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Van life (cancer edition) finale (imgur.com)
678 points by BadCookie on April 11, 2022 | hide | past | favorite | 262 comments

This was a worthwhile read, and better if you start at the beginning:

#1 https://imgur.com/gallery/YICxS34

#2 https://imgur.com/gallery/305Y0Y0

#3 https://imgur.com/gallery/AlIWFQr

#4 https://imgur.com/gallery/Yow1ZhF

#5 https://imgur.com/gallery/I5tA9rI

#6 https://imgur.com/gallery/RvtN51h

#7 (finale, the OP) https://imgur.com/gallery/prUy1Kt

One easy thing to confuse if you start reading at #7 - the author is the 26yo woman, not the older gentleman in one of the pictures. There's a FAQ at the end of #5 but be sure to click on the "Load More Images" button at the bottom or it's clipped.

I hate to be that person, but after reading all 7 posts I am starting to question if this is fake.

I saw a family member go from diagnosis to death from stage 4 cancer and several things just feel off to me. The timeline of the posts, with an initial expected death by end of April, then extended to next winter then a sudden "routine scan" that brings to back to end of April feels odd to me. Her energy to travel, sleep without meaningful heating in a van during the winter, deal with a van that keeps breaking down, and generally be active is also confusing to me. And the feel good writing, over 7 posts, starts to feel repetitively vague.

> I saw a family member go from diagnosis to death from stage 4 cancer and several things just feel off to me. The timeline of the posts, with an initial expected death by end of April, then extended to next winter then a sudden "routine scan" that brings to back to end of April feels odd to me.

That is not odd at all.

You start off with a rough estimate based on the survival rates of other people with the same or similar diagnosis.

That's your first expected date. You start planning around it. (In her case, planning active measures to end her life while she could.)

Then you outlive it -- because after all, a median date implies people do outlive it. And that actually gives you hope and purpose which allows you less pain and perhaps even fewer symptoms.

And then a scan brings you right back to the median again, or much less.

Because the cancer isn't the diagnosis, or the scans. There are loads of other unseen variables.

This story repeats again and again; very few people die the way or when they expect to. A lot of people go suddenly after a long time of inexorable progress, some from secondary disease that can sometimes be avoided, and other people rally and then fade.

I wrote this quickly while I was trying to think back through the way I lost a relative to cancer, and I suppose this brief bit kind of makes no sense because it sounds non-linear:

"And then a scan brings you right back to the median again, or much less."

What I meant here is that the first diagnosis is not the last. Once you start doing well, other treatments become possible that weren't possible without extra evidence or without some remission. And they give you hope -- they extend where you think you'll get to; which life events you will see. You might get to a kind of remission that surprises even the doctors; they try to help you understand how long you might now have.

But parts of this are like Monty Hall -- some of the probabilities are new, but some are from the original diagnosis all the same.

The diagnosis isn't the cancer, and the lump of cancer they are watching might not be the offshoot that does the final damage.


My SIL was diagnosed with MM. At that time, the life expectancy was 6 mo - 2 years. And then thanks to being at the right place at the right time, she went into 5 separate clinical trials and lived 10 years. But then very suddenly, it returned and she was dead in a matter of weeks.

I'd hate to be that person too. This is how cancer progression can go. Friend went from 'years' to 'months' to 'days' in the space of a few weeks. The last bit went by so fast that I missed out on saying goodbye because he was already too far gone, we'd been on the phone a week and a bit prior to that and he was as good as could be given the prognosis.

Cancer is so variable. A friend of ours realised they were ill because their half-marathon time (which would have had a heart attack trying to hit) was way worse than expected. He was dead about two months later. Like your freind he went from looking "a bit peeky" but still going on cycle rides, to being barely able to talk in the space of a few weeks.

He and his wife are planning all the things they would do in early retirement. His death taught me an important lesson about not waiting too long to do the things you really want to do with the people you really want to be with.

Another of my wife's friend has been suffering from a cancer that was expected to kill her about two years ago but she just keeps going and surprising everyone. Cancer can be so damn capricious.

