The party should take up a big section of
Swiss Chalet, a family-style chain restaurant on the road out of town. Mr.
Shields wanted his last supper to be one he so often enjoyed on Friday nights
when he was a young Catholic priest — rotisserie chicken legs with gravy.
Then, his family would take him home and
he would die there in the morning, preferably in the garden. It was his
favorite spot, rocky and wild. Flowering native shrubs pressed in from all
sides and a stone Buddha and birdbath peeked out from among the ferns and
boulders. Before he got sick, Mr. Shields liked to sit in his old Adirondack chair and watch the bald eagles train their
juveniles to soar overhead. He meditated there twice a day, among the towering Douglas firs.
“Someone once asked me how did I get to
become unique,” he said that afternoon in his hospice bed. “I recommend
meditation as a starting place — bringing your consciousness to bear.”
Mr. Shields intended to die swiftly and
peacefully by lethal injection, administered by his doctor. Last June, the
Canadian government legalized what it termed “medical assistance in dying” for
competent adult patients who are near death and suffering intolerably from
irremediable illnesses. When his doctor, Stefanie Green, informed him that he
qualified, Mr. Shields felt the first hope since a doctor told him more than a
year before that he had a rare and incurable disease called amyloidosis, which
caused proteins to build up in his heart and painfully damage the nerves in his
arms and legs.
Having control over the terms of his death
made him feel empowered over the disease rather than crippled by it, a common
response among Dr. Green’s patients. Mr. Shields believed that dying openly and
without fear could be his most meaningful legacy — which was saying something.
The man had packed five lifetimes of service into one: He had been a civil
rights activist, a social worker for children, the head of British Columbia ’s biggest union and, most
recently, the savior of a floundering land trust that included 7,191 acres of
protected wilderness and historic properties.
His newly developed plan for how he would
spend his last moments, though, worried his wife, Robin June Hood. Her husband
had not left his bed once since he arrived at the hospice on a stretcher, 17
days earlier. His 78-year-old body had thinned; his voice dimmed. He lasted
only 15 minutes in conversation before his eyes fluttered closed. Just leaving
the room would exhaust him. She knew he could not make it to the restaurant,
and there was no way she could tend to his needs at home, even for one night —
especially his last.
Happily, Dr. Green had become adept at
brokering delicate family discussions over the past year. She had presided over
35 deaths since the law passed, each intimately different from the next. One
man got dressed in his amateur clown costume, complete with wig and red nose,
and died telling her jokes. He had insisted on being alone in the room with
her, but most of her patients died surrounded by loved ones. Many were too sick
to devise elaborate rituals, but others had chosen the location, attendees,
readings and music as if planning a wedding. Dr. Green called them something
she picked up at a conference on euthanasia in the Netherlands : “choreographed
deaths.”
She arrived at Mr. Shields’s hospice room
that day to finalize the plans. The couple held hands as she helped them stitch
a compromise. On March 23, the last night of Mr. Shields’s life, they would
host a party in the hospice solarium with Swiss Chalet takeout for all. The
next morning, he would die in his hospice room. Then, his wife and stepdaughter
would take his body home and lay it out in his beloved garden for two days.
The plan, Mr. Shields said that afternoon,
was “absolutely terrific.”
One Man’s Cosmic Journey
A year and a half earlier, Mr. Shields was
driving down a wooded provincial highway across the belly of Vancouver
Island when he blacked out. His S.U.V. crossed the centerline, plunged
into a ditch and hit a tree.
Ms. Hood, who had been sleeping in the
back seat, was violently thrown. She snapped five ribs and ruptured her spleen.
Mr. Shields broke his back in three places. When he came to, he thought he had
been paralyzed.
The fact that he was not, and that they
had not been killed or struck another car, seemed a sign to Mr. Shields. Then
there was this: An off-duty firefighter or police officer (they cannot remember
which) happened to be driving behind them and summoned rescue workers, who
arrived within minutes. Even their little cairn terrier, Diego, was rushed to
emergency surgery.
Mr. Shields believed every person played a
part in the continuing evolution of the universe. Clearly, he thought, he had
more to do.
But just a few months later, in the fall
of 2015, a doctor summoned him to his office and broke the news. A biopsy of
his heart, taken after the accident, revealed that Mr. Shields had a hereditary
form of amyloidosis. The disease had caused his heart to stop temporarily —
hence his blacking out behind the wheel — and was the source of the numbness
and painful tingling in his fingers and feet that had plagued him for a couple
of years.
Leslye
Davis/The New York Times
“I know I’m holding her hand, but I can’t feel it? It’s a devilish, devilish little thing.”
