MAID day - Monday, November 19, 2018

Ok, this is it. 6 a.m. on death-day. One of Jack’s sons remarked last night that it seems like science fiction and he’s right - who would have imagined in our lifetime we’d have the right to schedule death. My heart grows to match the pride I feel about living in a country where MAID is legal.  And then it swells a little more when I consider the brave man two floors below me who has chosen to exercise this right. Then I think about tomorrow morning at this time and how my basement will be devoid of life, my widowhood 12 hours old.  Pride is quickly replaced by grief and sadness.  Morning tears are new for me - I have always been someone for whom the morning is perfect, not yet sullied by the blemishes and misfortunes that most days hold, if you look for them.  Over the last weeks though, one day’s blemishes and misfortunes pile onto the next and the next and the cumulative effect means each morning has the potential to bring me to tears. Today, for example. 

It’s 6:30 and I descend to the kitchen, showered, ready for a big day. My job is to make sure Jack gets his wish and that along the way, my own needs are met too. I hear nothing from the basement so spend a bit of time scritching heads. Bidi and Molly, my dear walking companions, will support me through the months that follow. They got through a lot of their grief weeks ago, as Jack moved from playmate and waiter to someone who patted their heads from time to time to the nearly inanimate person in the bed they aren’t allowed on. I kick them into the backyard to pee and poo and cross my fingers they won’t encounter a skunk on this cold autumn morning. If I need an escape later, I’ll give them a walk but right now, I feel like taking this special day off from that. 

Still no sounds from the basement so I make breakfast. By 6:45, we all three go down to visit our patient and his carer. Tomek is playing a video game on his laptop. Jack has just lit his first smoke of the day. It seems so normal. Bidi and Molly even get an ear rub from Jack. 

“Morning, Jack!” He turns to me, screws up his eyes, and puckers his lips. I oblige. God I’m gonna miss this. “Ready for some food?” He waves me away for a moment. Smokes over food, always. I put his plate down on the bedside table where I write today’s date on a piece of paper and tape it over yesterday’s date. I started this practice a couple of weeks ago to help Jack stay rooted in reality. Another thing I will do today for the last time. More tears but I suppress them. Jack does not appreciate me crying. 

Two cigarettes later, Jack sits on the side of the bed and takes half a bite of egg. It enters the wrong pipe as it goes down. Tomek and I exchange worried looks until the choking subsides. This would not be the peaceful death Jack’s aiming for and a cruel irony to die the very death he’s trying to avoid on the day MAID is scheduled. 

Tomek announces he’s going home for a shower. I quietly asked him yesterday if I could have the morning alone with Jack just as I’ve quietly asked Alexa not to come until this afternoon. It feels selfish but I just want a few hours of what’s become normal - lazing about together doing nothing, saying little, and knowing I was spot-on in the obit when I said “They were both profoundly grateful to have found each other and curse cancer for cutting short their time as a couple.”

I glance from the TV to Jack from time to time and see his small, weakened frame. I remember the shock I saw on his sons’ faces last night and imagine how Stanley will feel when he arrives this afternoon. He hasn’t seen Jack in a few weeks now and back then, Jack was still climbing the stairs to the living room during the day. This is not right - the 67 year old should not die before his 90 year old uncle. I look beyond Jack to the papers, medical supplies, foot care lotion, extra blankets, and other detritus of caregiving on the bar beside his bed and think, “I know what’s missing.” 

“Laura,” I say whisper into the phone. My niece is exactly the support I’ll need - easy quiet, companionship; organized; and non-judgmental. She’s agreed to arrive mid-afternoon today and then stay until the celebration of Jack’s life on Thursday. “On your way today, can you pick up some flowers somewhere? Nothing fancy, just something to brighten the basement. Oh, and not red roses. We both hate them - too cliche.” Jack’s given me so many bouquets over the years; I want to return the favour. She’s happy to do it. Everyone wants to help but rarely does anyone figure out how. Assigning people jobs is best, but I’m learning that lesson too late in this caregiving gig. 

At 12:30, Jack comes above the consciousness line briefly, looks at me and says: “where are my kids?” His tone is angry, accusatory. “And Jolanta and Stanley?” 

