government for the right to die. She lost, but she started the right to die movement in Canada. 

His health continued to decline. He was told he had to have a major surgery.

He decided he didn’t want to do that. He wrote us an email, told us he’d been to his doctor to say he didn’t want the surgery and they had discussed whether he was eligible for the end of life option. The answer was yes, and he chose it that day.

He had had surgeries and every time he went under general anesthesia his memory would be terrible for a while afterwards. I didn’t  know if he would remember our conversation about Sue Rodriguez, but he remembered very well.

He didn’t tell us beforehand. He made his own decision. He talked with his doctor and then told us. He had been in a relationship with a woman for many years and although very sad, she understood and supported his decision, as did my sister and I.

How did it play out?

The law states you have to be assessed by two doctors. You don’t have to have a terminal illness, but the end of your life must be foreseeable, and your condition has become unbearable to you. It is for the individual to decide what unbearable is.

There’s screening so someone who is depressed would be ruled out.

His family doctor was one of the two to assess him. She was the one who administered the drugs. Doctors don’t have to perform the procedure, but if they don’t want to, they have to refer you to someone who will. 

She found another doctor in her clinic who would do the second assessment. All that happened in a day. That evening he emailed us. There was a mandatory ten-day waiting period. He chose the day after the waiting period ended. It sounds strange to say, but he was so relieved he could do this, he was very happy.

My sister and I traveled to stay with him. We went to the doctor with him to hear about what would happen. What drugs they would give him, how long it would take. 

My dad wanted to be sitting on his living room couch and that’s where it happened. Not bedridden. 

Dad said anyone who wanted to be there could be. My sister and her husband and daughter — his only granddaughter — were there. As was his partner and her daughter. I was there too.

On the morning of, a nurse put in two IVs, one on each arm, and left. She then came back a short while later with the doctor. There is a procedure the doctor must follow to reconfirm the person’s intention.

“You know why I’m here, J—. You requested this.” He had to sign another form. The family thought that was overkill, the additional paperwork, but it is there for safety in case someone has changed their mind.

Knowing he’d have to give a final consent, my Dad refused any pain medication so he would be fully conscious and there would be no doubt about his consent. He thanked Sue Rodriguez.

The administration of drugs began. First he was put to sleep. His final words were, “I think it’s working.”

He fell asleep. I put a pillow behind his head. It took ten to fifteen minutes to give all the drugs through the IV. There is an option to take it orally, but some people have nausea problems, vomiting. 

First came a sedative, then lidocaine, then an anti-seizure medication, and finally propofol, which stops the lungs.

His death was very peaceful. A couple of deep breaths and then he stopped breathing. I have been present at two other unassisted deaths, where the person was struggling for breath. He didn’t struggle, just relaxed.

How did you react? 

It was hard. I was crying. I really wanted to sob, but I was concerned he would be distressed if he could hear me, so I held myself back as much as I could.

Afterwards, I didn’t feel the need to cry anymore. 

You felt comfortable even though you were sad?

Yes. There was never any question that this was what he wanted.

When he chose to end his own suffering, he ended mine as well. I hated seeing him suffer. I was at peace too. 

How long has it been? 

Four months.

I miss him a lot. When other people I’ve been close to have died, I missed them, but this experience is so different. This was a positive experience. My mom died of colon cancer. She had a long, terrible death. My dad nursed her through it. He didn’t want that experience for himself. It was terrible for all of us when she died. It was ruthless. This was so different. I was at peace with it and I still am.

What about the other people in the room?

I was focused on my Dad. We were sitting on the couch side by side. I could feel his shoulder next to mine. He had an eye problem, had an eye patch, and I was on that side. That was why I sat close to him — so he could feel me because he wouldn’t have been able to see me. 

I don’t think my sister cried. Dad’s partner and her daughter were on the other side of him. I couldn’t see them. We were all pretty quiet.

Were there any obstacles, bumps in the road during the process?

None. I thought there would be more bureaucracy. But the B.C. government website was clearest I’ve ever read. Very good about explaining what the steps were. And that’s what did happen. Everyone we dealt with was helpful and compassionate.

Thank you for sharing your story. 

UPDATE: Sections of Canada medically assisted dying law were overturned by a court in September, with a Quebec Superior Court justice declaring the federal and provincial laws are too restrictive. Like the U.S. laws, the Canadian law requires the patient have “foreseeable or imminent death.”

Justice Christine Baudouin ruled that “The reasonably foreseeable natural death requirement deprives both individuals and claimants of their autonomy and their choice to end their lives at the time and in the manner desired.”

The provision will not be suspended for six months to give the government time to develop a new law.

‘The Magic of Ordinary Things’ — An Interview with Singer Gina Harris

by | Oct 24, 2019 | End of Life

One of Reimagine End of Life SF’s more than 200 events is a performance by Gina Harris called “The Magic of Ordinary Things.” I met Gina in September at a collaborators meeting in San Francisco and spoke with on the phone earlier this month. 

You’re performing “The Magic of Ordinary Things” at the end of this month. Tell me more about your event. 

My show is a solo performance inspired by losing three of the most important people in my life. I call it a musical memoir — about how I struggled through grief and found happiness and a home inside myself.

Although the show is about loss, it’s not a melancholic show.  It’s about how tender, wonderful and funny people can be together.  

I note that you say it’s not melancholic. It’s almost as if you have to say that because people assume that if you’re dealing with grief and death, it will be heavy. 
Yes, loss and memories are so much more than melancholy. There is that, of course, but also love and laughter and the moments we were close (are close still!) with those who have died.  
How did you start writing the show? 

I’ve been a performer for years in Los Angeles, on Broadway and in jazz clubs in The Bay Area, so performing and writing are part of who I am. Then I lost my father, my mother, and my singing teacher, who was like a mother to me — and it felt like it happened all at once.  