John Shields
The disease was unpredictable, but it
would likely cause him to lose all feeling and basic use of his arms and legs
before shutting down his heart, Mr. Shields recalled the doctor’s telling him.
Mr. Shields had seen a friend die from a
painful and disabling disease. He was terrified of facing a similar fate. “One
quality of life that’s important to me is my dignity — and sparing anxiety for
my wife and daughter,” he said. Becoming debilitated and being tube-fed was
unacceptable to him. “All of those painful and demeaning things,” he said, “I
considered beyond the threshold of how I would like to live.”
If service was the biggest theme of Mr.
Shields’s life, the other was freedom — intellectual, spiritual, personal. He
was always growing and exploring. In the last few months of his life, he tried
a psychedelic drug for the first time and enrolled in an advanced online course
on “transcending transpersonal realms.”
Mr. Shields was the rare combination of
introspective extrovert. He could be seen wearing a silly hat made from a
napkin one night and hosting a spiritual circle for men on another.
He loved rituals, which began with the
Catholic Masses of his childhood in New
York City . He was the only child of a steamfitter and
a teacher, both Irish and devout. Family lore had it that when Mr. Shields was
a baby, his grandfather hoisted him up in one hand and proclaimed he would be America ’s first
pope.
At 17, he enrolled in seminary. By the
time he was ordained years later, the Second Vatican Council had convened.
Shaken at first by changes the council was recommending, Mr. Shields came to
embrace them, especially the use of modern historical criticism in interpreting
Scripture.
In his mind, this changed Christ’s message
from one of sin’s redemption to pure love. But his was a minority view, and it
set him on a radical path at odds with his bosses. He was transferred from his
first parish, in Vancouver , and then barred from
preaching and teaching at his second posting, in Austin , Tex.
After only four years, he walked away from
the priesthood, forlorn and distressed. The decision cost him not only his
faith, but also his purpose and livelihood.
But from that difficult time emerged two
loves. One was Madeleine Longo, who had worked with him in both places and who
soon became his wife. The second was the wild and rugged landscapes of British Columbia , Vancouver ’s
province.
In 1969, the couple moved here and Mr.
Shields found a job as a social worker. His first clients were unwed pregnant
women, many of whom wanted illegal abortions. He put aside any vestiges of
Catholic doctrine after he heard their anguished stories. For Mr. Shields,
nothing was black and white.
He eventually became a manager, but was
not satisfied treating problems at what he called the “discharge end of the
social injustice pipe.” As a seminary student, he was active in the civil
rights movement and had met the Rev. Dr. Martin Luther King Jr.
He wanted transformational change.
Mr. Shields successfully ran for president
of the British Columbia Government Employees’ Union
— which over his 14-year tenure grew by more than 20,000 members to around
58,700. He was known as “the skipper” — a calm captain who was open-minded and
unerringly ethical, but also tough. He was most proud of securing equal pay for
women in the union.
While his post-church professional life
surged with purpose, Mr. Shields’s search for existential and spiritual answers
was slow and meandering, often veering to the fringe.
He studied Gestalt therapy and picked up
dowsing, the art of divining energy with copper rods. Finally, a lecture by
Brian Swimme, a professor at the California Institute of Integral Studies,
changed Mr. Shields’s life. He became a spiritual cosmologist, believing that
the universe was conscious and that everything was inextricably connected.
“We come out of the universe to play a
role in the unfolding of the universe,” Mr. Shields wrote in his 2011 memoir,
“The Priest Who Left His Religion in Pursuit of Cosmic Spirituality.” “This
perspective riveted me. This is the opposite of meaningless. I come forth at
this precise moment to contribute my unique gifts to the great unfolding.”
In 1999, when Ms. Longo became ill with
lymphoma, Mr. Shields decided to step down from his union post and care for her
full time.
He was still grieving from her death, in
2005, when he met Ms. Hood, an environmentalist with a doctorate in
education who was 15 years his junior and had spent years working on human
rights in Central America .
She moved into his daffodil-colored stucco
house, at the base of a cliff. It seemed more a cabin in a national park than a
home in an old and genteel part of Victoria
locally referred to as “behind the tweed curtain.” Deer grazed on bushes nearby
and raccoons wandered liberally, enticed by the bowls of food and water set out
by Mr. Shields. Orcas could be seen in the ocean, just a block away, and beyond
that the white-capped peaks of Washington
State
Ms. Hood’s then-19-year-old daughter,
Nikki Sanchez, joined them and developed a close bond with Mr. Shields. Later,
he would refer to her simply as his daughter and write that her love was “one
of the most delicious gifts of a generous universe.”
