Medical Assistance in Dying

Last Wednesday (March 7) it came to my attention that there is a heated debate in my area regarding the provision of Medical Assistance in Dying (MAiD) within a hospice/palliative care setting.  My local newspaper posted this article. 

In response to this article I have written the following letter to our local Hospice Society (and subsequently also to the Hospice itself which is run independently) which I also submitted to my local paper as an open letter to the editor.  It is my hopes that it will be printed in tomorrow’s publication.  I share it with you all here.  I welcome you to share it with whomever you desire.

In writing this letter I have uncovered that it is the Fraser Health Authority which is in the process of mandating ALL Fraser Health facilities, inclusive of palliative care, offer MAiD (another article about what's going on here).  This alarms and concerns me.  Things move slowly in my life, but my next step is to write a similar letter directed towards Fraser Health.  Furthermore, the Canadian Society of Palliative Care Physicians is advocating for exclusion of MAiD from Palliative facilities and provides assistance to Canadians in advocacy and advice.  As such, I plan to enlist their help.

Thank you for taking time to read my concerns.

Dear Sue,

I write in response to the recent article in The Chilliwack Progress informing Chilliwack residents of the Chilliwack Hospice Society’s pending decision regarding allowing Medical Assistance in Dying (MAiD) “in house”.

This matter is of utmost concern to me as I am a Chilliwack resident and was diagnosed with terminal brain cancer in October 2016.  I have already lived past the average survival of individuals with my diagnosis.  It comforts me greatly to know that my community has comprehensive palliative services.  However, it alarms me that the society providing these services is considering allowing MAiD.  I strongly petition you to NOT support MAiD within your programs and services.

I firmly believe that the vulnerable process of dying naturally is beautiful and allows a special bond of love to flow between the person breathing their last breaths and the loved one bearing witness to it.  This is a beneficial and shaping experience and is what I desire for my own death.  I make this decision with my personal experience of encountering the beauty and value of being present in the tender moments of my grandmothers’ last days. 

 As I see my own death approaching I’ve already begun to experience the beauty and vulnerability of dying.  Until recently I was a pharmacist and a depended upon health care provider in our community.  I am now the patient trusting my health care team.  Additionally, as a mother I was accustomed to caring for my 3 young children.  Now I am the fragile, dependent, and needy one.  I’ve had to ask for and accept a great deal of help.  Yet in receiving this help I’ve gained much more than the practical support I’ve needed.  These beautiful acts of humanity have been life-giving gifts for both the givers and myself. 

At the same time, my diagnosis is precipitating raw and vulnerable conversations.  While rewarding these are difficult waters to tread.  This journey requires courage; in my frailty I rest on the shoulders of those supporting me to garner this courage.  Meaningful and safe relationships are of utmost importance.  I need to know that those supporting me are fully invested so I can lay bare my aches, disappointments, heart, and hopes to continue on this courageous journey.   I need to ensure that my care will continually foster this unguarded openness.  This is a vulnerable state requiring utmost trust in those I surround myself with.  I am exposed.  Because I am exposed I need to ensure that my circle of trust is not broken.  As palliative care physician Dr. L. Herx states, “The foundations of our work in palliative care are trust and relationship.” She continues, “Is trust really engendered when we reach out with one hand inviting patients to engage in the hard and intense work of addressing their suffering, while in the other hand we hold the needle to end life?” ¹ To ensure vital trust is protected at such a vulnerable time in life it is important to clearly segregate palliative and hospice care from any provision of MAiD.

Furthermore, I long for my care to be focused on living well while at the same time be fully committed to the arduous process of dying.  Indeed, the World Health Organization defines palliative care as affirming life and intending to neither hasten or post-pone death².  I believe the Hospice Society has championed this definition by supporting the palliative patient through providing holistic care and comfort as a patient lives their last days.  I am tremendously grateful a compassionate local environment like this exists where independence, as much as possible, is valued.  This will enable me to live as fully as possible, while I’m alive. To provide MAiD in this setting would be utterly off-focus and contrary to the purpose of a hospice and palliative care.  I plan to LIVE until I succumb to my disease.  This is an entirely different mind-set than choosing to die prematurely.  These 2 mind-sets cannot co-exist, certainly not housed under the same roof.  As Lincoln said, “A house divided against itself cannot stand.”

To continue providing this city, including myself, my husband and my 3 young children, with vital and life-bolstering care I sincerely urge the Chilliwack Hospice Society to safe-guard an environment of vulnerability, openness and whole-hearted support by NOT supporting MAiD within your programs and services.

Best Regards,

Cheryl Rostek

Citations:

1. Herx, L. (2015) Physician Assisted Death is not Palliative Care. Current Oncology, 22(2) doi: http://dx.doi.org/10.3747/co.22.2631.
2. World Health Organization Definition of Palliative Care. Retrieved from: http://www.who.int/cancer/palliative/definition/en.

