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the presentation, I am pretty certain this is what we are dealing with. And you did just have a double mastectomy. Sometimes patients are a bit confused after anesthesia. What do you remember?’

‘I remember everything. The mammogram. The ultrasound. Everyone rushing around like I was an infectious disease, just about to spread. Consents signed. God. I don’t know. I do remember seeing my brother and sister-in-law, and my husband or who used to be my husband, crying. I’m just so tired now. Everything has happened so fast. In the past month, I’ve almost killed my husband, almost drowned, been committed, and now this. I just want to sleep, be left alone. So, what is it that you want?’

He sat, head bowed, hands on both knees. His hair, like a boy’s, falling forward into his face. She watched as he stood and walked over to a computer terminal set on a mobile stand, typing in instructions. Soon images appeared on the screen. He turned the screen towards her, pointing out areas with his index finger.

‘See here and here? These are patches on the CT scan that might be metastasis so we need a test called a positron emission tomography, or PET scan to make sure. Like I said, this is one mean cancer and we have to be aggressive. We also need to get a bone scan, more blood work, and then we’ll start you on treatment as soon as possible. There are protocols to follow, clinical trials. You’re relatively young, healthy, so you should do fine. We can’t cure it but we can slow it down. You will be able to live a good life, possibly with remissions. And we can treat recurrence as they appear. Every day we are learning more and finding new ways to treat metastatic breast cancer. It isn’t as hopeless as it once was.’

Jet had reached over and laid her hand on Clair’s arm. Clair didn’t seem to notice. She stared at the ceiling, as though looking for a sign.

‘Will I die if I don’t take treatment?’ she asked, eyes still on the ceiling.

He had walked back over to her, sitting on the side of the bed, his hands folded in his lap.

‘Well, I can’t say for certain, but statistically, the odds are not in favor of your surviving for longer than a year to eighteen months.’

‘Good. I don’t want chemo or radiation,’ she said, shifting her gaze to Dr Ellerby. ‘I won’t do it. I want death with dignity. Just give me the goddamn pill.’

* * *

The family meeting took place in Clair’s room. She sat cross-legged in the middle of the bed, her hair brushed back, revealing a face drawn and tired. Two drains snaked down on either side of her body, serosanguinous fluid coursing down, gathering in small plastic bags that sat on the bed. She tucked them both under the bright colored fleece blanket covering her lap.

Adam stood quietly in the corner, arms crossed, leaning against the sink. He looked so out of place, Clair eyed him curiously, as though seeing him for the first time. Ben and Jodie sat side by side on the window seat. Dr Ellerby sat next to her bed, along with a palliative care nurse named Lorraine. Her psychiatrist, Dr Rebecca Bernstein was there, presumably to attest to her ability or inability to make a rational choice, given her status as a committed person. Clair had spent more time with Jet than the psychiatrist but felt safe with her, nonetheless. Jet sat on the other side, in eye shot, but not part of the circle of family.

‘It’s your party,’ Clair said to Dr. Ellerby, holding out her hands as though offering herself and these people to him.

He in turn looked at Lorraine. She nodded. A woman in her late fifties, she had the look of a nurse who had seen every possible good and bad thing that could happen to a person, and still maintained her equanimity and hope.

‘Clair, family, our focus for this meeting is to help clarify what is happening, what you hope will happen, and how we can support your own goals for your care and life, going forward. Now, Clair, first, what is it you understand about your situation?’

‘My situation is that I don’t have time for any of this, Lorraine, and I do appreciate your support here, but given my situation, I just really don’t need, want, nor will I participate in this. I have made up my mind and that’s that. I do need information. On how to obtain the death with dignity pill. If you can provide me with that, great. If not, I can find out on my own, through the web, of course.’

Lorraine didn’t ruffle. Outside the window, a mourning dove cooed. Clair wondered, what is she mourning? Not my life surely. This unit is full of people worthy of mourning. But not me, not a woman who loses her child, her special needs child, to a wild and cold ocean. That woman doesn’t deserve any of this. Not these kind people, not this family, not even this husband who seems determined to forgive her for trying to kill him. She welcomed the pain in her chest, masking the pain in her heart. Lorraine’s voice brought her back.

‘OK, I can provide you with some basic information. First, you will need to acquire a primary care physician who will write the initial request for you to be considered for death with dignity. Then, once that is done, a second physician will also need to review your case, talk with you, and ascertain that you are rational, not depressed or suicidal, and that you do have an illness that is terminal and will ultimately cause you a degree of suffering that cannot be managed with traditional treatments. Now, all this will take time. You don’t currently have a primary physician, do you?’

‘No, I don’t. Other than maternity, I’ve never needed a doctor. So, I’ll just sign up.’

‘Again, it isn’t

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