Ms. Hood warned him that marrying her also
meant inheriting a tribe of female friends she called “the intertidals.” Over
the years, many would wash up on their doorstep after a storm, and move in for
weekends or longer.
One, an environmentalist and writer,
Briony Penn, had persuaded Mr. Shields to come out of semiretirement and help
steer The Land Conservancy, which was
heavily in debt. He was driving home from a conservancy meeting the day he
blacked out and crashed his car.
After the diagnosis, Mr. Shields retreated
into his study and fell into the throes of grief. As someone who treasured
independence, the concept of being trapped in his own body frightened him. He
searched on the internet for what he called “life-ending cocktails.”
From Birth to Death: A Doctor’s Gift
Three walls of Stefanie Green’s office are
collaged with the faces of hundreds of smiling, angelic-looking newborns that
she delivered over her 22-year career.
Until three years ago, she specialized in
maternity and newborn care with a side practice in circumcisions — which started
not because of her Jewish upbringing but because few local doctors were willing
to perform them.
To her, it was a matter of principle.
“It’s about choice — the same as MAID,” said Dr. Green, a 48-year-old mother of
two, referring to the medical
assistance in dying law. “Give people good information and let them do what
they think is best for their family.”
Dr. Green gives off the aura of a
university volleyball team captain — warm, competent, no frills, no makeup,
nothing hidden. Last year, she took bridge lessons with a group of
octogenarians at the local seniors’ center and now plays weekly.
For family reasons, she took time off and
decided she needed a better life-work balance than the erratic schedule of
delivering babies allowed. A month before the new law came into effect; she
traveled to the Netherlands
for a conference on euthanasia.
“Birth and death, deliveries in and out —
I find it very transferable,” she explained one morning as she walked her small
white poodle, Benji, on a beach near her home. “Both are really intense and
really important.”
Many of her colleagues on Vancouver Island agree.
Off the west coast of Canada , Vancouver Island
has been ground zero for assisted suicide in the country. It was here that Sue
Rodriguez, a 42-year-old suffering from amyotrophic lateral sclerosis, or
A.L.S., began her battle to die with dignity in the 1990s, going all the way to
the Supreme Court. “If I cannot give consent to my own death, whose body is
this? Who owns my life?” she famously said.
The court sided
against her in 1993, ruling that the state’s interest was protecting life’s
sanctity. Less than five months later, Ms.
Rodriguez died in the company of a friend, from what the police called a
“doctor-assisted suicide” — although they never pressed charges. Seventeen
years later, other patients and lawyers in British Columbia picked up Ms. Rodriguez’s
case. This time, the Supreme Court struck
down the criminal sanctions against medical professionals who assist in
suicide and perform euthanasia in prescribed circumstances.
Under the new regulations passed by the
government, participants must be adults who are in an advanced state of a
“grievous and irremediable medical condition.” Their suffering must be
intolerable and their natural death “reasonably foreseeable” — meaning people
with long-term disabilities are not eligible unless they are near death.
Patients must also be deemed mentally capable of consenting to the procedure
moments before it happens. This stipulation is among the most debated parts of
the law since it automatically bars people with dementia, even if they give
advance consent.
Unlike in American states where similar
laws exist, the Canadian system puts doctors and nurse practitioners at its
center. They must not only determine whether a patient is eligible, but also
oversee administration of the lethal medication. Doctors are not legally bound
to participate, but in most provinces are expected to refer patients to
colleagues who do.
Many doctors have refused to take part,
believing that the law goes against their Hippocratic oath. Christian doctors
in Ontario
are taking their professional college to court, arguing that the requirement to
directly refer patients infringes on their religious freedoms. On the other
side, the lawyers who won the Supreme Court case have filed suit on behalf of
people suffering intolerably from illnesses that are not terminal. They think
the law should be expanded.
The public backlash many doctors feared
against the law never materialized. Still, most doctors across Canada who have
chosen to participate have done so quietly, even asking patients to withhold
their names from their obituaries.
The exception has been on Vancouver Island , where Dr. Green and many of her
colleagues advertise the service and publish
their email addresses and phone numbers online. They have formed a national organization on medically assisted
suicide and are holding their first conference in June.
And residents here have embraced it like
nowhere else. With a population of just 771,000, Vancouver
Island is the country’s retirement community as well as a hotbed
for alternative lifestyles. Of the 803 people across the country who chose
medical deaths in the first six months since the law passed, 80 of them were
from here.
Dr. Green and her colleagues have
witnessed how the law is changing not only the method of dying, but also the
rituals around it. Many patients are planning goodbye parties, requesting
special last meals and choosing to die at home.
