The path to MAID is not linear.  On October 18, five weeks ago today, Dr. Ed Weiss assessed Jack as eligible for a medically assisted death. The decision to get the ball rolling fell very quickly on the heels of my stepdaughter’s wedding, an event Jack was thrilled to attend and which, although we didn’t say it, we all knew did double duty - marriage and Jack’s goodbye party. Dr. Sun confirmed Weiss’ assessment six days later, starting a 10 day cooling period. It all seemed linear to this point. 

Providing Jack maintains capacity to consent at the time of the injection, all that is left is for him to decide he is ready to die. His clear-headedness, however, is slipping by the day. Since the 10 days have expired, I’ve periodically asked Jack if he’d like me to set a death date for him. It’s a tough question to ask: “are you ready to die?” I feel sure if it was me I’d have the date in my calendar. But it’s not me. I’m confused by his ambivalence. He’s even considered other diagnostics, for reasons that escape me and his medical team. His cancer has metastasized beyond the point of no return.

But the path to MAID is not linear.

This morning started with the usual routine. I am waking up to the alarm these days. Because there is a PSW spending the nights with Jack, I make sure I’m up an hour before she leaves so I can get the dogs out for a good brisk walk. I use the dogs as the excuse - they’d be just as happy peeing in the yard but it’s me who needs the fresh air. We’ve cycled through a few failed overnight PSWs, including one who greeted me one morning standing by the door with her coat on. She was pissed off, ready to call the Ministry of Labour because Jack lit a smoke in her presence. Tessie, the current one has been perfect. She comes at 11 and leaves at 7 and spends the night sitting peacefully by his bed leaving me to achieve what had previously seemed impossible - a night’s sleep. I asked her what she does all night and she smiled placidly and said “read my bible.” I smiled internally at that - Jack is a very lapsed Catholic but he’s lost interest in a good religious debate - or any other kind of debate. 

By 7, I’d had my walk, relieved Tessie to attend to her own life, and got Jack’s smoothie and meds into him. Just last evening, Jack elected to quit further exploration of his brain so my first call is to the Brain Mets Clinic to cancel an appointment scheduled for next week.  A couple of weeks ago, Jack developed blood clots and started on a blood thinner regimen. The thrombosis clinic wants a blood sample and so this morning I have scheduled that for tomorrow at a local lab. Just need a req from the clinic. All organized by 9:30.  Jack’s long-time colleague, Paola, drops by mid-morning for a visit, which unbeknownst to any of us will be her last. 

After she leaves, Jack looks at me intently. “Celia, come here,” he beckons me to his bed just a few feet from my chair which has become my office, my entertainment centre, my communication hub, and my dining room. His voice is weak and I need to be close to hear his next words. “I’m ready,” he says and smiles wanly. “Will you be ok?”  

I know exactly what he means. It takes all my effort but I do it: I respond, “of course.” My mind is racing, my heart is racing, I am both freezing and boiling. I know I have a thousand things to do to make Jack’s death happen now he’s decided. I know the thing I want to do most, however, is collapse. Not an option. But the good news - if there is any right now - is that I have a task that relies on skills I have and rather than the last few weeks of faking skills I lack. I am about to organize something. 

“Jack, we have to tell your kids now, right?”  

“Tonight.”

“I’ll text them.” 

For a couple whose relationship has been built on long, lively conversations peppered with witty comments and banter, it’s all down to short functional statements. It’s what Jack’s half-voice will allow; it’s what my energy will allow. 

I text his two youngest children, Alexa and Tomek. “Your dad and I would like to talk to you tonight. Can you come at 6?”  

Text is impersonal but I am afraid I will jump into the conversation if I get either on the phone. I’m not their mother but I’ve got good relationships with all of Jack’s four kids - the two younger ones here in Canada in their 20s and the older ones - close in age to me - in Europe with partners, kids, and careers. Alexa, in particular, has been a support to me through these last difficult weeks. She, her partner, and her two little girls have been here for as many Sunday dinners as possible since Jack’s cancer recurred in April. I’ve been pleased to give Jack that time with his favourite daughter and his two local grandkids. I’ve shared more with her about Jack’s illness than I have with anyone else and definitely more than Jack realizes. 

Tomek’s relationship with his dad hasn’t always been an easy one but Jack has been delighted to have his quiet attention in the last couple of weeks - he’s showed up when it mattered.  Jack doesn’t say it, but I know it’s tough for him to think he won’t see the European boys again. Thankfully they came for Alexa’s wedding in October. 

Although I have told my own circle of Jack’s plans, among Jack’s people, not even Alexa knows of his MAID intentions. While not terribly devout, they have Roman Catholic roots and I’ve been so concerned the family will react badly. Given Jack’s lack of clarity about it, I decided it wasn’t necessary for them to know yet. No point in getting people worked up - if that’s the result - for nothing. There’s no road map here.  

Ping! Ping! Alexa and Tomek confirm tonight promptly. 

