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8 months ago
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Rod Stewart’s ‘Forever Young’ played in the background as a dozen people gathered under twinkling lights and drank champagne and tequila.
The family and friends were gathered around the host, Dr Yolanda Martins, who was throwing her own goodbye party. But the 45-year-old wasn’t taking a trip or moving.
On that day in July 2018, she was going to die.
Dr Martins sat in the corner of the room in a plush velvet chair, with her guests weeping, reaching out to touch whichever body part they could.
A cocktail of drugs were then delivered via IV, which would slip Dr Martins into a coma, stop her heart and end her life.
Just before the first medication traveled through her veins, she said: 'I couldn't have asked for a better send-off.'
Eight months prior, Dr Martins had applied for Canada's Medical Assistance in Dying (MAiD) - a policy that allows anyone with an incurable medical condition to die by assisted suicide.
Dr Yolanda Martins applied for Canada's Medical Assistance in Dying (MAiD) because she was in constant pain from her rare condition - lymphangioleiomyomatosis (LAM)
After her diagnosis, the once-adventurous woman felt 'tethered to Earth' and could no longer partake in any of her favorite hobbies
For three decades, Dr Martins had been suffering from a rare and incurable condition, called LAM, that causes cysts to grow in the lungs and obstructs breathing.
After being approved for MAiD and organizing logistics to donate her body to science, she threw her 'death party.'
For years Dr Martins was unable to lead a normal life - she slept for 19 hours a day, couldn't work and had to move into her parents' house.
The academic and researcher who used to jump out of planes and swim with sharks could now barely leave the house and was exhausted - both physically and mentally - from battling her disease.
She had been living with the incurable disease for three decades and decided she would rather end her life painlessly than continue to have her health deteriorate and be in constant agony.
Dr Martins' MAiD case was among several detailed in the book 'The Last Doctor' by Dr Jean Marmoreo and Johanna Schneller.
Dr Martins' MAiD case was detailed in the book 'The Last Doctor: Lessons in Living from the Front Lines of Medical Assistance in Dying' by Dr Jean Marmoreo and Johanna Schneller.
The patient arrived at her death party at a friend’s house dressed in a blue kimono, leggings and velvet slippers.
Not far behind her was a tank hooked up to tubing that supplied life-sustaining oxygen to Dr Martins, who struggled to breathe.
The hearse and funeral home attendants waited outside for her to die so they could take her body to the hospital to retrieve her organs.
When it was time to begin, Dr Martins settled in a velvet chair in the corner of her friend’s living room.
As part of the process, there were a few last formalities to check off a list: 'I’m now going to ask for your consent,” Dr Marmoreo said.
‘You’ve been diagnosed with a rare lung disease. It’s in an advanced stage. You’ve been told your alternatives. None are acceptable to you. You are suffering as a result of your condition. 'You are requesting assistance to die,’ the family physician rattled off.
She listed out the five drugs to be used to end her patient's life.
Then she asked: 'You know this will result in your death. I will then call the coroner. Do you want me to proceed?'
Dr Martins gave her consent for a final time and left her guests with 'her last quote:' 'I'm surrounded by love and peace and I've never felt more sure of my decision.'
The process began at 10:40am as people crowded around her, crying and reaching out to hold on to whatever part of Dr Martins’ body they could reach.
In San Diego, Betsy Davis (center) was suffering from Lou Gehrig's disease, also known as ALS. The 41-year-old threw a two-day party to say goodbye to friends and family before she would take a deadly dose of drugs and end her life in 2016
More than 30 people attended the event. People played instruments, sipped on cocktails, ate pizza and watched one of Ms Davis' favorite movies
Ms Davis was then wheeled to a bed on a hillside where she took a handful of medications prescribed by her doctor that ended her life
By 11:23 am, she was declared dead.
LAM is a painful disease that almost exclusively impacts women - affecting about three to eight of every 1million, primarily of child-bearing age.
In Dr Martins' case, she had hundreds of cysts growing in her lungs, taking up air space and leaving her struggling to breath.
LAM is often misdiagnosed in early stages as asthma or pulmonary disease and there is no known cause.
A lung transplant and supplemental oxygen can help alleviate symptoms, but there is no cure and the life expectancy is only two years after diagnosis.
Like thousands of others unwilling to live any longer with a deadly condition, Dr Martins was one of the more than 21,000 Canadians who have opted to die via MAiD since its passage in 2016.
Euthanasia, assisted dying or physician-assisted suicide is legal in many countries, including parts of the US (it is still illegal in the UK) and as more people exercise their right to die on their own terms, similar death or euthanasia parties, life celebrations and living funerals have become more common.
In San Diego, Betsy Davis was suffering from Lou Gehrig's disease, also known as ALS. The 41-year-old threw a two-day party to say goodbye to friends and family before she would become one of the first patients in California to take a deadly dose of drugs and end her life in 2016.
More than 30 people attended the event. People played instruments, sipped on cocktails, ate pizza and watched one of Ms Davis' favorite movies.
At the end of the weekend, friends said goodbye and gathered for one last photo. Ms Davis was then wheeled to a bed on a hillside where she took a handful of medications prescribed by her doctor that ended her life.
