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My sister had stage 4 breast cancer. She was dying. The cancer had spread to the bones of both arms, one of her legs, her pelvis, both lungs and her liver. She was not going to get better. She knew that and all of us knew that. This was the final chapter of her life. Towards the end of this final chapter, my sister was at a large, world renown Hospital in Seattle.
At this point there was only one question:
Will my sister go home to die, or finish out her life in the hospital?
She wanted to go home, but the hospital required her to pass certain functionality tests before they would allow it. The tests were administered by a physical therapist. She had to demonstrate that she could walk a certain distance without assistance, get in and out of bed on her own, get on and off the toilet without any help, etc. At this point she couldn't pass the tests, but physical therapy was meeting with her every day and helping her, with the hope that she might be able to get enough strength back to be able to pass the tests and then be allowed to go home.
She desperately wanted to go home, with or without permission, and she did everything she could to talk us into taking her home, even Against Medical Advice. She threatened us, she begged, and she pleaded. She wanted us to grab a wheel chair, put her in it and head for the exit as fast as we could go!
But I would not agree to help her escape from the hospital. She needed lots of care, and the hospital was the best place for her.
The Reason she Wanted to go Home was That She had Horrible Nausea and Vomiting and
Nothing They Gave Her Would Help.
This nausea and vomiting started years before she had breast cancer. She had been to multiple specialists about this nausea and the only effective treatment she had ever found was cannabis. Even though she had used cannabis to treat her nausea for many years with the approval of her doctors, the hospital wouldn't allow her to use cannabis in the hospital.
Even though she had this nausea issue going on for years I didn't really know how bad it was until one day we were out running some errands in my car, when the nausea kicked in. This was before her breast cancer. She usually vaped some cannabis as soon as she felt the nausea starting, but she wouldn't use the cannabis in my car, even though I told her I didn't care. She just did not want to take a chance on me getting pulled over and getting in trouble with the law.
The next thing I know she is leaning out the window and retching horribly. I pulled over and she got out of the car and continues vomiting. Huge horrible full body vomiting, resulting in her falling over and vomiting uncontrollably. I was watching this, horrified at what I was seeing. Just as she wouldn't use it in my car, she was also reluctant to use cannabis in public, because even in Seattle, public use of cannabis was still illegal and she didn't want any legal problems. Finally, in desperation, she got her vape pen out of her purse and used it.
It only took 2 or 3 lungful's until the vomiting was gone, and just like the passing of a thunderstorm, she was suddenly back to normal. I was very impressed with the benefit she got from that vape pen. According to my sister, without the vape pen, that vomiting episode might have lasted another hour or so. She told me she might have 3-4 bad episodes like that in a bad day, and on other days just 1-2. She also had milder nausea that would come and last all day. Bad enough to feel miserable, but no actual vomiting. And sometimes she might go a day or so with no nausea, but that was rare. If she used the cannabis as soon as she started feeling the nausea, it was no big deal. A couple of puffs and she was fine. So you can understand why she relied on the cannabis.
My sister's situation was not unique. Cannabis is used all over the world to control nausea, and in fact nausea is one of the main medical uses for the weed. Researchers at The University of New Mexico studied cannabis for nausea and showed that using Cannabis results in an immediate average symptom improvement of nearly 4 points on a 0-10 scale just moments after consumption with increasing benefits over time. In a recent study, published in the Journal of Clinical Gastroenterology, researchers showed that more than 96% of patients using cannabis for nausea experienced relief.
BUT. There is always a but. And here it is. There is a condition known as Cannabis Hyperemesis Syndrome, which is an episodic vomiting that is actually caused by the cannabis. This condition is pretty rare, but it does happen. And so me and my siblings wondered if her nausea was actually being caused by the cannabis. The only treatment for cannabis hyperemesis syndrome is to stop using cannabis, and the vomiting episodes will go away. We wondered if we should be trying to get her to quit using cannabis, or just be glad she had the cannabis to control the nausea and vomiting.
However, there are some other prominent symptoms of cannabis hyperemesis syndrome which she did not have, so it seemed unlikely that she had cannabis hyperemesis syndrome, but we could never be sure.
In any event, she wasn't willing to quit the cannabis, and it did seem to work miracles for her, so over the years, when it came to her use of cannabis, I kept my nose out of her business.