Not sure if involved. But Medication can wipe a person out. I’ve been on a few (not cancer) that left me in bed barely able to speak for weeks on end. Skip a couple doses and I’m about and fine.

Yep. Relative had surgery and was told it was at least buying a few months. Few days later, sorry no it’s growing very fast. 10 days later dead.

By contrast it took several years to kill my mother. Even the last days were long and protracted.

There seems to be a wide range of patterns as far as my own experience goes.

My father died from a glioblastoma multiforme. Median survival length for a glio is 11 months. He was diagnosed September of 2010. My father was in his late 50s, lifetime smoker, not particularly amazing or poor health before the diagnosis. He had surgery, chemo, radiotherapy. He died in March 2015. During that time he had occasional seizures and memory issues, but no progressive physical symptoms. We went to concerts while he was sick. He traveled. Other than the memory issues nothing was impairing his life.

The first sign anything went wrong at the end was a routine scan showing a small amount of growth 2 weeks before his death. The second sign anything was wrong was a phone call I got on a Friday where his speech seemed very tired. On Monday I got a phone call saying to fly home. He was awake but not especially alert when I got there. He died on Thursday or Friday.

So all that to echo that the trajectory of this person's illness is believable, whether or not the story is ultimately true.

My father also died from glioblastoma multiforme, diagnosis early May of '16. First sign anything was wrong at all was double vision, shortly after diagnosis he lost balance and quickly become wheel chair and then bed bound, his personality pretty much evaporated and he never was 'himself' again. He died less than three months later due to pneumonia he was unable to fight from taking chemotherapy. Early 60s, good general health though somewhat obese, never smoked or drank.

The doctors told us they had never had a GBM patient deteriorate that quickly. Watching somebody perish from pneumonia put it pretty close to the top of the list of ways I don't want to go.

In any case this is also to say that we don't want to make too many assumptions about whether a case is real just based on timelines. People can either blow right pass the timeline, line up with it, or perish very early.

My father died recently from sudden illness at a really very advanced age -- with some problems from dementia that never really got to the worst possible. I lost my mother to one of the worst cancers possible when I was much younger (again suddenly but in the process of a long terminal diagnosis).

So I half want to upvote you both for the points you're making about variable, unpredictable survival times after diagnosis, and half want to hug you both in sympathy for the way you lost your fathers. That must have been rough and I hope you have found the support you needed.

Likewise, it doesn't sound like you had an easy time of it yourself.

I knew a man in Australia. A really crude guy, but also very sweet and kind. My friends and i met him in 2007, and he drove us around in his classic convertible Cadillac. We learned he had been told he had about 6 months until cancer would kill him. I met him again in 2009, and he seemed about the same, with his oily black hair down to his shoulders. He shared his expensive wine cellar with me and my friends, and drove a dozen of us to the bar in the back of his box van. He still had a 6 month prognosis. I met him again in 2011, and he was bald. He had sold all of his classic cars, and he said the doctors were pretty serious about the 6 months that time. I haven't been back to Australia since, but presumably he's passed on.

Yeah, it happens. My uncle had stage IV “you’ve got about six weeks” bowel cancer for 15 years. It got him in the end - his kids grew up with “dad is going to die soon” for their entire lives to date. Not easy.

Friend of mine's dad had 6 months to live, for 12 years. Same deal. Leukemia eventually got him.

> "he drove us around in his classic convertible Cadillac"

/checks username/... of course it's you :)

I only met him in 2009 and didn't not interact with him much... I remember mostly that car, and that he was happy to trade my US$ for AUS$ (daughter was making a trip to the US soon?), thereby solving my "how do I find time to do currency exchange" on that trip!

Lol, nice catch. I really do wonder about Steve's fate.

I'm prepping for the upcoming ASC event in July, as a scrutineer though. 1 week of solar car racing once a year is just the right amount. :-)

> My flight to [undisclosed sensible European country]

It's not the scan that brings it back to the end of April - she's planning euthanasia.

