A Last Reflection: Honoring a Patient’s Right to Choose

I often write letters to my patients who have died. For me, it is a way to process my experience and grief, recognize the impact that human life had on mine, and reflect on what I learned from them to make me a better person and a better physician. The following is an excerpt I wrote in a letter to a particularly impactful patient who has left this earth after utilizing medical aid in dying. 

“I have never seen two people approach this ending with such grace, thoughtfulness and intention. In ways it felt more like a wedding than a day of dying. The way you walked down the aisle- down the stairs from your bedroom, into your kitchen where I had the honor of giving you a great big hug, then watching your bride escort you along your beautiful sandstone walkway, with the help of your friends, to your final passage. Oh and the birds came too- I know you saw them. There were finches and towhees and so many other beauties. They came to the feeders to be near you and bask in your presence for those final minutes. You bravely took those medications- not with fear and trepidation, but with courage and hope. It was an honor to be invited into the raw and tender cocoon of that casita, where the love of your life held you through your transition. Your connection with her was so real and honest and true that without words, you said goodbye. And the moment you did, she knew. She blew you a kiss as you flew off on the breeze, with the winged ones racing after you. Never have I witnessed something so amazing. You taught me so much in our time together and for you I am truly grateful. I know that because of you, I will be better. And I will think of you often, and remember to take a big drink from life, and leave nothing behind. There is no greater gift than that- and you have given that to me. After you said your goodbye, the sky opened. The clouds clung to the mesa as mother sun came out to warm your tribe. And the sky became a dance- of light and dark, of wind and still. On display was the torment of your leaving, and the beauty you created and left behind. The whole Earth wept and mourned and celebrated you. And that’s what we will continue to do.”