J06

Canada, as some may know, has a health program wherein those with illnesses that impose a high burden of suffering can opt to apply for Medical Assistance in Death (MAiD). It's a touchy subject, understandably—where does one draw the line between suicide and ending undue suffering? How would the program affect the healthcare worker's oath to do no harm?

I've had two people in my life, now, make use of the program. Both had late-stage cancer. Both were in a lot of pain. And, crucially, both were at peace with their decision.

The first person in my life to die with medical assistance, I didn't know very well. She was my great-aunt. I'd see her at family get-togethers, and we'd chat, but it never went beyond that. I didn't know her favourite colour or what she thought of her neighbours. I knew, though, that she was sick for most of her life with diabetes that was difficult for her to manage. By the time she got her cancer diagnosis, her quality of life had already been degrading steadily for about a decade.

The day of her death, she called my dad, explaining her choice to him happily. I remember he didn't know whether to congratulate her or offer condolences. She laughed at him.

Most recently, my partner's grandmother chose to apply for the program after a short and devastating bout of cancer.

Did you know that primary liver cancer often doesn't have symptoms until it's too late? Neither did I, when we got the news of her diagnosis.

Doctors said she had a year, at most. That was around the new year. And the prognosis assumed that the treatments helped. But they didn't.

Her time got downgraded to six months. Then two. On July 15 we were told she had weeks. Today, she had her MAiD appointment.

We saw her for the last time yesterday. She was clearly tired, and in pain; she hadn't been able to keep food or water down for days. Jaundice had noticeably set in. But she said she had no regrets. She said she was just glad to pass on before she forgot anything—especially because she was already losing words.

It was difficult, but everyone was in the room to see her. We reminisced and laughed and cried and soaked up each other's presence. The weather was lovely, and her garden was in full bloom right outside the patio door.

Then the doctor came in today and administered the medication, and she passed on.

The process of mourning is different, I've discovered.

For those in my life who committed suicide, it hit like a punch to the gut. Three years out and those incidents still take my legs from under me sometimes. I have regrets that I'll carry with me for the rest of my life, anger about the injusticed that drove them there, questions that will never be answered.

For those who have died suddenly in their sleep, I still had regrets, but I was always glad they passed peacefully. The reaper is gentle when they come at night, after all.

But here, most of the mourning, I think, was anticipatory. By the time we went to see her yesterday, my partner's grandma had already declined so much, but she was in good spirits still, in the comfort of her home. I feel her presence missing, but I think I'm grateful. She didn't have to go through hospice care or put up with even more pain. The cancer seemed to have started in on her lungs, and she didn't have to feel that progress any further. She was surrounded by people who loved her to the last.

Honestly, I'm glad she had the choice. I'm glad she didn't have to face losing her memories, a prospect that terrified her. I'm glad we got to see her in good spirits one last time. I'm glad our last memories won't be of her wasting away in a hospital bed, when she'd been so full of life only months before.