“They are on their way in about an hour or so,” I reply, feeling shitty about prioritizing my need to be one-on-one over his desire to hang out with all his people. I hesitate and then come clean. “It was my idea, Jack. Don’t be mad at them. I asked them to come after lunch.” He looks annoyed. I remind myself that even six hours before death, we are still a married couple and there are times when we disagree on things or even do the wrong thing. I also remind myself this could be the result of his muddled head. Surely if he were in top mental form, he’d want time with just me. Surely. 

“Can I give you a foot rub?” I ask to change the subject. He nods, somewhat appeased. He falls back to sleep while I’m halfway through the first foot. I continue. Being on his back for most of the last five weeks along with yesterday’s pedicure have made his feet nearly as smooth as I imagine they were when Jack was Jacek, a baby in Poland. I think about the fleeting nature of life. Hard not to. 

—

“Stanley, please come in.” It’s 1:30 and I’ve left Tomek with his dad, knowing Stanley would likely come to the front door. We exchange two kisses, Polish style, and I take his coat.  “Let’s go to the basement. Can I get you a coffee?” 

“No, Celia, I’m fine. Let’s see Jack.” 

And so the party begins. 

By 2:30, the basement is full. All four of Jack’s kids, his son-in-law, and his niece chat quietly, moving in and out of the basement to the outdoors or the living room upstairs as necessary. Jolanta and Stanley stay mostly with Jack, often speaking Polish or the blend of Polish and English that results when people are confident in two languages. It’s likely the last time I’ll hear this in my house. Jack drifts in and out of conversations, sometimes sitting at his smoking desk, sometimes in his bed. 

At about 3:15, a nurse arrives to insert the IV Dr. Weiss will use later to administer the MAID drugs. The care co-ordinator at the Local Health Integration Network (the LHIN) had to arrange this one specially since the nursing agency assigned to Jack’s care is faith based, not willing therefore to have any part of MAID. Coincidentally, the IV nurse is Polish and Jack turns on the magnetic charm one last time. It’s lovely to watch. He’s so comfortable with all of this; I’m surprised he didn’t ask to insert the IV himself. Jack has always had an inquisitive mind about how things work, including the human body. 

A bit later, Laura arrives. While an odd time to meet people, I introduce her around.  She’d likely met Jack’s family at our wedding reception two years ago but, like many weddings, the guests fell into two camps - bride-side; groom-side. With (re)intros done, I take her aside. “Laura, I gotta get out of here. Will you come with me to the bank?”  

To everyone else I say, “my power of attorney over Jack’s finances will technically die with him. I need to do one last deposit.” I leave Jack surrounded by family and we sneak out. I’m remarkably calm. I just need downtime and Laura is ideal for that. If being here to support her aunt while her aunt’s husband dies is upsetting her, she masks it. I’m grateful. 

We are back in 30 minutes. Laura goes upstairs to wait for everything to be over. She could go to Susan’s with my other supports but she’s chosen to be onsite. People drift up to see her - escape? - from time to time. I am left to my hosting. 

“Jack, want to see Bidi and Molly?” I ask. He nods. Bidi, a boxer/bulldog whom Jack delivered along with her five siblings just seven years ago, needs little encouragement. She makes the easy leap onto the bed careful not to land on her beloved owner. Molly, her more recently adopted Llaso-poo sibling, needs help. I hoist her up and join them all. Our happy family. My heart’s breaking. 

Stanley asks gently if he can take a photo. I agree, knowing that whatever I do with all the other beautiful photos I have of Jack and me, this one will be private. Jack would not appreciate anyone seeing him this unwell. 

“Anyone up for a Prosecco?” I inquire at about 4. There are nods all around. I fill the flutes behind the bar.

Jack’s sitting at his computer enjoying a cigarette and he calls out “Bombay.” I mix him what I believe will be his last gin and tonic, tipping the blue bottle up thinking about so many other G&Ts I’ve made for us both. 

Jack finds music on his computer he wants to hear: Polish jazz trumpeter, Tomas Stanko playing a piece from Rosemary’s Baby. Much later, I will learn the piece is called “Sleep Safe and Warm,” fitting music for the occasion. 

He moves back to the bed and we each spend a little time with him. His voice is weak and so large conversations are not easy. I hear snippets though and he’s saying all the right things. 