“You don’t judge a civilization by its
riches, but by how it treats its vulnerable,” Dr. Green said. “I think this is
a mark of our humanity.”
She’s never understood doctors who say
offering lethal medicine goes against their training. “I think people go into
medicine because they want to help people,” she said. “This is on the continuum
of care of helping people.”
She and other doctors said that most of
their patients suffer more from psychological than physical pain. Just being
approved for a medical death can be therapeutic. For some, the knowledge that
they can control their exit translates into more peaceful final days.
The first death Dr. Green oversaw remains
her touchstone. The man was dying from liver failure and his family opened
their home for friends and neighbors to drop in and say goodbye. When he died,
they all held him, including Dr. Green.
“It was a beautiful event,” she said. “It
felt really like we were giving him a gift. It felt so good.”
Last October, Dr. Green participated in a
panel discussion about medical deaths in the little public recreation center
near Mr. Shields’s home. Sitting in the audience that day was Ms. Hood.
‘I Don’t Want to Suffer Anymore’
By the time Dr. Green paid her first house
call to the couple’s home three months later, Mr. Shields’s neuropathy had
progressed so much that his feet were permanently numb and covered in sores. He
wore leather gloves on his hands, which had also lost all feeling. His skin was
distressingly itchy. He could no longer swallow dry food. He vomited regularly.
When he noticed his wife and daughter were
shielding their torment about his declining health, he asked them to start a
new tradition. Every Wednesday, they would light the dining room candles, put
out the nicest hand-thrown pottery and silverware, and share their grief,
anxiety and anger with him. They also began to discuss the plans for his death.
The result, he said, was that they felt closer.
“What could be more meaningful than
planning for the end of your life?” he said.
He focused his energy on a workshop his
wife helped facilitate called “Living Well, Dying Well,” speaking openly about
his pending death and making new, intimate friends. While many people
approaching death become increasingly insular, Mr. Shields continued to expand
his world.
Still, he had not set a death date. He
expected to live through spring, and hoped to see summer blossoms emerge in his
garden.
One night in February, less than two weeks
after he was approved for assisted dying, Mr. Shields awoke in his favorite
maroon chair in the living room in a delirious state. He had fallen asleep
reading and missed a round of medication.
“He didn’t make any sense,” Ms. Hood said.
“He was totally incoherent.”
A nurse from the Victoria Hospice was
dispatched to the house in the middle of the night. She thought he had an
infection and put an intravenous catheter into his arm so his wife could
administer medications.
In the morning, it took three women — his
wife, his stepdaughter and a friend — an hour to guide him a dozen paces to the
washroom. One lifted each foot with her hands. They realized that he had been
in much more pain than he let on and that they could no longer care for him at
home.
Later that morning, he was settled into a
room in Victoria ’s
only hospice, an Art Deco, cotton-candy pink building on the edge of a
hospital. It opened in 1946 as a maternity ward and retains that ambience.
His family carted in pots of daffodils to
scatter around his room, along with some of his favorite books and CDs. They
loaded up the bar fridge with food and settled into the brown sofa chairs in
the corner to wait and worry.
A testament to Mr. Shields’s wide legacy:
A nurse on the floor had been one of his foster care cases from his time as a
social worker, and a counselor at the hospice was one of his oldest friends who
had worked with him back in 1971.
Three days later, Dr. Green came to check
in on Mr. Shields and tell him she was going on vacation with her husband. That
put the family in a difficult position. If Mr. Shields wanted to proceed with his
death, he had two options: schedule it for the very next day or in two weeks,
on March 24.
David Massel,
one of Mr. Shields’s doctors, signing forms to confirm that he qualified for a
medically assisted death. Credit Leslye Davis/The New York Times
“Can you imagine?” said Ms. Hood, sitting
on a couch in the hospice’s comfortable lounge. A half-finished puzzle had been
left on a nearby table and a guitar hung on the wall for general use. Tears
filled her blue eyes. “Your partner all of a sudden is going to die the next
day. It’s bad enough he’s going to die in a few weeks. But tomorrow? That was
too much.”
The scheduling was not the only agonizing
part of the decision. She also worried about Mr. Shields’s mental capacity. He
was not thinking clearly. That morning, he asked her if she had brought his
sleeping bag. He was going on a voyage, he said.
She was not sure if his confusion stemmed
from the disease’s progression or the cocktail of pain medication hospice
doctors had put him on. Either way, she worried that his lucidity would slip
further and that Dr. Green would not be able to perform the procedure.