But now she was in the hospital, suffering horribly from nausea and vomiting, and the meds the hospital gave her just did not help. And she was miserable. So of course "somebody" had to go to the pot shop and buy vape pens for her and she had to hide them from the nurses. They're not too expensive, about $30 or $40 at the time, IIRC.
But of course it was always just a matter of time until the nurses would find her vape pen and confiscate it. "Somebody" would give her another one, and she kept trying to find better hiding places, but the nurses aren't stupid and "somebody" ended up spending quite a bit of money on replacement vapes. The nurses were irritated and kept demanding to know who was bringing these vape pens in to her.
Here is the Weird Part!
One day this doctor comes into see her and has this big conversation with her, right in front of me, about "death with dignity" and "taking control", and choosing your own "transition" day. He lets her know she doesn't have to keep suffering. She can just....well you know, she can do the Dr Kevorkian treatment. Finally my sister figures out he is talking about physician assisted suicide!
She was in pretty bad shape at this point, and spent most of the day confused about everything. So she looks at me and says "What does our Church teach about this?" I responded, that if she wanted to stay in line with the teachings of our Church there were 2 things to keep in mind:
She didn't need to agree to heroic measures to artificially prolong her life.
But that God was in charge of life and death and it was His decision to decide when it was time for her to come home to be with Him, and not something we should take into our own hands.
Everybody may not agree with this, but this is the teaching of the Church that my sister had belonged to and embraced all of her life. It was her belief. So she thought about it for just a split second and turned to the doctor and said, "Thanks for coming by, but I really could not consider doing anything like you are suggesting." She was very clear about it. The doctor tried to protest and he made a couple of statements to the effect that many Christians chose this path, but she just cut him off and said, "Not me. You have my answer."
I thought this was a settled issue when I went home that day. I was surprised the next time I visited to hear my sister say that the "suicide doctor" had been back, to make sure she had not changed her mind! She felt he was pretty pushy about the whole thing, and although she couldn't remember for sure, she thought he had been back more than once.
Now step back and look at the bigger picture here.
Her worst suffering is the nausea.
She has an effective medicine, known the world over, that works great.
They won't let her use this known effective medicine.
Instead they offer to assist her with suicide, to escape the nausea, which they won't allow her to treat.
AND they get pushy about the suicide!
Is there something wrong with this picture? This is what she was hearing:
We won't allow you to relieve your suffering, but since you're so miserable,
why don't you just hurry up and die?
Let us help you commit suicide, before you run up a lot more
expensive hospital charges.
Yes, we'll help you, and don't feel bad. A lot of Christians, when they are suffering,
as we are making you suffer, weaken, and take the easy way out.
Why Would any Medical Professional Want to Withhold Cannabis From Her?
Fear it might be a gateway drug that might lead to narcotics? She was on narcotics around the clock, just as you would be if you had cancer eating away at most of the major bones in your body, and your internal organs.
Fear that vaping might be bad for her lungs? No, she had cancer in both lungs, the vaping wasn't an issue.
Fear that cannabis might trigger schizophrenia? A legitimate concern for society, but hardly relevant to my sister at this point in her journey.
Don't feel it's appropriate to be supplying "reefer" to your patients? Not an issue. All they had to do was not prevent somebody else from supplying it.
The Highest and Most Important Duty
of Doctors and Nurses is
to Relieve Suffering.
That obligation is more important than any mandates of government agencies or hospital rule makers. There was no rational reason to withhold cannabis from my sister.
If We do ALL We Can to Relieve the Misery of the Dying, and Still the Person is Suffering Horribly,
Then and Only Then, Let Them Consider
Physician Assisted Suicide.
But ONLY if the PATIENT Chooses It.
But to withhold a treatment, known around the world to be effective and then promote physician assisted suicide is an abuse of the system. And to pressure people who have stated their preference is beyond horrible. It's gruesome.
What Did I Learn From my Sister's Death?
Don't expect the System to always be on your side. Sometimes your needs will only be met by going outside of the System.
Don't expect medical professionals to put your interests first and foremost. In most cases doctors and nurses will follow the System to protect their job and license, even when it is clear that doing so will make you suffer needlessly.
The Death with Dignity, assisted suicide movement is not about the patient's dignity. It really is about certain peoples vision of an efficient System that doesn't waste valuable resources on terminal patients.
Take care and BE HEALTHY!
CW Jasper
May 2023
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