"I’m planning a little road trip through some of Europe, given I seem to have been gifted more than my allotted time. I’m thinking ferry across to France, drive through Belgium, Luxembourg, and maybe Germany, and then finishing in Switzerland. Yes, finishing."

From the 6th post.

Ah, ok, that explains the bit about not wanting her relatives to be prosecuted in the UK. Why can't we just let the dying die their own way?


> The timeline of the posts, with an initial expected death by end of April, then extended to next winter then a sudden "routine scan" that brings to back to end of April feels odd to me.

It feels like an odd timeline on one hand but is also all too familiar in the context of cancer — uncertain prognosis followed by respites of hope dashed again without warning.

He's planning euthanasia, he just want to do it before cancer gets him, so yeah if doctors suddenly says "you have couple weeks left" then it's either now or cancer will get him first


I was struck more by other inconsistencies; I can believe the changing prognosis.

She talks about losing her hair and getting a wig (although something about that wig selfie looks off), but then can be seen in the last post in multiple photos video and a with natural hair that can't possibly have grown that long since December.

She says she is homeless, and at one point has to sleep in a tent, but also says she has family in the UK (Grandparents are mentioned specifically).

One picture shows a bed in the van that was acquired from and returned to a charity shop, and being replaced but a wooden platform, but no such platform appears in any subsequent photos of the van interior.

Not having enough money for fuel or vehicle repairs, but having enough to pay for assisted end of life. (Perhaps that was always being kept in reserve).

And other little things. So I have no idea. Maybe it's all true, and I'm seeing things that aren't there, as I don't know why someone would go to the trouble of making all or part of this up.

I agree that the wig selfie is processed in some way that makes it appear fake, but I think the hair pictures aren't necessarily inconsistent. She may have only lost chunks of hair rather than all of her hair, which seems sort of consistent with the swimming picture in the last post. The other hair picture further down on the last post looks like a wig to me.

Pictures may not have been supplied chronologically.

Seriously: the number of people that can be counted on to should 'fake' at any kind of story that is outside of their personal experience is a bit tiring.

Keep in mind that absolutely nobody has anything to gain by being found out to be 'the girl that faked having cancer' with their face and half their life's story out for the whole world to relate to. That doesn't mean fakes do not happen, but what it does mean is that absent hard evidence shouting 'fake' is just another low brow dismissal.

And there is plenty of evidence that proves that it is a real story, including hospital pictures, pictures of the vehicle, pictures of her in happier times and so on. Skepticism is fine but let's not overdo it.

Some of us read every post, top to bottom, end to end, including those missing from the chronology. You decided to refute any criticism, clearly without taking the time to read even one of the original posts.

You didn't even bother to read the post you responded to, or you'd realise it was essentially supporting your uninformed position. You have a made a name for yourself by being vocal, but it takes more than that. Step up or step out.


I assumed the pictures and video was from a time "before".

Stage 4 means cancer has spread to multiple organs.

But all cancers are not the same.

For example Lance Armstrong had stage 4 testicular cancer that spread to his brain in 1996.

Then won all those bicycle races.

One thing often not mentioned in stories about Lance Armstrong is that he didn't go to a doctor until he was coughing up blood. This was despite having symptoms for quite some time. He mentions this quite clearly in his autobiography.

In other words, had he gone to a doctor earlier, it's quite possible he would have had a "routine" testicular cancer diagnosis with a much better prognosis and recovery.

I mention this because testicular cancer is more common than most people recognize and his story should be more a testament to "get checked early and often" vs "look at the power of the human spirit!".

I'd vote this up to the top if I could - this is all so very true. I'm a testicular cancer survivor myself, and I did the self exams and caught it early.

Caught at its earliest, testicular cancer is basically curable with a 99% 5 year relative survival rate. Even if you catch it early-ish, you're still looking at 96%. The odds take a big dive to 73% once it spreads. [1]

The self-exam is exceedingly easy to do, and once you get the hang of it you can do it in maybe a minute or two in the shower with near zero impact to your routine/schedule. [2]

[1] https://www.cancer.org/cancer/testicular-cancer/detection-di...

