In New York

In New York

Monday, 15 June 2015

Six years since diagnosis: Tennyson, Assisted Dying and Living Life

Six Years of MND

Coming up to the sixth anniversary since Roch’s diagnosis, it feels like a time for reflection. Neither of us thought that he would last this long and to my surprise I’m finding that reaching this stage requires a change of mind-set on my part. In fact, our reactions to the reality of his survival well beyond initial prognosis appear to me to be quite different and I find this interesting. On my part I realise that I no longer view my husband as someone with a terminal illness. It’s true - his deterioration has been so slow and I am so used to his level of disability that although I find it trying at times and struggle with the limitations it imposes on both our lives, I don’t see him as a dying person. To me, he’s just Roch. I have ceased thinking about his death and this means I need to focus more on acceptance of Life as it is now and for the foreseeable future. It means living in the moment not just as a couple, but for me as an individual, too and not postponing life until some future uncertain l-a-r* date. But this is for a separate blogpost.

A Young Man's Fancy

I think Roch’s feelings are different. Alfred, Lord Tennyson once wrote:“In the Spring, a young man’s fancy lightly turns to thoughts of love.”This quote shot into my mind as I began this post, but I amend it here to match our circumstances:

“In the Spring, a brave man’s fancy grimly turns to thoughts of death.” 

Doesn’t have the same ring to it, does it? And yet, it’s true. I have no doubt that thoughts of death are often in his mind, but June is a special time for us. This June especially, death is very much in our thoughts, as an old and dear friend is dying, not from MND but from cancer. Roch feels it acutely. Six years ago he expected to be dead long before anyone else of our acquaintance. Once again, I know his thoughts are occupied with questions about how his own end will come. What form will it take? How ‘decrepit’ will be be? (His word, not mine.) The internet is a wonderful thing and yet it can also be a frightening thing. We read about other men and women living with MND as they and their loved ones document their experience. Some of what we read scares us. He dreads a long and lingering death, immobile, unable to communicate freely. He often speaks of suffocating, choking etc.  His doctors cannot tell him how the end will be for him, because they don’t know. They can’t answer his question because everyone with MND is different. Of course not everyone with MND will die a lingering and distressing death, but the best I can say to him when we read of someone else’s struggle and misery, as they battle against distressing symptoms at the end of life is:

“It may not be like that for you.” It’s little comfort. How do we know?

So Roch ponders the manner of his death and worries, feeling that he has no control and not enough information.  Aware that Assisted Dying is illegal in the UK, Roch feels his options are limited. He would like to choose the manner and time of his death but presently feels that to exercise control he may decide to refuse food and drink. What would the physical symptoms be? What would the level of pain/discomfort be? If he didn’t accept nutrition, but was kept hydrated – how long then before the end? 

The hospice nurse is unable to answer these questions and as the law currently stands, we can’t expect that he will. He really cannot discuss issues around end of life in any context which might be construed, however tenuously, with Assisted Dying and so tries valiantly instead to offer reassurance to Roch; that his death is not imminent, that the palliative care at the hospice is excellent, that his family are more than willing to continue to care for him as long as it takes. We know these things, Roch knows these things, but knowing them doesn’t help him.  Roch remains in a state of constant anxiety and will continue to wake at night on occasion, with ‘the horrors’ as he describes it, facing an uncertainty about his end with no control over the outcome. He doesn’t want to die. We don’t want him to die, but if he is to enjoy the rest of his life at all, he needs to have control over the end of it.

Assisted Dying Legislation in the House of Commons

So earlier this month we were delighted to learn that MPs are to debate Assisted Dying legislation on 11th September. Labour MP Rob Marris, who is introducing the bill, said,

“Alongside the vast majority of the public, I am in favour of terminally ill people who are of sound mind having choice at the end of life. It is a choice that I would want for myself and I do not think we should be denying this to people who are facing imminent death.”

This will be an opportunity for Members of Parliament to debate the best law which will not only give dying people choice but also protect the vulnerable.

So here we are, on the eve of 16th June, six years since diagnosis and we are still making plans and trying to enjoy as much as we can together, as a couple and as a family. Wouldn’t it be nice if Roch could relax and make the most of what’s left to him, untroubled by thoughts of his death, knowing he would have some control at the end? 82% of the public would agree. Do you?


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