Deep Reads: Finding an answer and purpose through MAID

Note: The following piece contains graphic descriptions of death and medical assistance in dying (MAID). Some readers may find the subject matter distressing.

 

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Judy Pettersen will remember the day forever - March 28, 2018. It was the day her husband Clarence chose to end his fight with cancer before the illness could end him.

Most people in Flin Flon know the broad strokes of the story by now. Clarence, a beloved community figure, a teacher and educator and, for a brief time, a provincial political kingmaker, died following a long battle with cancer. There are no spoilers. The end of the story, as most people know it, is already written.

Contained with that story is how Pettersen lived in his final months, how the family came together and stood beside the paterfamilias and how Judy handled her loss and grief. A retired teacher, product designer and writer, Judy has taken to writing and community support to find solace after his death.

Models created by psychologists break grief down into a series of stages. First, there’s a shock or trauma, refusal or inability to understand, then resistance, catharsis - the release of repressed emotions, possibly sadness or despair but also relief and joy - then resignation to reality and reintegration back into the world.

 

Shock and refusal

Clarence was first diagnosed with cancer in 2013, not long after he was elected as MLA for Flin Flon. He had surgery and was briefly in the clear, but the disease returned in a year.

“At that point, we were told that he would have about four years,” said Judy.

“The doctor saw how upset we were and said, ‘But some people get longer!’ but he had almost exactly four years.”

More treatment followed. Once again, Clarence looked like he had beat the disease. A visit to an oncologist in May 2017 proved otherwise.

“When we were in the office and we got that news - and I mean this with all my heart - the doctor left the room and I said to Clarence, ‘I feel really bad for somebody but there's been a mix-up. We’ve got someone else’s file,’” Judy said.

Following his diagnosis, Clarence was told his options. Aggressive treatment could extend his life, but the cancer would still eventually overcome. He could also refuse treatment and let the disease take its course, likely ending up in a hospital and dying surrounded by machines.

There was, however, a third option – still new at the time.

A doctor mentioned medical assistance in dying (MAID). At that point, MAID was a new policy in Canada and in Manitoba. For many years, MAID was classified as criminal and anyone who had either helped the person die, helped plan the death or knew about the plan and chose not to intervene would be committing a crime. In several countries, MAID is still seen that way by the law.

Starting in June 2016, MAID would be allowed across Canada.

After some contemplation, Clarence, ever the maverick, chose the third route. Clarence did not want to rage against the dying of the light through more rounds of chemotherapy and treatment. Instead, he chose to rage in his own way, raging against the typical cancer narrative, going gently into the good night with his family and friends close at hand.

He would not be the first person from Flin Flon to apply for MAID, but due to the advanced stage of his cancer, he would likely be the first person in the community to die through the program.

 

Resistance

In order to qualify for MAID in Manitoba, a person must meet a long list of qualifiers, including having what the province described as a “grievous and irremediable medical condition”, being able to make their own health decisions and being able to give informed consent.

Clarence ticked all the boxes.

In Manitoba, MAID is administered by a group of medical professionals based in Winnipeg. The decision is made with due diligence. They don’t advertise. Their work is kept hidden to some extent.

“You have two interviews with them. We went down to Winnipeg and they let us do one on a Friday and one on a Monday instead of having to go back - though they will actually come to you for an interview if you’re too ill,” Judy said.

“It’s on the downlow. The building is just across the street from the Health Sciences Centre and the people there didn’t know where it was.”

Despite the severity of the subject, the tone was casual. MAID team members mentioned at almost every opportunity that the person about to die can opt out of the plan at any time.

“We met them and it was like a visit with friends. It was really wonderful. It was very warm. They really wanted to make sure that the person is not being pressured in any way. That was a big part. They want to make sure that they’re doing it for the right reasons. They say, ‘You know, we can get a handle on your pain and all these things,’ even at the hour of their death,” said Judy.

“It speaks to quality of life - and after a while, there’s not much quality of life there.”

The details of Clarence’s death were worked out - that he would die at home in Flin Flon, that family and friends would be around, that no secrets shall be left unknown and the grieving should be accompanied by joy and thanks.