The miraculous gift of life

I glance on Facebook and see that today is International Women’s Day.  As I recently read I am Malala to my 5 year old daughter (and she was enthralled and couldn’t “put it down”) and am reading about Christine Caine’s organization A21, which is an anti-human trafficking organization, this day holds greater weight. Being a woman around the world poses discussion far beyond the challenges of fertility, mothering, “me-too”, and the intricacies of being daughter, sister, friend.     So here I pause for a moment to acknowledge every woman and her story, spoken or silent.

A woman cannot deny that her body was designed to bear children.  She was created with a womb and her monthly cycle reminds her of this.  She may choose not to have children, she may struggle with barrenness, she may become pregnant when she didn’t want to be.  But she cannot deny her physiology.  It shapes her.

In this vein, mothering has shaped me.  I always wanted to be a mother, not that I profoundly loved dolls or babies (in fact, to this day, I’m not particularly fond of holding babies); but I desired to be mom.  I was awakened to the reality that motherhood is wrought with “intense pain and suffering” (Genesis 3:16) when I miscarried my first pregnancy.  Subsequently, I realized mothering does not go as “planned” when I (finally) became pregnant with my second child only to surprisingly find out I was being blessed with an extra baby: twins.  Mothering twins is an arduous endeavor.

In my recent challenges of facing brain cancer, reading the bible and spending time in prayer has become an absolute life-line for me.  It was in a recent time of prayer that I became aware that my role as a mother is more profound than I realized.  It matters greatly.

As I realize my primary role in mothering ---- this happened: my love for my children is bursting out of me.  Our pastor recently spoke on “where your focus is your feelings will follow.”  As I focus on my children more, my feelings overflow!  And below I catalogue the result.

A prayer for my children

My children I truly pray and believe that you will change your worlds; however, I also realize how greatly you already have.  You shape me and help loosen out the junk in my life.  You compel me to equip myself well to be your mom.  In the process I am better able to make a positive impact in our family, our neighborhood, our city.  Children my prayer is that you’ll always remember your God-given ability to change your world!

The Gift  

Exhausted, these hands are full.

I am weary and oh so worn.

I am broken.

I feel my inadequacies. 

They penetrate: the everything I try to accomplish

                        : the everything I try to be.

And I am not enough. Not even close.

These blessings I hold are more than I could have imagined

And so often, more than I can handle.

I am humbled that I’ve been chosen.

Chosen to mother.

When you were conceived I did not understand what lay ahead.

My children have become great teachers in my life.

Non-stop relentless

Frustrating, precipitating anger I didn’t know could exist in my bones.

My flaws are magnified, amplified for clear view.

Dear God:

Oh Maker of my children, Maker of me

I thank you.

For the beauty I hold in my arms.

Blessings abound and flood over me.

These children

Are

My

Legacy.

My gift to shape and raise

(Oh God grant me wisdom!)

And give these children eyes to see your beauty

And lips to proclaim your blessings,

Wisdom to understand how to use the gifts and talent you have granted them.

God replies:

I turn everything to good.

I am the great Creator.

Look at these children bringing LIFE into your home!

Look at this life journey and the treasures you’ve uncovered.

I bring LIFE

I bring LIFE

I bring LIFE ABUNDANTLY!

------

Ephesians 6:10  “Be strong with the LORD’S Mighty Power.

Children, this life will batter you sooner or later, so always remember where your strength comes from: God’s mighty power!

My children shape me tremendously.  I learn from them as they require me to sharpen myself as a mother, as I see my stark inadequacies and try to remedy them.  I learn from them as they teach me to believe, to love, to have courage, to be passionate and to find tenderness.  I learn from them continuously.  They reflect my own self back to me and I see strengths and I see weaknesses.  I see humanity.

I hold my tender 2 year old daughter and stroke her cheek and look at her precious small toes.  I am overcome by belief in my Almighty God; my children are a testament to me of our great Creator.  These 3 children knit in my womb, flesh of my flesh.  And there’s something about 2 year olds: they are no longer babies, they’ve become these precious miniature, but full of life, humans.  Humans with rage and delightful sweetness entertwined, cute as can be and exhausting as all get out.  The miracle of life overwhelms me.  This little life I hold in my arms is already passionately beautiful.  She came from me with perfect little toes, so lovely.  Life breathed into her by God Himself.  And I am blessed beyond measure to witness this miracle in my home.

Oh how my God is so good.

Thank you Allison for teaching me passion and tenderness.  Thank you Rayna for teaching me kindness and generosity.  Thank you Garrett for teaching me diligence and light-heartedness.  Thank you children for opening my world to greater love.  I love you all more than I can possibly describe and in ever-increasing measure.

