Meet the man who attended his own wake
After deciding to die on his own terms, John Shields made plans for his last day
VICTORIA, BRITISH COLUMBIA— Two days before he was scheduled to die, John Shields roused in his hospice bed with an unusual idea. He wanted to organize an Irish wake for himself. It would be old-fashioned with music and booze, except for one notable detail — he would be present.
The party should take up a big section of a nearby Swiss Chalet.
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. Shields used to meditate there twice a day, among the towering Douglas firs. “Someone once asked me how did I get to become unique,” he said. “I recommend meditation as a starting place — bringing your consciousness to bear.”
Shields intended to die swiftly and peacefully by lethal injection, administered by his doctor. In 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, 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.
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 saviour of a floundering land trust that included 2,900 hectares 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.
Green had become adept at brokering delicate family discussions over the past year. She had presided over 35 deaths since the law passed.
She arrived at Shields’s hospice room and helped them stitch a compromise. On March 23, the last night of 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.
Ayear and a half earlier, Shields was driving down a wooded provincial highway across the belly of Vancouver Island when he blacked out. His SUV crossed the centreline, plunged into a ditch and hit a tree.
Hood, who had been sleeping in the back seat, was violently thrown. She snapped five ribs and ruptured her spleen. Shields broke his back in three places. When he came to, he thought he had been paralyzed.
That he was not, and that they had not been killed or struck another car, seemed a sign to Shields.
But just a few months later, in fall 2015, a doctor summoned him to his office and broke the news. A biopsy of his heart, taken after the accident, revealed that 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.
The disease would likely cause him to lose all feeling and basic use of his arms and legs before shutting down his heart, Shields recalled the doctor telling him.
Vancouver Island has been ground zero for assisted suicide in the country. It was here that Sue Rodriguez, who suffered from amyotrophic lateral sclerosis, or ALS, began her battle to die with dignity in the 1990s, going all the way to the Supreme Court.
The court ruled against her in 1993, saying that the state’s interest was protecting life’s sanctity. Less than five months later, Rodriguez died in the company of a friend, from what police called a “doctor-assisted suicide” — although they never pressed charges. Seventeen years later, other patients and lawyers in British Columbia picked up 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 centre.
They must not only determine whether a patient is eligible but also oversee administration of the lethal medication.
On Vancouver Island, residents have embraced the law like nowhere else. 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.
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 Shields had asked to help guide the party and preside over his death the next morning.
Efforts had been made to convert what normally felt like a doctor’s waiting room into a place worthy of the occasion.
Apale 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 Shields’s favourite quotations.
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 Shields had requested.
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 p.m., two nurses wearing blue latex gloves wheeled Shields into the solarium and plugged his medication pump into a wall socket. He was sitting up in his giant humming air-bed, 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?” Shields said when presented with his plate of Swiss Chalet chicken. Laughter erupted around him.
The morning of Shields’s death, Green took her small white poodle, 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, Shields chose the second.
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.
The propofol would put Shields into a coma. The final drug Green would inject into his IV catheter was a paralyzer called rocuronium. It stops all movement.
Green would administer doses of saline after all but one of these drugs, to make sure they had completely entered Shields’s system.
A pharmacist gave 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 longer than average. Since then, 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.
Green was convinced that Shields was of sound enough mind to make this decision.
He signed the last page of official paperwork.
Shields had asked five people to be there: his wife, his stepdaughter, his best friend, a grief counsellor and Allport. When they entered his room, 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.
Later, Shields began singing a refrain from an old Gershwin Broadway tune: “Who could ask for anything more?”
Others joined in. “I got daisies, in green pastures. I’ve got my man. Who could ask for anything more?”
Shields was delighting in life, right to the end.
Green took the first syringe from the table and screwed its tip into the IV catheter on the tender side of Shields’s left arm, then pressed its plunger down.
He closed his eyes. His face relaxed. He appeared to go into a deep sleep.
One after the other, Green went through the syringes until none were left on the table. Shields’s body remained still. He made no grimaces. The only change was a slight yellowing of his face.
Green pulled her stethoscope from around her neck and listened to his heart. It was still beating.
Afew minutes later, she did it again. And then, a third time.
Finally, 13 minutes after she had administered the first medication, she nodded to Hood. Shields was gone.
That evening, Shields’s body lay on a stretcher in his backyard.
The scheduling both tormented Hood 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.
At night, Shields’s friends serenaded his still body and memory.
“He would have loved it,” his wife said.
Those two days, the weather was fickle. Flocks of birds arrived. Deer and raccoons visited.
The majestic Douglas firs swayed above Shields. His garden was wild and beautiful, just as he had loved it.