In Canada, the granddaughter of an 88-year-old with sepsis who was in extreme pain threw her grandmother an ‘assisted suicide party.'
Susie Adelson wrote for Toronto Life in 2019 that a dozen friends and family gathered in her grandmother's room at Sunnybrook Health Centre for ‘a deathbed party.’
Sonia Goodman swiped on her bright red lipstick and laid in her hospital bed as guests gathered around her while Mozart and Bach played in the background. The room was decorated with drawings by her great-granddaughter and champagne was shared.
A doctor administered a series of drugs to make Ms Goodman fall asleep, relax her muscles and stop her heart.
In 2019, a 68-year-old grandfather — also from Canada — suffering complications from his worsening diabetes threw a death party before undergoing a medically-assisted death.
In Canada in 2019, Susie Adelson threw her 88-year-old grandmother with sepsis who was in extreme pain an ‘assisted suicide party'
In 2019, a 68-year-old grandfather — also from Canada — suffering complications from his worsening diabetes threw a death party before undergoing a medically-assisted death
Dan Laramie’s gathering was filled with live music, food, whiskey and cigars. At the end of the celebration, nurses arrived to administer drugs that would kill him.
Canada’s MAiD is widely considered one of the most permissive assisted dying policies in the world.
At first, only people with terminal illnesses whose natural death was reasonably foreseeable — known as Track One patients — were eligible to apply for MAiD.
But in March 2021 the legislation was updated to create Track Two patients. These are defined as people who suffer 'intolerable' and 'irreversible' disease or disability who may not be near natural death.
In 2022, data showed 13,241 people chose MAiD to die, a 31 percent increase from 2021. This accounted for one in 20 total deaths in the country.
The controversial policy, which some worry will see people kill themselves out of desperation, was further updated in December 2022 so people looking to MAiD to end their lives solely due to mental illness will be eligible in March 2024.
However, earlier this year, Canada delayed the plan to offer MAiD to people suffering solely from mental illness.
Dr Marmoreo immediately felt compelled to participate in MAiD cases. When the policy was passed, she told herself: 'This would be my next job - and my last.'
She wrote in her book: 'I had long believed in assisted death, but I never thought it would happen in my lifetime.
'Now I could close out my 45-year career as a physician by helping people end their lives their way.'
Dr Marmoreo was contacted by Dr Martins in November 2017 for a MAiD consultation at a friend's home.
More than 21,000 Canadians have opted to die via MAiD since its passage in 2016
Dr Martins said in 2017: 'For years now, I’ve felt tired all the time. My lungs don’t open and close the way they should, so my muscles are always tight. My body is stiffening because I can’t move around freely. I can’t get comfortable. My sleep is horrible.
'Sitting in a chair is work. Projecting my voice is work. I don’t like background music anymore because I have to talk over it. It’s hard to bend forward because my diaphragm is so tight.
'I can’t make my bed anymore. I can only wear flat shoes. I struggle to follow conversations.
'I don't feel happy. I don't feel depressed. I feel nothing.'
She could no longer cook for herself, go out on her own or travel.
Dr Martins added: 'A long time ago, I promised myself that when I couldn't travel, when I lost interest in it - when I lost interest in participating in the world - that's when I would know it's time.
'It's time for me to say goodbye. My body has been fighting this disease for more than half my life. I'm ready to stop fighting.
'This is my path. I’m going to die from this disease. There’s no saving me from it. The only question is "Will I have a peaceful death or a terrifying one?"'
Dr Marmoreo said her patient 'wasn't afraid of dying... but she was afraid of suffering and of the pain her family would feel.'
Death was certain for Dr Martins - the lifespan for LAM was just two years after diagnosis.
And after speaking extensively with her, Dr Marmoreo knew she was an appropriate candidate for MAiD.
But over the next several months, both Drs Martins and Marmoreo struggled with paperwork and logistics. Dr Martins wanted to donate her body to science for research.
This meant timing needed to be precise from the moment she died to the moment she would be in an operating room.
But weeks of dozens of emails between her extensive medical team, a transplant team, the coroner and funeral home left Dr Martins 'shouting for help as loudly as she could.'
She said: 'Westernized culture focuses on getting treatments — 'It’s available, try it!"
'We assume that more life is always the goal. But in my case, that hasn’t been the goal for a long time. I don’t want to keep living this way. The last two days it’s been so nice out, but I haven’t left the house.
'I don’t have the stamina to fill my own oxygen tank and put it in my walker. My life is a regimen of pills and exercises. What’s left for me is sitting in a home, fading away, and I’m going to skip that part.
'So now what I want is to relax and see the people I love, try to go to the beach, and be as free from a schedule as I can be. I want to be as chilled out as possible until it happens.'
Finally, everything came together and she died on July 31, 2018.
Dr Marmoreo wrote: 'I wouldn’t understand until later that Yolanda represented the best of my hopes for MAiD — that for the right person, it’s an essential component of care — and she also represented the worst of my frustrations with MAiD’s shortcomings. We’re doing a good thing. We have to do it better.'
She added: 'An end to intolerable suffering. A dignified, peaceful exit, honoring the patient, their values, and the meaning of their lives. A moment of grace. We all want that. I’m honored to help provide it.'
English (US)