Love,

Mom

XOXO

Work in Progress

I write this out mainly for my own benefit: to remember.  Oh how forgetful I am.  Oh how easily I forget what I have learned.  Perhaps something I share will resonate with you, perhaps not.  But this is me living out transparently what this life experience of mine is like. (Complicated, simple, messy, beautiful.)

I am a work in progress.  Oh how I need a lot of work done yet.  Proverbs 3:12 says “The Lord corrects those he loves, as parents correct a child of whom they are proud.”

(You’d think I’d be able to understand this as I correct my own children’s behavior.)

It started like this (I think…) God’s been teaching me much.  I’ve been blown away by how fruitful it is to spend time meditating on scripture.   My journal has become filled with truth and hope and LIFE as I reflect on God’s word and it is spilling into the way I live life.  I am seeing the profound importance of my role as mother.  In John 2 Jesus’ mother asks him to step up when they are at a wedding and the wine runs out.  And Jesus listens to her!  I read this and realized – mothers have a very important and influential role that is profound and needs NOT be taken lightly.  God keeps speaking to me the primary importance of being a mother (secondary to my marriage alone).  Deut 6:8 says, “The LORD is our God, the Lord alone.  And you must love the LORD your God with all your heart, all your soul, and all your strength. (I’ve spoken of these verses before, they were vital words for me to keep pressing whole-heartedly into Jesus when I needed HOPE.  But it continues: )  “And you must commit yourselves wholeheartedly to these commands….repeat them again and again to your children.  Talk about them when you are at home and when you are away on a journey, when you are lying down and getting up again.  Tie them to your hands as a reminder, wear them on your forehead.  Write them on the doorposts of your house and on your gates.”

Being a mother and the teaching I provide as a mother is pivotal in my children’s lives.  Now as I write this I remember when Rayna was around 3 years old and I felt that we should be teaching her more about faith; but I didn’t really know how.  Ever since my cancer diagnosis I began seeking God with my whole heart, soul, and strength.  Now I am teaching Rayna about faith all the time, speaking about it, reading about it, as we go and intentionally.  It is natural.  We are praying with our 2 year olds already, because it matters to us.  Faith is our anchor.  That’s how our family survives and thrives.  Because this is how we are choosing to LIVE my kids will learn much about Jesus.  (Dr. Currie states that children who see a belief in God lived out at home are the ones who hold onto faith when they leave home.)  Indeed it is how my own parents taught me and I am so grateful to reflect on the wonderful ways I learned of Jesus in my home (But that’s a whole post of itself).

God drove home the importance of my role as a mother yesterday in the hot tub at Harrison Hot Springs Hotel.  We entered the hot tub and a Ukranian man immediately started talking to us.  He asked us why we looked so serious.  Ryan replied that we have a 5 year old and 2 year old twins at home, that’s why: we’re tired.  He proceeded to tell us about his 12 children and of how children are a gift from God.  I’ll admit at first I found him obtrusive to my enjoyment of the hot tub and I was annoyed with his loud and bold conversation, and the strain to listen to him through his accent.  But, upon reflection, how wrong of me! (Not only because this life is about loving people well; but also because I realized that our society’s perspectives on children is all backwards and I’ve allowed this to influence me.)  This man clearly came from a culture and mindset where children are considered blessings and gifts from God.  How often does our culture see children as inconveniences?  I am guilty.  I am selfish.  I sure did not immediately view my “extra” child as an out-pouring of extra blessing in my life (though certainly that view is changing).  Again this could be a whole blog post ---- but this Ukrainian man reminded me of the important role of mothering.

Let’s shift gear here.  I’ve also been learning in the gospels of how many times Jesus asks “Do you believe?”  John 16:31 “Do you guys finally believe that I came from God?” (my version) And you hear it over again and again through out the gospels.  You see the doubt in the disciples: they see miracle after miracle and they still fret and fear about circumstances that arise.  Brian Hardin who narrates the Daily Audio Bible that I listen to states that how reading the scriptures gives us a reflection into ourselves.  And I’ll be honest that in these doubting disciples I see myself and I’m ever so glad I’m not alone because over and over I find myself in doubt.  After all God has done for me doubt still  pops up.  I have to pray like the man in Mark 9 “God, I believe, help my unbelief.”