[2] https://www.cancer.org/cancer/testicular-cancer/detection-di...

Perhaps. Even if it was, there are enough stories that did play out exactly like this for real, so I don't suppose it terribly matters much. Being aware of something being fake becomes most relevant if people start soliciting donations etc.

The author does solicit donations via cashapp in multiple posts. Also links to an Amazon birthday wish list which is pretty bizarre...

They also wouldn't do gofundme and their Amazon wish list has wigs and camping gear on it.

I really don't think that they're doing this for the money.

Why is that bizarre?

I assure you, her course is not unlike many I see in my patients. Cancer prognosis is, by necessity, an inexact science of probabilities. More, Stage says little about progression and much about prognosis. In essence, it just describes metastatic spread which, depending on where you stand on treatments, may manifest in a multitude of different forms.

I have patients who, days before we "refrained from heroic actions," had been skiing in the alps, running a marathon, or gave birth to a child. And I have patients who, for months, waste away as we can do little but soothe the pain and provide comfort.

It's messy, strange, inexact, and different from patient to patient.

Felt the same way. Was a bit flummoxed how she has the energy to do anything and was able to maintain her weight like that. Terminal abdominal cancer makes that all but impossible.

I was surprised that she doesn't look ill at all. Not even any weight loss to speak of. I don't know much about these things, but surprising nonetheless.

The sensible European country also makes me think this is very subtle and excellent astroturf for euthanasia.

You mean a sly marketing campaign?

A friend from some years back went to a sensible European country.

It doesn't work the way you are suggesting.

who in the world do you think is astroturfing for euthanasia

People that can profit from it?

Planned parenthood evolved from the eugenics movement.

Environmentalists and anti-natalists, would like less people on the planet.

I’m sure there is a list of people and groups who don’t mind the population thinning itself.

> I’m sure there is a list of people and groups who don’t mind the population thinning itself.

Note that if you have terminal cancer, and expedite your demise by a few months, that's not really the "population thinning itself."

People should be able to do what they want. This includes, if they're of sane mind to make the decision, stop living.

This is a plainly weird position to take.

I don't know how you imagine this working, but you should read about the Dignitas operation and the legal and policing framework in which it exists.

I’m disabled and live in Canada where we have medically assisted suicide as a legal option, and some people who are disabled and mistreated by the government that ignores the plight of the less fortunate, feel that government views disabled people as a burden and it would be preferable for society or government for the disabled people to just choose to end their suffering.

Not sure if I believe that, but it sort of makes (twisted, dark) sense.

This is absolutely the primary non-religious argument against euthanasia, and it's a serious one; what happens to the priorities of a healthcare system that "prices in" assisted dying?

Discussions like this have even happened around the Liverpool Care Pathway in the UK.


I don't really know how I feel about it, except to say that my once-strong certainty that I (as someone with no dependents) would choose such a route has been softened by witnessing the astonishing care and dedication in end-of-life care even in a very overstretched NHS.

I just don't think it's fair to suggest that there is a European end-of-life-care industry that would "astroturf" this discussion; those are not the ways in which it operates.

Many of the largest proponents of euthanasia (organizationally and financially) require diagnosis with a terminal illness.

For now.

Once the practice is normalized, there is potential for the concept to be broadened in availability to anyone who wants it. Then we are only one step away from mandating it for certain people or groups.

It’s not like eugenics is a new concept!

Abortion has been around for a while and no one's out there trying to abort pregnancies in their last trimester. I don't think everything is necessarily a slippery slope.

I can think of worse causes to try this for.

I totally support the cause, I'm mostly curious about who the commenter thinks is doing the astroturfing work on its behalf.

You might be missing a couple of posts:

5a: https://imgur.com/gallery/2CCOhv6

5b: https://imgur.com/gallery/4lDUI2f

Not sure why they weren't part of the numbered sequence.