Periodically, I grab a few moments with Jack. It’s hard not to reflect on our time together since meeting nine years ago in my kitchen while he fixed my fridge: both a lifetime ago and no time at all. We don’t say much except “I love you,” words we’ve said so frequently. Then I let others have another turn as I go and fill glasses including Jack’s which remarkably he’s emptied despite having eaten next to nothing for weeks and not having had a drink for longer. 

He grins and whispers “a double” just as I have heard him say countless times before. There’s such an odd normalcy to this party. 

About 5:45, Jack, powered now by gin, drifts off to sleep. We all continue our nervous merriment around this passed out MAID candidate. I’m sure I’m not the only one thinking, “Fuck, his capacity!” I feel responsible - shoulda watered down those drinks but who’s going to deny a dying man a double G&T? 

At 6, I’m anxiously listening for the doorbell. Laura’s upstairs ready to bring Dr. Weiss - Ed - to the basement.  At 6:10, I’m panicking - still not here. 6:12 Laura opens the basement door and Ed comes down. I greet him and bring him to Jack who has revived somewhat.  After being introduced to the family, Ed asks us to leave them alone to ensure Jack’s still resolved in his decision and, more pressingly for me, to determine whether he has the necessary capacity to consent.

An eternity passes - 3 minutes? 5 ? - and then Ed calls us back down. Jack is eligible. I breathe a massive sigh of relief. The only thing worse than this happening today is this not happening today. 

We gather around Jack. By now, someone has changed the music to Paul Reddick’s latest CD - Ride the One. I think back to the beginning of Jack’s bromance with Reddick in a club in Halifax a couple of years ago. It’s fitting that Paul is in the room. 

I sit on the end of the bed with Jack’s legs across mine. I know everyone else is around, but for me, the room contains just Jack, Ed, and me. Ed explains the three meds he’ll administer: one to sedate, one to slow everything down, and one to kill. 

“It will take 10 minutes,” he says. “Are you ready, Jack?” 

Jack nods, looks at me, and smiles. I smile back through tears. As the first med is going in, Jack pulls me close so I am lying with my right ear over his heart and his left arm in a familiar place around my back. All I can see is Jack’s right arm with the IV and Ed flushing the line and changing the meds. Jack’s arm is rock solid. Whatever ambivalence was there previously, there is clear resolve now.

I hear Jack’s breathing stop, and then his heart.

A moment or two passes, and Ed pronounces him dead. It’s about 6:45 p.m. I lay there a bit longer with Jack’s arm still warm on my back. I don’t know whether people are talking. I doubt it.

I get up slowly and look at Jack’s body. He is no longer suffering.

—-

Ed is on the phone now, talking to the coroner as is required in Ontario after a medically assisted death. He calls me over and hands me the phone. My administrative role is not quite over. I’m asked a few questions to confirm everything went according to plan. This is routine; I’d been warned. 

“Yes, I’m the patient’s wife.” (patient? that seems wrong - can’t quite say ‘the deceased’) “Yes, Dr. Weiss administered the three drugs. Yes, it went as expected.” I hand the phone back to Ed. 

I grab my own phone and call Susan next door. “You and the rest of the support crew can come over. Come to the main floor, Susan.” They arrive a moment later. Ingrid joins her kids and her step-sons. I asked Alexa a day or two ago if she would mind rounding them all up and taking them back to her house. She agreed - they were a unit long before I came on the scene and they will want to grieve as a group. Jolanta, her daughter, and Stanley are all gathering up their things to leave too. It’s been an exhausting day and they want to process this in their own ways, just as I do. 

I make another call. “Hello, yes, I let you know this morning my husband was scheduled to die today. The body is now ready for you.” The funeral home seemed to take my call in stride this morning but I will later learn Jack’s was their first MAID death and it threw their process into turmoil. They assure me tonight though they are on their way.  I give instructions to come to the basement door; they arrive soon after.  

By 8:30, I’m in the dining room with my friends. Kleenex boxes sit on the table amid Prosecco glasses and appetizer platters. Two other neighbours - my walking partner, Janice, and Kathi, the second witness for Jack’s MAID paperwork - have also come. I feel like I’ve just finished hosting a 9 year party. I’m preparing for a helluva hangover that will last on and off for years. Tonight, however, is the first of many debriefs with those who will see me through.