“John is right smack in the middle of the
issue he was worried about — his ability to give consent,” Ms. Hood said.
This is the fine edge patients must
balance — stretching out the last moments of their lives before the option to
control their deaths disappears. It is a bit like playing chicken.
Dr. Green has had to disqualify a number
of patients who could no longer understand the gravity of the decision before
them.
“It feels like there should be flexibility
in the law, but right now there isn’t,” Dr. Green said. “Sometimes, it feels
cruel.”
Leslye
Davis/The New York Times
“I don’t want to suffer anymore.”
John Shields
Over the next few days, Mr. Shields’s pain
got worse and worse. None of the usual treatments worked. For the first time in
their decade-long marriage, his wife saw him cry. He became weaker. He lost
weight. And his mind continued to be murky. He could express his thoughts for a
few sentences, then lose them in a rush of words.
The hospice’s expertise was end-stage
cancer, not amyloidosis. Mr. Shields’s case was the first its medical chief of
staff had seen in his 20 years of palliative care.
Two weeks after Mr. Shields was admitted,
doctors tried lidocaine — a powerful local anesthetic commonly used by
dentists. For the first time in months, Mr. Shields slept through the night.
His thoughts became noticeably clearer.
Once impossibly and improbably far away,
March 24 barreled down like a speeding train. Family and friends who visited
him at the hospice felt conflicted. They knew this was what he wanted, but it
broke their hearts — particularly now that he seemed more like himself. One
moment, his niece wanted to rip off the remaining time like a Band-Aid; the
next, she longed to linger inside each precious second.
“This should be easier on me because it’s
predictable. But it isn’t,” said Donna Morton, who had lived in the family’s
spare bedroom for more than a year and considered Mr. Shields her spiritual
father. “I feel a little panicky.”
Buoyed by his improvement, his wife hoped
he might push off the date. But he did not want to. “No matter how I looked at
it, I saw pain,” he said. “No matter how I looked at my life from this moment
on, I see personal, physical unbearable suffering. I don’t want to suffer
anymore.”
He also felt like a pioneer. Recently, he
dreamed that he was sweeping up large shards of glass from a hallway, making it
safe for others who would pass that way after him.
The idea for a final party with fixings
from Swiss Chalet came to him because of the extraordinary kindness he had
received at the hospice — from friends and strangers alike. That morning, a
hospice volunteer gave him a pastel-colored homemade quilt, which was now
covering his lap. He wanted to spread some of that “loving energy” around.
“Besides,” he said, “I like chicken.”
Ms. Hood felt like escaping to the woods
to cry. It was her husband’s last night, and he wanted to have a party with
food from a restaurant they had never eaten at together. But this was one last
token of love she could give him. Putting aside her anxiety and sorrow, she
sent out an email invitation to select friends.
It was titled “John’s Farewell Party.”
“He wants to throw a party and I think, ‘Wow, you want to throw a party and all I want to do is cry in the woods.’”
Robin June Hood
Saying Goodbye. But First, Chicken.
On March 23 at 6 p.m., a heavy atmosphere
hung over the small hospice room aspirationally called a solarium.
No one knew what to expect from a living
wake, not even Penny Allport, the
life-cycle celebrant Mr. Shields had asked to help guide the party and preside
over his death the next morning. She was trained and certified for funerals and
weddings, but nothing like this.
Efforts had been made to convert what
normally felt like a doctor’s waiting room into a place worthy of the occasion.
A pale green hospice blanket served as a tablecloth over two adjacent coffee
tables, which were decorated with a vase of simple daisies and daffodils and
strewn with cue cards, each of which bore one of Mr. Shields’s favorite
quotations in colored ink.
“Tell me, what is it you plan to do with your
one wild and precious life?” – Mary Oliver
“There is nothing more mysterious than
destiny — of a person, of our species, of our planet, or of the universe
itself.” — Brian Swimme
A small electronic keyboard was tucked
into a corner and repurposed as a bar. On one end were bottles of a local Shiraz with “Rebellion:
On Your Own Terms” on the label. On the other was a chocolate hazelnut cake Mr.
Shields had requested. It came from a virtuous bakery, even by Victoria ’s hippie
standards — grain bought locally and ground in-house. The foil to Swiss Chalet,
it captured the opposite extremes of Mr. Shields’s personality.
People milled about in a nearby kitchen
area, taming their grief and nerves by pouring out bowls of nuts and chopping
apples. More arrived, bearing instruments and flowers.
At 6:12, two nurses wearing blue latex
gloves wheeled Mr. Shields into the solarium and plugged his medication pump
into a wall socket. He was sitting up in his giant humming airbed, a royal
purple shawl hanging around his neck like a towel after a tennis game.