Bloody hell, that Winnie the Pooh quote got my eyes watering. I see people in the comments questioning whether the story is real but, regardless of that, I do want to compliment this woman's style of writing. It's not overly grim, not saccharine "everything is beautiful". Very matter of fact, very bittersweet.

Cancer is a terrible thing and I hope we beat it one day. I'm glad she at least had the NHS covering her expenses because I cannot imagine how gutting it'd be to deal with the loss of a loved one compounded with debt.

May her last days be as devoid of fear as possible.

The original Winnie the Pooh stories are genuinely wonderful. If your only exposure is the Disney version I thoroughly recommend reading them.

I've always loved the way that the other animals treat Eeyor.

I agree, the original stories are something very special. The Disney movies are very hit or miss - the ones which stick close to the stories are generally good renderings of the original tone. The 'cash grab' holiday themed ones are generally awful.

There are moments in those stories that made my kids and I laugh out loud - Eeyore is such a funny character. Him drifting down the river in the "Pooh sticks" story is a mental image that still brings a smile to my face.

Until you experience this simple way of traveling, it may look like an uncomfortable thing to do. My girlfriend has Chronic Fatigue Syndrome and loves traveling this way, where she would often be bedridden at home for days, when traveling she can at least be in a natural park, listening to birds, waking up by a tawny owl, see deer and foxes pass by the car without noticing you. Life becomes simple and you're so much closer to nature. Even with sub zero temperatures and no heating at night, with the right gear this is still very doable. Of course you have to go to places with low population density and be mindful of your surroundings.

What are the costs like per month/year?

Van investment: from $5,000 to $175,000, but more likely $20,000-$50,000.

Maintenance: $2500/yr.

Insurance: $300/m.

Gas: $150-$400/m, depending how much you drive.

Camp site fees: $0-50/day.

Food: $100/m.

I think the bigger question is, what does it cost you to give up on your dream?

"It depends". You might find a lot of additional costs, depending on what you want and need to do. Small things that are taken for granted when owning a house, might start adding up quickly.

For example: when, for your job, you must receive packages, and post, additional costs for renting several post-boxes might accumulate. Satellite internet when you must have connection at all times, will be expensive. Simple things like a hot shower or garbage disposal might suddenly cost you a few €s each time. Space limitations means you'll have to do small shopping rounds, several times a week, often at smaller (and more expensive) convenience stores. Things like "a monthly subscription at the local gym" are not possible, so you'll be paying per-hour instead, often more expensive. When something in your car breaks, you'll need the fastest, closest and often only mechanic to look at it ASAP, far, far more expensive than the cheapest-goto-mechanic downtown, you found for your Yaris¹. Electricity, when available at e.g. campsites, is sometimes 100x more expensive per kWh than what you'd pay in, say, an appartment in Madrid.

And so on. Living from a van is limiting -which also makes it worthwhile!- and often those limitations make costs go up.

Source: I travel (edit: a few months per year!) through Europe in my T3 van while doing freelance programming.

¹ edit: allthough my oltimer is easy to fix myself, quite often: a bit of ductape, some WD40, a tie-rip or a bang with a hammer and all runs again. And then, I've found many a mechanic who would gladly help for a beer or a bottle of wine, and for the fun of kicking an old car, instead of his daily routine of connecting-readout-computers-to-toyota's.

Spot on. That insurance number is for the average van investment so if you start out with a $5000 van like I did you will pay closer to $300 a year for insurance.

In case it isn’t obvious, this budget includes like one meal eaten out per month if that.

Difficult to say as it depends on the region and distances you are going to travel. We often do this for a couple of weeks with the longest trip being 2 months, while traveling from Northern to Southern Europe where we spend the winter at a rental villa. Biggest cost is the occasional hotel or apartment to freshen up. Otherwise just fuel + food.

I am in the same boat as this woman, probably got a few good months left. I am planning self deliverance with helium as soon as symptoms become significant. For now I am just checking things off my bucket list and trying to have as many adventures as possible (I am an outdoor adventurer and a software engineer).

