Dignity in Dying.....

Another one bites the dust.....

 

The Grim Reaper has struck again – in my family, twice in six months.  First Amanda, my partner of some forty-five years.  Now, Meadow, our cat, my friend for nearly seventeen.

 

Some may say there’s a difference, and, of course, there is, but having lost my wife in February, it seems a cruel twist of fate to lose my remaining housemate so soon after.

 

Not everyone will agree with me – they rarely do – but I don’t see life as being anthropocentric. Yes, OK, I will admit that I am a little wary of total equality – I mean, I will swat a mosquito against the hotel wall if it needles my sleep, and I think I would prefer a world without crocodiles or slugs – but that apart, life is life and this world only makes sense because there is life on it (for the moment).  

 

I am not a Jain, nor am I vegan, but I do sometimes feel sorry for the carrot I chop up into my pasta sauce.  But, bear with me, that is not the point of this piece, (you sigh?)

 

The simple point is that our cat died quietly and simply with a lethal injection administered by the vet, here, in my study, just two hours ago. She had been ill for a while, losing weight and eventually not eating or even drinking.  The vet believed she had a lymphoma in her intestines. I tried to nurse her (the cat....), but she lost strength and agility and became thin and very unsteady.  Although I would (I think) have preferred Meadow to shuffle off in her sleep, oblivious of anything but cat dreams, organisms don’t usually do that, as they struggle to survive (otherwise some would not live at all).

 

As indeed was the case with Amanda.  Her diagnosis of dementia came in in her mid-fifties, her death at the age of sixty-nine.  The first few years were manageable, though little difficulties became big ones, and slowly she lost the capacity to speak or to reason, or to look after herself.  The last few years were a torment for her, unable to communicate and eventually unable to move.  

From this......

Yes, I appreciate there are many reasonable arguments against pulling the plug on a human life.  Yes, it is somewhat different to that of a pet animal – not least in that no relative is going to say they disagree....  But, although Amanda and I never actually discussed assisted dying – and that may well have been because we didn’t realise how it was going to be until it was too late – I am confident that had she been able to speak or write or communicate in some way, she would have asked to be released from the mortal coil long before the agonies took her breath away.

 

To this......

And I know that when my time approaches, if I am able, I will book myself a place in Switzerland, or Belgium, or wherever will have me, to avoid the indignity and the pain of an extended demise.

 

Meadow was suffering, but she faced her end with a calm resignation.  No fuss.  No attempt to have one last chase around the garden. She went willingly (or so I imagine).  If only Amanda could have called in the vet..... 

 

Now rest in peace, my loves.  Thank you both for all the years of love and happiness. 

 

For what it is worth, I would support the legalisation of assisted dying. I would advocate safeguards, though I don’t think it should be made too complicated.  If possible, the dyee (is there such a word) should be able to have an opinion, but where this isn’t possible, then the next of kin should have a say, and at least two doctors should also be consulted.  I don’t (yet) know how the system works in Switzerland, Belgium or other countries, but it would seem that it has been working for some time and I haven’t read about too many people who have requested a reversal of the deed.

 

I suspect that one of the obstacles in this country may be our parliamentary system where Members of Parliament are fearful of making decisions (or taking stands) that may be either against their party lines or potentially unpopular. There are also religious considerations, but I personally don’t believe that any god should have the last word, so, even though you may believe that, please keep it to yourself. 

 

So, if Meadow can be relieved of her suffering in such a clean, painless and dignified way, why the hell can’t I?

 

RIP Meadow Gibbs

*****

Post Script:  I have just read today about the ordeals of Miranda Tuckett and Sue Lawford, both of whom were arrested and held in cells after returning from accompanying a British woman who took her life at Dignitas in Switzerland. They were arrested and investigated on suspicion of encouraging suicide. Miranda Tuckett, who is researching a doctoral thesis on Britons going to Switzerland to take their own lives, is bringing a high court claim for damages abasing Dyfed-Powys police for false imprisonment, breach of her academic freedoms and assault and battery (The Guardian).

 

Assisted dying in this country is not without its history and it is time to legalise it.  I once knew a nurse (whose father, for the record, was a prison governor) who told me that in her hospital it was not uncommon for doctors to write on severely ill patient’s notes, Brompton Cocktail, TLC.  She was in no doubt that the dose administered was intended to be fatal.

 

This is what Wikipedia has to say:

 

Brompton cocktail, sometimes called Brompton mixture or Brompton's cocktail, was an elixir meant for use as a pain suppressant dosed for prophylaxis. Made from morphine or diacetylmorphine (heroin), cocaine, highly-pure ethyl alcohol (some recipes specify gin), and sometimes with chlorpromazine (Thorazine) to counteract nausea, it was given to terminally-ill individuals (especially cancer patients) to relieve pain and promote sociability near death. A common formulation included "a variable amount of morphine, 10 mg of cocaine, 2.5 mL of 98% ethyl alcohol, 5 mL of syrup BP and a variable amount of chloroform water." Brompton's cocktail was given most in the mid twentieth century. It is now considered obsolete.

 

In popular culture it also came to be associated with medical euthanasia. According to legend (and perhaps in fact) doctors would provide a large dose to terminally ill patients who wished to die.

 

I’ll have mine with ice and a twist of lemon, thanks.....

Every eight days a Briton travels to Dignitas for help to die. The absence of an assisted dying law forces dying people to take drastic measures to control their death.  

For more on this, please see:

https://www.dignityindying.org.uk/why-we-need-change/dignitas/

On the run.....