One of the hardest things to agree on wasn’t the how - it was the when. Clarence and his family had a hard time deciding when the day would be.

“First, he said at the end of December. We all thought, ‘That’s too soon - and Christmas would be ruined forever,’” Judy said. Later, the end of February was proposed.

Then, the Pettersens remembered one of their family traditions. The Academy Awards were always a big event for the family, who would hold a viewing party with guests where Clarence, summoning all the bluster he could, would serve as the MC - and that year, the Oscars would be March 4.

“We would dress up, we would have fashion shows. He would be the person announcing what this person was wearing for the guests who were there. He’d make up a designer - he’d ask people, ‘Is your suit by Valentino?’” Judy recalled.

“We’d have so much food and a red carpet and lights. I said to him, ‘Honey, you can’t pick Feb. 28. The Academy Awards are March 4.’ He says, ‘Oh my gosh, I can’t miss my last Academy Awards.’”

The final date agreed on was March 28 - during spring break, with family members able to travel back up north.

The stars aligned. That March, the Pettersens watched The Shape of Water take Best Picture. Clarence was in pain, dressed in pajamas instead of his standard host get-up, but ever the ham, he got up to his standard hijinks one last time. His loved ones, wearing their own pajamas in solidarity, played as the audience.

 

Catharsis

As the calendar ticked down, Clarence’s condition worsened. His physical pain increased daily, but Judy said it came paired with a sense of clarity.

“As it came closer to the day that he had picked, I know he got calmer and happier. He was excited about leaving his body and mind and having a fresh start, which we both really believed would happen,” Judy said.

Family and friends came to Flin Flon to say their goodbyes, holding what were in essence a series of living funerals - fstarting off with a raucous, loud party at home where close friends and family sang songs well into the night.

“The next day and that night, all his nieces and nephews had their own private time with Clarence to say goodbye - the next day, all the siblings came over to say goodbye, then more,” Judy said.

On March 28, Judy woke Clarence up for a morning bath, the last one they would share. She dressed him afterward and they walked together into the living room, where Clarence sat in his favourite recliner. Judy prepared his medication. Clarence took it and the family ate breakfast, even though Clarence had trouble eating his last meal.

The three-person MAID team arrived around 11 a.m., flying up from Winnipeg. Once again, the group met with the whole family, explaining once more what would happen. A series of needles would be used to do the deed. IVs would be put into both of Clarence’s arms while the MAID team explained what would happen one last time, giving a final chance to back out, first asking with his family in the room, then moving family out temporarily to speak privately with Clarence.

Clarence Pettersen was never a quitter.

The injections would put him into a blissful sleep, then would stop his heart. He would feel no pain.

With Clarence giving one last thumbs-up, the Pettersens reentered the room and stood with the MAID team. Clarence hand-picked one of his favourite records - The Best of Cat Stevens - to be playing during the moment.

There were final conversations. First, Clarence brought up a family item - a marble bowl he had found in Mexico that had been damaged at some point. He had never found out who had broke part of the bowl and before he died, he wanted to know who did it.

“Right before he died, he kind of held up his hand and he said, ‘Wait a minute... I have to ask a question,’” Judy recalled.

“‘It's almost over for me. Just confess now - who broke the horn of the bowl?’ Our kids said, ‘Dad, we would tell you in a heartbeat, because we know you want to know, but we don’t know.’”

Then, not long before the injection, Clarence had another request.

“He held up his hand and said, ‘Don’t let this ruin Cat Stevens for you. I want you to keep listening to Cat Stevens,’” Judy said.

“The kids said, ‘We promise, Dad. We won’t let it ruin Cat Stevens for us’. On the anniversary, we tend to play Cat Stevens all day long. It was kind of sweet and he had a smile on his face. We just thought, ‘This is very Clarence.’”

The first injection went in shortly after. Clarence, now fully at peace and reclining in his La-Z-Boy, went to sleep.

Shortly before noon March 28, Clarence Pettersen caught the peace train and it took him home again.

 

This story is the first part of a two-part feature on the Pettersen family, medical assistance in dying, grief, faith and community. The second part of this story will be in next week’s issue of The Reminder and will be found on our website at thereminder.ca.

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