Any advice or thoughts about life to those of us carrying on? No worries if not, I just figure someone in your position can be more honest than most.

Either way, thanks for sharing and I hope things go as peacefully as possible for you (and you get some adventures in there).

I know a larger than life man who is now very old. Years ago, he assured me that he would go the helium route himself, as soon as he realized his mind was slipping. I wouldn't be surprised if I hear that news any day now, although it would be quite sad news. He has many grandchildren and great grandchildren, and thousands of people like me that had the pleasure of knowing him. Perhaps you two will bump into each other in a spiritual realm, and swap stories of sailing and computer history!

This is my first time hearing of Helium. Does it have any advantages over Nitrogen?

If someone barges in asking what you're doing, you'll get a good laugh out of them?

I'm really surprised that people think Nitrogen is laughing gas. I thought everyone knew 80% of Earth's atmosphere is Nitrogen.

I meant because your voice would be high pitched from the helium...

Availability? Helium at any party store, but I thought you needed to do something illegal or jump through hoops to get laughing gas

Laughing gas is nitrous oxide (N2O). I'm talking about normal atmospheric Nitrogen (N2). Nitrogen is available anywhere and significantly cheaper than Helium. Nitrogen can be used for welding or for brewing certain types of beer.

My father died recently from cancer. He was doing well until his blood iron just dropped out. He was taken care of by the hospice so well.

They do an amazing job of making the end peaceful.

I wish you many great adventures

Sorry to hear this.


What an outright evil thing to say to someone. I think you do yourself, and, whatever religion you may have been indoctrinated into a great disfavour by not actually learning about your faith.

Most religions don’t actually forbid suicide anymore than they forbid a lot of other things like wearing leather pants. The fact that organised religions still make it more tabu has a lot more to do with controlling populations through faith than what is actually written in your religions texts.

And it's always about how others should live. I'm perfectly ok with people deciding for themselves that they want to live by scripture x, y or z but then they invariably want others to live by their scripture as well.

I'm not religious but a good analogy for a believer would be telling someone to eat limes to stave off scurvy.

If you had a cure would you just keep it to yourself so you don't "tell others how to live"?

I'm not religious either, but a better analogy for a believer would be telling someone to pray or sacrifice a goat to stave off scurvy.

If you really believed some nonsense, sure you'd want to not keep it to yourself, and to tell others how to live. But that wouldn't actually be a good thing, despite the believer believing it was.

I believe a better analogy would be telling someone to put on some leeches to stave off the Black Death.

No, a better on would be "dont drink from that well or you'll get dysentery" before anyone knew of the microbiology.

You twice used examples where a "believer" has (at least observational) evidence to support that belief.

Some of organized religion has roots in that (some of the Jewish dietary laws have practical basis), but much of the prescriptions of organized religion is preference-based rather than evidence-based.

Observational evidence nobody else believed.

That still makes it testable in a way purely faith-based restrictions are not.

"to the believer"

I know it's tough, but try and picture from someone's else perspective.

Now try picturing it from the someone else’s perspective who isn’t a believer.

No, that's not a good analogy.

There is evidence for eating limes to stave off scurvy.

This is why you're so upset, you didn't even read what I wrote.

> This is why you're so upset

On the contrary, I'm not upset at all, do you claim to be able to read minds?

> you didn't even read what I wrote.

I actually did, and responded to it. Your analogy is a bad one.

No, you didn't read my comment or you would have noticed I said "a good analogy for a believer".

Not everyone views the world the way you do, so you shouldn't judge their actions or motives based on your world view.

Are you talking about the same religions that exists on planet earth? because in our earth suicide is prohibited even in many non-religious Ideologies. It's one thing to feel with the pain of others, but another thing to glorify or defend things that shouldn't be.

The Christian bible doesn’t condemn suicide. Most of the mentions were written in a period where society didn’t combine suicide with something inherently bad. Even in the more recent parts you can see Mathew praising the suicide or Judas because it was better than living with the guilt.