It was as if a switch had been flipped.
With his appearance, the room’s heaviness lifted.
“You think I’m only going to have one
portion?” Mr. Shields said when presented with his plate of Swiss Chalet
chicken. Laughter erupted around him.
His stepdaughter, Ms. Sanchez, pulled his
favorite black-brimmed skipper’s hat down over his brow.
Once he finished his meal, Ms. Allport
began the farewell ceremony. Tall with long, wavy brown hair streaked with
gray, she had the posture of a yoga instructor, which she had been for years.
Standing behind him, she held up a white khata — a Buddhist prayer scarf — and
instructed each guest to place a verbal blessing in it for Mr. Shields. She
called his death his “great blooming.”
“My name is Penny,” she said, pressing the
scarf to her chest. “I offer the blessing of courageous heart.”
The scarf was passed to Ms. Hood, who held
her husband’s hand and looked into his eyes as she spoke.
“My name is Robin,” she said, her soft
voice catching in emotion. “I bring the blessing of community, of justice, of
peace and of having been the partner of a wise and beautiful loving man.”
The room was filled to capacity. Two dozen
people hovered over Mr. Shields, pressing themselves against the walls and
folding their bodies onto the floor. Others bunched by the door.
Dale Perkins, a retired United Church
The scarf traveled reverently from hand to
hand. Ears strained to catch each word.
“My name is Sarah,” said a dark-haired
woman with a deep voice, seated in a chair in the corner. “And I love you.”
A box of Kleenex was passed like a
busker’s hat at a variety show. Mr. Perkins pulled a handkerchief from his
pocket and mopped his face.
One after another, proclamations of love,
admiration and gratitude poured forth. They thanked their host for opening his
door when they were brokenhearted. They thanked him for his friendship. They
thanked him for his courage.
“I thank you for the gift you are giving
us tonight,” said Heather Fox, the grief counselor he met in 1971.
Time and again, Mr. Shields acknowledged
and thanked each speaker and doled out some tailor-made insight or joke to
lighten the mood. When a former colleague planted a goodbye kiss on his lips,
he unleashed more laughter with the quip: “I was just thinking, ‘I’d like to
see more of that.’ Then I thought, ‘That’s not a good idea.’”
Ms. Hood saw the priest her husband once
was, offering blessings and benedictions to his congregation. Union friends
remembered his speaking before giant crowds at rallies in the 1980s. “He has
never met an audience he didn’t love,” said Preben Skovgaard, his former chief
of staff and best friend.
Mr. Skovgaard found the public weight of
the moment too much and escaped to the hall for most of the evening. When he
was finally yanked by one arm into the room, he offered a loving roast.
“You’ve talked a lot about some of John’s
abilities,” he said. “I want to talk about one more. And that is, he has an
innate ability to piss you off.”
This was an Irish wake, without grief’s
frantic edge. Mr. Shields was still here, sipping his final glass of American
beer. Many looked over at him with wonder, understanding that he was offering
them one final lesson.
As the party wound down, Ms. Fox handed
out the lyrics to the Celtic folk song “The Parting Glass.” They
serenaded him.
But since it falls, unto my lot,
That I should rise and you should
not,
I’ll gently rise and I’ll softly
call,
Good night and joy be with you
all.
Mr. Shields was waning. He had already
tried to make a speech, but his mind wandered off script. This time, he hoped
to get through what he called the “verses of a special departure song.” He
closed his eyes. Eighteen seconds passed, until it seemed perhaps he had
drifted off to sleep.
“When we blossom forth into the night,” he
said finally, his eyes still closed, “what do we hear? We hear the silence of
the bees. We hear the brushing of the wind in the trees. We hear the whisper of
wind to branch and branch to wind. And we know that we are close to the end of
the journey.”
He opened his eyes. “And to all of us, who
have come together. You are seeing me get sad. It would never happen without
some sadness.”
He thanked his friends, one more time.
When they came to their death and they heard the song of the bees, he hoped
they were as happy as he was. “I’m welcoming you all to sing it with joy,” he
said.
At 7:40, the nurses arrived and unplugged
his medication pump. Mr. Shields waved to his friends as his bed was wheeled
out of the solarium. “I will see you later,” he said, smiling.
‘Who Could Ask for Anything More?’
The morning of Mr. Shields’s death, Dr.
Green took Benji for a walk on the beach before driving to the hospital
pharmacy to pick up the drugs for the procedure.
Patients have two options: They can drink
a cocktail of lethal medication, or they can have the doctor administer drugs
intravenously. Like nearly everyone, Mr. Shields chose the second.