I get down to business. Of the two assessors, Jack and I felt more comfortable with Dr. Weiss so I call him to check his schedule to provide MAID. His earliest available appointment is Monday evening. We lock him in. Irene, the palliative care nurse practitioner, comes for a scheduled visit, learns of Jack’s plans, and spends a long time sitting with us both. Jack is asleep - he’s made a tough decision and is exhausted. I am reeling. This surreal time with Irene is grounded by the farts of the dogs who spend their days sleeping on their bed in the basement. I’m surprised she spends as long as she does. The practical part of me is thinking “Irene, you’re going to miss your other appointments.” The emotional wreck in me is profoundly grateful for her time and care.

Before Irene leaves, she gives me the number of a service that will come on a non-emergency basis to pick up someone who’s fallen. Jack’s had a couple of bad tumbles lately as he staggers to the bathroom. He won’t use the walker or the commode. I’ve given up even trying. But twice he’s fallen and I’ve been lucky Tomek’s been here to set him upright again. I’ve got four more days and I don’t want to be helpless with Jack on the floor.

Jack’s awake, more lucid and sitting at his computer. I’ve just given him two cigarettes, cued by his move to the desk. I don’t love it but the moment to deal with smoking has long passed. We do have other priorities though so I seize the moment: “Jack, tomorrow’s payday. We need to do Paola’s last payroll. How many days do we owe her?”

He brightens at feeling useful. “Four days. And vacation pay.” I do the payroll deductions, check them with him, and transfer the funds to Paola.  Jack set me up as having power of attorney over his bank accounts in April so I could take care of things if his health deteriorated. I’m grateful for that bit of forethought but I’m concerned I didn’t get more info out of Jack when he was more able. Why I expected this entirely chaotic man to have well-organized payables and receivables is a mystery! I dread trying to sort out the mess but it will be something to do afterwards. 

5:55 p.m. - tap tap at the back door. Tomek enters. He gives his dad a hug, awkward for this young man who towers over us all (and whose heart is breaking). “Hi dad.” And then he hugs me too, a feature of Sikorski life that has become familiar, despite it being entirely unfamiliar in my own family.“Hey, Celia. Did I beat Alexa again?” We share a laugh. Tomek and I understand the value of being on time. We are alone among Sikorskis. He sits on the couch and teases Bidi, the boxer/bulldog who was a puppy when Jack lived with his kids. Playing with the dogs - the best way we all know to avoid the enormity of the situation. 

6:06 p.m. - another tap. Alexa’s on a mission, Jack always says. Tonight is no exception. “Daddy, how are you today?” she says, kissing him. “Want some jello?” She picks up the bowl beside his bed, spooning some towards his mouth. He grins and waves her away. She’s a born caregiver. If anyone else swept in like this, I’d feel inadequate but with her, I relinquish the role, breathing more easily. Jack motions for her to raise the head on his hospital bed. I’ve watched him for the last half hour as he’s tried to muster energy for what he’s known will be a difficult conversation.  He’s ready, waving to them both to come closer. They perch on his bed. They somehow know it’s an important moment. 

He sits up. “I’m going to do it,” he says barely audibly. “I’m going to die.” They both nod. This is not news. “No, I am going to do it Monday. Celia, explain?” He’s sapped. 

They look at me expectantly. “Let’s let your dad sleep.” I say, kissing him and rising to go upstairs. “We’ll be back in a bit, Jack.” They look confused but follow. 

In the kitchen, a familiar glass of wine in my hand, I begin. I’m nervous. “So what your dad was trying to tell you is he’s decided to have a medically assisted death. I know this might be a bit shocking to you, but he made the decision a long time ago that he didn’t want to live if he’s suffering. And you know he’s suffering now, right?” They are starting to cry. I’m crying. I go on. “So just after your wedding, Alexa, he met with a doctor who agreed he was eligible for MAID - that’s what they call it. Then a second doctor had to agree - that’s the law. And so now he’s decided to do it on Monday night. It may not be possible. He has to have mental capacity to consent to the death at the time of the injection.” I take a breath. “I hope you’re not mad at me for not telling you. I’m glad he’s made the decision. He’ll only get worse.” 

“I get it,” Alexa breaks into my babbling. “He’s always said, ‘I want to die if I can’t wipe my own ass.’ It makes sense.” She’s crying but not angry. Not surprised. I’m so relieved. 

By now, Tomek has left the kitchen and gone outside. I pour another wine and see him outside smoking. He’s always smoked pot but it’s increased along with his tobacco consumption. Trying to be closer to Jack, I wonder?  

Alexa and I talk quietly. She agrees she’ll call their European brothers. We also agree we’ll keep this news mostly to ourselves. There will be some relatives who do not approve. 

Tomek re-enters in a cloud of blue smoke. 

“We should go back down.” They nod and follow me. 

We hang out in the basement a bit longer. Jack’s in and out of consciousness and they recognize I’m wiped out. We agree they’ll come back Saturday and Tomek will stay until Monday. Although Jack and I haven’t discussed who will be present at the death, they will be here. 

After they leave, I sit with Jack and we watch a little Netflix. Jack is hooked on a British drama called “Bodyguard.” He can’t follow it anymore but it comforts him to have it on. I can’t follow it either. All I think about is Monday  - and then after Monday.