This week has been tiring.  Though Ryan and I were able to get away for a lovely night away it came after a week of our nanny being away sick.  I am still recouping.  In my tiredness I think guards came down and thoughts started leading me to desire control.  I’ll try to explain.  A few months ago I started to truly believe that by releasing my life I would regain it, just as scripture explains.  And in doing so, indeed, I found more life and life freed from crippling fear.  I’m not sure why this past week these new struggles came, perhaps because with our nanny away I was doing way more and it felt good to be able to do and be capable, in control and productive (though truly slowly it was exhausting me to an unhealthy level that I am recovering from).  But I captured a desire for control.  (This is a desire I first started dealing with when we had a miscarriage before my oldest child was born.  I was devastated, obviously by the emotion from this event; but also devastated that control had been ripped from my hands.  It was my first big realization of “real life” and that I wasn’t as in control as I thought I was.) 

So this past week for some reason my work as a pharmacist has been popping into my mind.  At this point I am not “fit” to return to work, so really whether I return to work at some point or not is not a relevant or imminent decision.  However, this past week I’ve been clinging to the idea of returning to work someday and I was unable to release this desire.  Clinging to things doesn’t work well, I should have learned that by now; but I was clenching and not willing to release it.  To release that even one day if I am fit to return work, that may not be the right answer or the answer that God would speak to me.  I do not like this notion.  Why?  It takes my control away.  Even in the theoretical I was clinging to control. I was battling against God – big time.  You see what’s more is that I was trying to contemplate what I might say on Easter when I’ve been given the opportunity to briefly share in church how God has changed everything for me.  And I was feeling uncertain, doubting and so very unsure how I could possibly speak in public about trusting God when I wasn’t feeling it.

Then this morning I started another 3 day fast (more about that below**).  As I was driving I realized my frail humanity and how I am so not in control.  Lest I feel in control, I realized how I need food.  How these 3 days will be challenging because I am a mere human.  I am not in control (and really with my history, wouldn’t you have thought I’d have learned this already?!!).  I need SO much.  I need God.  Always have, always will.  I can’t fool myself, and yet I try.  And I end up asking forgiveness and God abundantly forgives and lavishes me with love.  I give God my vocation and I know He fill my hands and hearts to overflowing as I trust Him.

Deep Breath

Because all this comes on the tail of realizing that I feel so much more alive than I ever have!  These battles in my soul are getting rid of the junk of my life so I can live lightly and freely.  So I can feel even more alive than I already do!

This is the power of Jesus!!!  This is why I choose to believe in Jesus!! This is why I immerse myself in the scriptures, why I keep seeking more of Him and keep finding more LIFE!

Jesus fills my life with love, hope, passion, peace, wisdom, power and I want more of it so it can spill out of me and overflow into my family, my friends, my community, my city, my world!  THIS is why I choose to believe Jesus is who he said he is. HE HAS CHANGED EVERYTHING FOR ME!

 

(Sorry for shouting)

How wonderful the privilege of teaching this to my children.

**The last time I saw my oncologist Ryan probed him more regarding my prognosis since I am doing so well.  Though most people (over 50% at this point) with my diagnosis would have died, this is no indicator of what the future holds for me (5 year survival is 5%, but medicine has no good indicators of who will be in that 5%).  However my oncologist (who we both really like!) offered 2 suggestions with some evidence: intermittent fasting and daily meditation.  Interestingly these are both biblical practices.  I have taken a “hearing God” class put on by my church and am trying to implement principles learned there into (a goal of) 30 minutes of meditation on scripture daily.  (This is too cool not to mention, so indulge me.  I have a degree in Biochemistry so when my doc presented this evidence to me it caught my attention:  meditation actually extends the telomeres on your DNA.  These telomeres are essentially protective “end-caps” on your DNA which gradually shorten as you age, as they shorten you risk damage to your actual coding DNA.  But this study showed you can grow your telomeres by meditating daily!)

Regarding fasting, a few months ago I did a 3 day fast.  At the time I was reading Esther and I began experiencing visual symptoms which freaked me out, so I immediately started a 3 day fast (the length that Esther did leading up to petitioning the King for her people).  I learned much from that fast: patience, fortitude, thankfulness (for gifts like food!), passion and emotion (anger at points for not being able to eat!), self-control.  Then at the beginning of January, since our church was doing 21 days of prayer and fasting, I chose to again do another “Esther fast”.  This time I began to see a shift in my thinking.  For example instead of seeing meal times as awful because I wasn’t eating but I still needed to feed my family, I began to see them as opportunities to be more available to serve my family because I didn’t need to eat.  Also, it served as an opportunity to rest: if you’re sleeping in the evening you don’t feel like eating! And on breaking my fast the gratitude I experienced was tremendous!  Gratitude for the rich gifts my heavenly father provides. 

I had not intended to do another fast so soon; but with the words from my oncologist I have now decided to do a 3 day fast monthly.  It gets easier each time and this time I didn’t dread entering my fasting days like last time!  I encourage you, it is a discipline worth exploring and I welcome comments or experiences of others who have fasted.