Opinion: Why I believe in an end-of-life option

Living with stage IV colon cancer, Elizabeth Wallner is determined to die with her faculties intact

June 24, 2015 7:30PM ET

by Elizabeth Wallner

Elizabeth Wallner is among four plaintiffs who recently sued the state of California, claiming a constitutional right to have a physician prescribe them life-ending medication. The suit comes as a bill that could legalize medically assisted suicide makes its way through the California Legislature.

It was never a question for me. I knew from the get-go that a slow, agonizing death was too much – and unnecessary. Now, I am more resolved than ever to have control over when and the condition I am in if cancer takes my life.

When I was a child, my 88-year-old grandmother was dying in England. She had survived seven heart attacks and several strokes. At the end, she was weak, tired and kept alive by medication and sheer will. At some point, the will left her. Her doctor told her that if she stopped taking her medication, she would have between 10 days and a few weeks to live. She called my mother to come. She planned her funeral, paid all the bills and said goodbye to her loved ones. Ten days later, she died peacefully at home with my mother by her side. Hers was, in all ways, a good death after a good life. She could have lasted several more months if she had continued the medication. She was an amazing woman. I still miss her and admire her strength. I loved her. However, it was never a question in my mind – then or now – if the doctor did the right thing. It was her choice.

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In March of 2011, I went in for a routine sigmoidoscopy – a test that checks inside one's colon and rectum. It was far from routine! The doctors said it was inconclusive and I needed further testing. Three days later, they did a colonoscopy, and I was diagnosed with colon cancer.

I was 47. I was a single mother of a teenager. Life became a whirl of fear, medical appointments, phone calls to loved ones and a very steep learning curve. In “staging" my cancer, doctors did a CT scan and discovered lesions (tumors) in my liver. My cancer turned out to be stage IV. My beloved son was only 15, and here I had 18 months to live. But the doctors never told me this plainly. I asked if it was going to be a very bad year. Did I need to make plans for my son? They said I did need to make plans for my boy. Their best guess was 18 months for when those plans would be needed.

In short order, I began chemotherapy that rocked my world. Every three weeks, I went through an 84-hour chemo session. I worked with a chemo pump strapped to my body. Beep. Whoosh. Beep. Whoosh. All day and night for 84 hours. After six rounds of that, a partial colectomy followed. Then came six more rounds of chemo.

At this point, I could not touch anything cold. Picking up a carton of milk sent shockwaves through my hands. I had to drink from a straw. I began to look like a hamster, as fine blond hair appeared across nearly my entire face. Seriously! My eyelashes and eyebrows looked huge and black! Every morning, I had to pry my eyelids apart; the lashes were so long they knitted together. My mind was as fuzzy as my face, with a horrible memory and a hard time tracking conversations. I was, of course, nauseated and weak.

After that, it was time for a liver surgery known as a hepatectomy to remove a lobe that showed lesions. However, upon opening me up, the doctor found there were far too many lesions to do a hepatectomy. Instead, he did four hours of radioablation. Then, came more chemo and another liver surgery that removed about a third of my liver. I was done! … for eight months.

A check-up in the winter of 2013 showed that the cancer returned to my liver and in the lower left lobe of my lungs. Another liver surgery and radiation on my lung. I was done! … for 10 months.

Then in January, tests revealed that the lung tumor was not dead and there was another tumor in my liver. The doctors did cyber-knife radiation (OMG, that was awful!) on my liver and radioablation on my lung. That was two months ago. I do not know if it all worked. I do not know if the cancer is dead or I am waiting for another round of “Whac-A-Mole cancer”.

In addition to all of the above, I did reike and acupuncture, ate turmeric and tons of kale, drank green and dandelion teas, consulted John of God, did Journey work, read Dr. Wayne Dyer, Louse Hay and the autobiographies of cancer survivors. I take a handful of vitamins and minerals daily and drink quarts of fresh vegetable juice. I consume only organic foods, grass-fed beef and milk, and free-range chicken and eggs. I do anything that anyone tells me is good for fighting cancer.

All of this is a long way of saying: I do not want to die!

I desperately want to meet my daughter-in-law, hold my grandbabies and act too young for my age at 80. I want to help my aging parents’ transition into their next journey; I want to spend more time with my siblings. I am not done.

However, I also remember crouching on the bathroom floor, vomiting for what felt like the 700^th time after a round of chemo. My son was there helping me. I looked over at his face and the anguish and pain there was unbearable! My son has seen enough. My son has done enough. He lost his high school years to cancer. He lost all sense of security in the world. My adored son and family have seen me in pain, weak from chemo or surgeries and exhausted from this fight for far too long.

After one liver surgery, my lungs began to fill with fluid. The doctors took me to surgery to install a drain. I felt it. I was literally screaming from pain on the surgical table! Because of this, I do not have faith that palliative care is as effective as I once believed. Palliative sedation is the use of medication to reduce a patient's awareness and “relieve otherwise intractable suffering at the end of life.” If the doctors cannot keep the pain at bay during surgery, I really do not believe they can at the end of my life. The idea of being in pain but not being able to let anyone know due to medication is a horrific idea to me.

I am immeasurably grateful for the place that cancer has brought me. I am closer to those I love than ever before. As Gilda Radner said before her death from ovarian cancer, “If it weren’t for the downside, everyone would want to have it.” I am more present in my daily life. I have walked some dark corridors and I am happy where I have come out.

What I know is that if the cancer comes back and all the kale and chemo in the world won’t beat it back again, I want to be in control of my ending. I do not want to be in agony. I do not want to be scared in my last days. I do not want to lose my ability to recognize my son, to hold his dear hand, to listen to his stories. I definitely do not want my son’s last memory of me to be one of vomiting, agony, fear and diapers. I want to be in my bed, looking out at my garden, with my son and my family around me. I want to live as long as I can live and then say goodbye with my faculties intact.