Part one:  Getting Away

This is a personal story, but I am not claiming it's exceptional.  The pandemic has laid waste all sense of normality and created suffering across the world.  At the same time our struggle with dementia is more manageable, perhaps, than that of others.  We are fortunate, too, that we have support, from family and others, and can afford, at the moment, to pay people to help us.  

Things could be worse.  

That said, it is not easy, and I want to share experience so that others may understand.  So that anyone in a similar position, today or tomorrow, may be able to feel some company.

There is a saying that, Once you have met one person with dementia....  You have met one person with dementia.  No two cases are the same, though some may be similar and certain types of dementia may be better understood and more predictable than others.

As I have recounted before in these pieces, Amanda, my wife of some 38 years, has developed Frontotemporal Dementia (Semantic Variant), which is one of the rarer forms of dementia.  She has been afflicted for about ten years and has now reached the stage where she needs full time care, helping her with all the things we take for granted in daily life, from eating bread and fruit, to going to the toilet.  With Alzheimer's disease life expectancy from diagnosis to death is around ten years.  Amanda's dementia, coupled with the fact it was a fairly young onset, means she will probably live much longer than that before the general decay of the brain leaves her vulnerable to something which will finish her off.

In the meantime, it is a kind of slow demise, a slow death, and a slow bereavement.  But, to look on the bright side, she appears content and will chuckle and smile in an innocent, uncomplicated way.  And one of my messages, for what it is worth, to all and sundry (though I'm no paragon), is to grasp those positives.....

We moved in January this year.  A monumental enterprise (from my point of view) and one that left Amanda traumatised......  But this here (below) is our new home, and with the aid of certain prescribed medication and a persistent routine we have become accustomed to our new address.....

But, everything takes its toll, and, despite the help I get from family and employees, I have been responsible for the whole shebang - which includes everything from taxation to pensions, to the move, to dentistry, to ensuring we have enough Tena pants and medication - and the state, bless its convoluted ego, is not empowered to be of much assistance (though please don't take this wrong - those who are involved with us have been wonderful; just that there is a very clear limit for social care and mental health - it's not like you break your leg and they do everything!)

And so, with the permission of one of our daughters and a following wind, and given the alignment of the stars and a number of other fragments of luck, I take the train to Paris on my way south for a brief respite break.  My ultimate aim is Tuscany, where I hope to meet up with some old friends, and to rest.  I am apprehensive, but I look forward to several days not having to wake up at a certain time, not having to keep an ear out for the little steps upstairs (as I write this, I am listening for signs that Amanda may get out of bed upstairs, meaning I will need to go up and check that all is well....) 

But I am hoping to be able to go to a restaurant and relax with the menu and a glass.  To be 'free' to choose this way or that without a thought to where the nearest toilet may be, nor thinking what we can eat this evening (at six) without spitting it out.....

So, here I am, at Le Train Bleu, at Gare de Lyon, Paris. An indulgence that not even sophisticated Parisians (such as my companion on the Eurostar) have all treated themselves to.

And it is a luxury.  Wow, what an ambience!  Am I dreaming?  A quick zap of my NHS Covid Pass (no qualms there, and the zapper immediately knows who I am and how well vaxed I am) and I am seated under sprawling frescoes of women in shaded porticoes overlooking Monaco (Montenard pinxit).  Then food of an order of well trained angels, and Riesling that could baptise an Archbishop.  

I wouldn't want to dine here every day.  But.... It's one thing off the bucket list.

But then, forgive me, the first twinge of conscience.  I used to try places out in Paris with Amanda by my side.  Yes, being me, I often made the choices, but she was with me, and smiling, and we would accompany each other through these experiences, however difficult.....  Now, perforce, she is not here.  I have no hand to hold.  Somehow the food doesn't taste quite so good......

A little later I am seated on a train bound for Geneva, Switzerland. Another country.  Hundreds of miles.  But a mere three and a half hours from Paris, reaching 300kph at times and whipping through the history of Europe, up the last stretch as though the pre-Alps were something of a minor inconvenience, and then disembarking in a city without so much of a scratch on my passport.

I have little connection with Switzerland.  Amanda and I drove through it a few years ago on our last overland trip to Italy, just after some of the people in the United Kingdom (sic) chose to turn their back on the mainland. It was then an embarrassment.  It is now a shame.  But 'the people' had their wish and we have to live with it - for now.  

We also drove through the country when the girls were small, and each time I have been here  I have thought how calm and neat and clean and pleasant a land it is.  Right now, on my own, I think rather differently.  I am at ease, sort of, but on my shoulder is the unwelcome weight of a conscience, niggling at me - should I be here?

But then, what do I know?

So I am on the run.  Escaping from my responsibilities, trying to forget the daily pain of watching a loved one disappear.  But friends and counsellors have told me I need to look after myself, or who will care for - Amanda.  And there is the rub.  We both worked all our lives to save a little for our twilight days, and now it will all be tied up in her care (or perhaps mine as well?)  I am a pawn in the government's game. If I fall over, then the bill will fall to the local authority, already starved of resources by a cabinet of fools, but until that day, we pay.....  

And the result is that I feel guilty. Guilty for abandoning my powerless partner. Guilty for perhaps enjoying myself.  Guilty even for expecting some help when there are others more needy than us..... But, guilty, as charged, for being a self-centred Europhile flaneur, riding the TGV to Geneva and eating (and drinking Chasselan) care of Jose et Carlos Farina, at the Bistrot du Bœuf Rouge, 17 rue Dr. Alfred-Vincent, CH 1201 Genève.... 

Yes.  On the run.  

And guilty.

But.....