The pharmacist had already prepared the
doses for Dr. Green. There were four drugs, drawn up into syringes. First, an
anti-anxiety medication called midazolam that puts most people to sleep
quickly. Then a small amount of lidocaine to numb the vein, followed by a large
dose of propofol — the anesthetic often used to ease people to sleep before
operations. The thick, white fluid filled two fat syringes the diameter of
quarters. Dr. Green always warned family and friends about the ominous size of
those needles before she started the procedure, so they were not frightened.
The propofol would put Mr. Shields into a
coma. The final drug she would inject into his IV catheter was a paralyzer
called rocuronium. It stops all movement.
Dr. Green would administer doses of saline
after all but one of these drugs, to make sure they completely entered Mr.
Shields’s system.
The pharmacist gave Dr. Green a second
dosage of everything, in case she needed to restart the protocol. That has
happened to her only once. It involved a younger patient, whose heart took 19
minutes to stop — nine long minutes more than average. Since then, Dr. Green
has set a limit. If a patient’s heart does not stop 15 minutes after she
administers the propofol, she starts the entire procedure again, just to be
sure.
The pharmacist packed the medication into
two blue boxes, like the ones construction workers use to carry their lunches.
Dr. Green took one in each hand.
Another doctor on Vancouver
Island admits she has trouble sleeping the night before a
procedure. One other has her partner drive her home afterward — she is so
emotionally drained.
Dr. Green has neither of those problems.
She was well rested and happy heading to the hospice that morning. If she felt
jittery, it was only because she was double- and triple-checking the procedure
in her mind and making sure she was ready.
She took the elevator to the third floor
and walked down the hospice’s beige hall to Mr. Shields’s room. They talked
intimately for a few minutes. She asked him if he still wanted to go ahead. He
did.
She was convinced that he was of sound
enough mind to make this decision. He signed the last page of official
paperwork, confirming that he had been given the chance to change his mind and
that he still wanted to go through with this.
Dr. Green instructed a nurse to set up his
intravenous line while she slipped down the hall to go over the procedure with
his friends and family.
She assured them that his death would be
peaceful. He would simply go into a deep sleep and might even snore. But, if at
any time it got too hard, they should leave the room. “There are no medals for
staying,” she said. “There’s no judgment for leaving.”
Mr. Shields had asked five people to be
there: his wife, his stepdaughter, Mr. Skovgaard, Ms. Fox and Ms. Allport, who
was overseeing his death ceremony. When they entered his room, Mr. Shields
greeted them with a smile. His blue eyes twinkled, matching a fresh aqua T-shirt.
The quilt of unexpected kindness was spread over his legs.
The room was dark and cool. The overhead
lights were off and one of the windows was open. Across its sill, an altar had
been fashioned with cedar boughs, smooth stones, eagle feathers, a small red
candle and a tiny bell. The emerald moss coating the limbs of a giant Garry oak
tree outside glowed into the room.
Since Mr. Shields could not die in his
garden, his garden had been brought to him.
A large white candle flickered on the
night stand beside him. The hospital tray that had held his meals for the past
two weeks was pushed to the side. Upon it was one of Dr. Green’s blue boxes,
and eight syringes lined up neatly in a row.
The group formed a circle around Mr.
Shields, with his wife at his head, touching his shoulder. He asked her what
was happening, and she recounted what Dr. Green had said about the procedure,
adding that he should go toward the light.
“Sounds perfect,” he said, giving a thumbs-up.
It didn’t sound so perfect to her, she replied.
It was as good as it was going to get, he said.
Ms. Allport began the ceremony she had
designed with input from Mr. Shields and inspirations from a mix of cultural
traditions.
She opened her arms wide, turned to each
direction of the room and related it to Mr. Shields’s life. The east was the
wind on which his beloved eagles fly. The south was fire and the snake shedding
its skin, as he soon would. The west was water, filled with whales that passed
his house. The north was the trees, like the thousands he had protected.
She had taken the bell from the windowsill
and rang it between each turn, its tone bouncing lightly from the walls.
She called up to the sky and the heavens,
and crouched down on the floor, thanking the earth for carrying his body for 78
years.
When she finished, she paused. There was
not a sound in the room.
Mr. Shields, she said, would need
ancestors to help guide his journey. They needed to be summoned. She asked
everyone to mimic a movement she noticed Mr. Shields making recently: two hands
placed on the heart and then swung open like saloon doors. If the names of
ancestors came to their minds, they should call them out.
Ms. Hood whispered the names of his
father, mother and former wife, Madeleine.
