“I want to die at home, surrounded by people who love me”

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For Dr Kate Granger, preparing for a ‘good’ death has allowed her to accept her diagnosis of incurable cancer

Kate and her husband Chris at the renewal of their wedding vows

Kate and her husband Chris at the renewal of their wedding vows

“Facing death is not something anybody ever wants to contemplate. But that is exactly what I’ve had to do for the past five years. At the age of 29 I had the perfect life. Happily married, successful career, great network of friends and family, beautiful home and in the early stages of planning to conceive our first child. My life was all I’d ever dreamed it would be. But all that was shattered into minuscule pieces when the cancer sledge hammer hit us, and we discovered my incurable diagnosis; a diagnosis that came completely out of the blue and destroyed our lives as we knew them.

As a doctor specialising in the care of older people I had some familiarity with dying. I’d sat and held the hands of patients as they drew their final breaths. I’d comforted families through difficult conversations around end of life care for their loved ones and their eventual bereavement. But now it was my own mortality that had come into a sharp, unavoidable reality.

The cancer was very aggressive and advanced; my kidneys had failed; I was in intractable pain. There really was no hope of cure no matter how optimistic your view. As a clinician I didn’t know any way to get through something so life changing, other than addressing it head on. Within days of discovering I had bone and liver metastases, I had made the decision that I did not want to undergo cardiopulmonary resuscitation. I wrote my Bucket List. I made a will. I started work on a memory box for Chris. I specified my end of life care preferences in writing. Attending to these practical considerations gave me a peace of mind that allowed us to accept what was happening, and then move on with living in the present with a degree of calmness.001

Thoughts about death often creep into my consciousness though. I wonder about what it will feel like, what symptoms I might experience and I reflect frequently on my personal vision of a peaceful, ‘good’ death. I’ve picked out my favourite music, particular candles with soothing scents and the books I’d like my Mum to read to me. I desperately want to die at home, surrounded by the people who love me. These preparations are designed to create an environment with comforting childhood memories, making me feel as safe as I can despite the horrendous circumstances.

However given my professional experience I know only too well that I may not achieve my serene death ambitions. I know that my symptoms may become uncontrollable at home, especially if I develop a bowel obstruction. I fear being bundled into an ambulance and carted off to hospital. I fear my eventual loss of independence. I fear not being strong enough to see it through to the end.

I have been extremely publicly transparent about my health problems by writing books and using social media. Looking back I think this is thanks to my inner teacher; I want to share my experiences to improve care for other patients. I felt so useless and lacking in purpose at the beginning of my illness. Getting my laptop out to write the whole sorry saga down seemed a natural response. I needed to process what I was going through and I wanted to emphasise how healthcare professionals’ behaviour impacts the people they look after. This project has now gone one step further, and I plan to share the end of my life on Twitter using the hashtag #deathbedlive. Unexpectedly I now have a huge social media following, and I hope one of my final legacies will be to promote a national conversation in society around death and dying by using this powerful voice.

I’m one of the lucky ones. I genuinely believe that. I have the support of an amazing husband, who has been there for me every single step of the way. He has made our lives truly incredible and I never know what the next lovely surprise might be. We are able to live comfortably in our own skins, with the lurking existence of the death gremlin, because we are honest and open with each other. Talking about death is never going to be an easy task, but Chris knows my wishes and I am absolutely sure that he will protect them right up until the end.

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