As I kept going with the songwriting and singing, I felt like the songs tapped me on the shoulder and said, “hey we’re a show.”

I was putting together this show together last year when I heard Brad interviewed. [Brad Wolfe is the executive director of Reimagine End of Life.]

You said this show grew out of your grief. How did you go from grief to creation of your show? Wasn’t that a painful process?

It was a baffling and mysterious process. I kept living my life, but where the hell did my people go? I didn’t know what to do. I couldn’t bear that they were dead. 

So I thought about when they were alive. I wrote songs. The songs were more about who they were in life. Who we were together.

I felt so alone. I asked myself, was I a good daughter? These songs were a way of coming back. They came from pain. The benefit was that I remembered my loved ones better. I got to know them better through writing the songs and singing them. My relationship with my parents deepened after they died. I thought and felt so much about what we had done together, how we had been together. 

I was the closest companion for both my parents. First my Mother and Father and me. Then my Mother and me. Then Lilian, my Singing Teacher, and me.

Will this be the first time you’ve performed the show?

Yes, this show is premiering for Reimagine. Though I’ve sung some of the songs before. I put the songs together and wove them into a story. 

What do you hope participants will get out of this? 

Exactly the word you said. Hope. 

What would you say has surprised you most about what you’re doing? What have you learned?

It reminded me of how much I learned from my parents, and about my parents. I would say relationships between Mothers and daughters can be fraught with tension. I was her only child. She was trying to fix me, which I resisted. I always loved her. Doing the show reminded me of her love for me and mine for her. 

What do you do when you’re not performing a musical memoir?

I’m a vocal coach and I’m a singer-songwriter.

Tell me again where and when.

It’s at the Phoenix Theater on October 30 (Wednesday), November 1 (Friday), and November 2 (Sunday).  The Phoenix is at 414 Mason. Suite 601. 

 

What They Left Behind — An Interview with Laura Turbow of Still Life Stories

by | Oct 18, 2019 | End of Life

One of Reimagine End of Life SF’s more than 200 events is a storytelling gathering in Berkeley led by Laura Turbow and Rachael Friedman of Still Life Stories. I met Laura in September at a gathering of “collaborators” at The Laundry in San Francisco and spoke with on the phone earlier this week. 

Your upcoming event is called “What They Left Behind: A Night of Storytelling.” Tell me more about it. 

We hope our gathering will give people time to think about loved ones who’ve passed away.

I’m a big fan of The Moth, live storytelling and our event is Moth-like. We are asking participants to bring an object and a story to share. Unlike the Moth, you can use notes. you don’t need to memorize your story. The idea is that the story is about someone who has died, and the object is a way you remember them. 

In our business, Still Life Stories, we use objects as springboards to tell stories about our lives as well as the lives of people important to us who have died. 

Can you give me an example of an object that might turn into a story. 

Here’s one I love. A friend, her husband Jon passed away while their daughters were still young. She had a box of Jon’s things, which included a broken plastic camera. If the girls were to find that camera, it would mean nothing to them. But it has a story. Jon had been in Africa, in the Peace Corps, and she went to visit him, and when she was there, they were out in the jungles and Jon was taking photos with this camera when they were chased by gorillas.

So the object might have little meaning by itself, but the story gives it meaning?

Exactly. This whole idea for Still Life Stories, which we started three years ago, came from a client who asked me to photograph a sweater. She had kept it for decades.  It was not in good shape anymore. It had meaning, but she was never going to wear it, so she had me photograph it so she could let it go. She felt that she could let it go if she had a photograph of it and told the story. So the photo, or the object itself, can lead to the story. 

How did you come to be involved in the end-of-life movement?

We found out about it last year. My partner, Rachel Friedman, and I contributed a few photographs to the Reimagine art gallery last year.  We also did some photography and interviewing at some of the events. 

What do you hope participants will get out of your gathering? Do they have to have something prepared in advance?

I want it to be a community night — they hear something that strikes them, they have a chance to share. I have a great belief in storytelling. I hope this will also be  a way of giving time to people who have passed away. There’s mourning and sometimes with stories, you can tap into those who have died after they’ve gone.

What would you say has surprised you most about what you’re doing? What have you learned?

You know it sort of like things coming out of the closet. It’s hard for people to talk about dying and death. This whole Reimagine End of Life idea is like an awakening to death. It turns it on its head. It’s a more accepting approach. So many of us deny the idea of death, but that can make us us crazy. Accepting death is easier than denying it. 

I have this big place for gratitude in my mind and my heart. I’m grateful for many joyful experiences. But my mind can go from having gratitude and at the same time to an anxious feeling of loss and “what-ifs.” Especially if I think about people I know who have died. I’m happy to be alive. I feel lucky to have all the gratitude. But it’s a muscle we have to work. My father-in-law is a former oncologist who helped his patients with end of life, death and dying worked his gratitude muscle every day and is a person who now regularly leans in toward gratitude.

Have you done this before?

No. We started our business three years ago, but this is our first big, live storytelling gathering. We do have two lead storytellers to help get it going. We’re really hoping people will come with objects and stories. 

I think Reimagine is ahead of the curve as far as getting the conversation about death out there on the table for us all to digest. But we’ve made progress. Remember, for a long time, you would whisper the word cancer. Now you can say it out loud.

Tell me again where and when.

In Berkeley at Congregation Beth-El, 1301 Oxford Street, Wednesday, October 30, at 7 pm. We hope to see you there. 

Storytelling allows people to feel connected. It’s important for people to tell their stories, important for them to be heard. It’s important to honor those who have passed away. We don’t talk about the dead as much as we could.