Mr. Shields opened his eyes and quietly
said Rumi, the 13th-century Persian poet.
Ms. Sanchez held his right hand in hers,
sobbing. Her nails were painted metal green, accentuating how pale his numb
fingers had become. One of his regrets was that he could no longer feel a touch
like this.
His wife leaned over and told him his love
had been radiant. When she finished, he said, “Thank you, my darling.”
Mr. Shields then began singing a refrain
from an old Gershwin Broadway tune: “Who could ask for anything more?”
The others joined in. “I got daisies, in
green pastures. I’ve got my man. Who could ask for anything more?”
The singing came like intermission during
a heartbreaking movie. Mr. Shields was delighting in life, right to the end.
The ritual held the moment’s solemn structure; he was adding some human
lightness. He did not seem afraid.
The day before, when Ms. Allport asked him
if there was a poem he would like read, he asked for a Catholic one: The Prayer
of St. Francis of Assisi .
Standing at his feet, Ms. Fox unfolded a
copy. “Lord, make me an instrument of thy peace,” she began. Mr. Shields
mouthed the words silently. He had left Catholicism almost five decades before,
but Catholicism had not entirely left him. It was as if all the disparate
strands of his life were being woven into this final moment.
Where there is hatred, let me sow
love;
Where there is injury, pardon;
Where there is doubt, faith;
Where there is despair, hope.
“I think I’ve learned that lesson,” he
said, when she finished.
For all of his openness and shared
emotions, Mr. Shields was a stoic man. But when his wife told him that fires
were burning for him on different islands, and that native elders were playing
drums for him farther north on Vancouver Island ,
he closed his eyes and wept.
He talked about his father and his mother.
In his life, he said, he had come to believe that everyone shared the same
cosmic energy.
“We are all one,” he said.
He thanked everyone for their kindness.
The sound of cars passing in the street below echoed up faintly through the
window. Hands touched shoulders and hands.
Dr. Green leaned over and quietly asked
him if he was ready.
By then, Ms. Allport had laid the white
khata from the night before across Mr. Shields’s neck. His eyes were closed. He
opened them and slowly scanned the faces around him, taking in each one.
“Are we ready, friends?” he asked. He
turned his head to look at the doctor. “Yes, Stefanie,” he said. “I am ready.”
She took the first syringe from the table
and screwed its tip into the IV catheter on the tender side of Mr. Shields’s
left arm, then pressed its plunger down.
He closed his eyes. His face relaxed. He
appeared to go into a deep sleep.
The only sound in the room was his
stepdaughter’s crying.
One after the other, Dr. Green went
through the syringes until none were left on the table. Mr. Shields’s body
remained still. He made no grimaces. The only change was a slight yellowing of
his face.
Dr. Green pulled her stethoscope from
around her neck and listened to his heart. It was still beating.
A few minutes later, she did it again. And
then, a third time.
Finally, 13 minutes after she had
administered the first medication, she nodded to Ms. Hood. Mr. Shields was
gone.
Going Home to His Garden
That evening, Mr. Shields’s body lay on a
stretcher in his backyard. A large purple sheet was draped over his face and
body, followed by a thick brown blanket — as though he had been tucked into
bed.
His favorite black hat with the skipper’s
brim had been pulled over his concealed brow, and a thin book of poetry slipped
beneath his pillow: “The Subject Tonight Is Love” by Hafiz, a 14th-century
Persian.
A beige canvas shelter protected him from
the sprinkling rain. Boughs of cedar, white currant and flowering plum hung in
bouquets from its corners, and its lip was decorated with prayer flags.
A candle flickered on a nearby table.
Friends sat in chairs that were placed around him.
For Ms. Hood, the best part of this new
way of dying in Canada
was also the worst part. The scheduling tormented her and organized her. While
her husband was intentional about his death, she was intentional about his
final rites. They would be administered at home, by his loved ones, and not by
the funeral industry.
She believed that her husband’s spirit
would stay with his body for two days before journeying on. So someone was
always in the garden with him — reading poetry, recounting stories or just
sitting silently, keeping him company until he was taken to the crematory.
Neighbors dropped off food, wine and cords
of wood for the fire, which burned continuously. At night, Mr. Shields’s
friends stood around it and serenaded his still body and memory. It was
spiritual and poignant, ritualistic and community-based.
“He would have loved it,” his wife said.
Those two days, the weather was fickle —
the rain gave way to sun, the wind to calm, and then it rained again. Flocks of
birds arrived. Deer and raccoons visited.
The majestic Douglas
firs swayed above Mr. Shields. His garden was wild and beautiful, just as he
had loved it.