Obviously organised religions have found ways around what’s actually written in the bible, and you won’t have a hard time finding Christian’s who think that not killing includes yourself. That is an interpretation though, and unless God spoke to you personally to clarify it, then it’s frankly a lot worse for you to judge someone than to leave that sort or stuff up to God. Even if you are on some misplaced quest to save souls then Jesus already has you covered by dying for your sins.

Contrary to what you may think I don’t have a problem with religion, but I do think people who use religion to spread hurt are assholes. Considering that religious texts were written, selected and curated by people I frankly think it’s on the individual to interpret them. If your interpretation leads you to harassing dying people then you should stop and become a better person instead.

In all forms of Buddhism, suicide is one of the karmically worst things you can do

So what about Sokushinbutsu?

You going to tell me that all these hardcore monks were actually breaking a core tenet of their religion?

Guilt tripping people who are already down based on what you personally believe in is pretty bad form.

This is actively harmful and despicable behavior.

I hope you reflect on your need to hurt other people in your search for spiritual comfort.

It's moments like these, when facing your own mortality, when the mind starts looking for something bigger. To some it may be religion, for others it could be something completely different.

I think a lot of people feel similarly although it is maybe not the first thing that comes to mind, but to me, music is one of those things that carries an inherent immortality in it. Music is able to touch us emotionally like not a lot of other things can. Listening to a beautiful piece of music can be very inspiring, and in can also give comfort. It has this feeling of an eternal beauty, I find, it's hard to put in words.

Just think of it this way: We will not all die, but we will all be transformed! It will happen in a moment, in the blink of an eye, when the last trumpet is blown. For when the trumpet sounds, those who have died will be raised to live forever. And we who are living will also be transformed. For our dying bodies must be transformed into bodies that will never die; our mortal bodies must be transformed into immortal bodies.

Life is short for all of us. Don't put off living.


Partial to the Louis Prima version https://m.youtube.com/watch?v=n7VT2EHa0b4

Since nobody's posted it, The Specials cover: https://www.youtube.com/watch?v=6liD8TdlJFA

While we all think of the 'right to die' or 'live life to the fullest', we should also think about how we can stop metastatic cancer. As I continue to read on the biology of cancer (due to several family illnesses), it seems so strange how epithelial cells not only bypass cell growth restrictions, but also migrate and survive in places in the body it shouldn't be in. How do tumor cells create a micro environment and thrive? How can we disable this?

Although tumor cells vary wildly, my gut feeling is there may be a few commonalities we can surface that can slow down metastatic progression. Car-T cell therapy doesn't seem to be the way forward. Keytruda and immunotherapy seems more likely. Can we do better?

Where is a good place to start reading for someone without a medical background, unfortunately my mum has received a terminal diagnosis in the last week.

I honestly don't have a reading recommendation but I just wanted to comment my mom also received a terminal diagnosis. She went on to live a number more fulfilling years and we made some fun memories in that time. I do genuinely hope things go as well as they can for you and your mum. <3

I have been reading "Molecular Biology of Cancer Mechanisms, Targets, and Therapeutics" by Lauren Pecorino, Fifth edition.

As a complete layman, I read Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee and found it interesting, especially with respect to how little we know about cancer, even today.

You can think all you want. It won't matter. We are not remotely getting closer (my sister is a VP ops at a major biotech/pharma firm - she provides me with sober sanity about such things). Cancer is not one thing - it's like saying "food is just one thing; how do we replace/control food". Well the goal is far too complex to even have meaning. The easier path is "How do we accept death?"

You WILL DIE. I WILL DIE. And it might be cancer or it might be stroke or heart attack. No one gets out alive.

My SIL dies of MM metastasis - dead within 1 month of discover of this after 10 years of "successful" experimental treatments. My father died of SSC metastasis within one week of discovery.

>> The easier path is "How do we accept death?"

These discussions are not mutually exclusive. We can accept death for ourselves, and also make effort in to studying and finding new data points for these serious diseases.

Meta subject but I owned a Fiat Doblo and it was a write off at 35k miles. Never buy one. The things are money sinks. If you want van life buy anything else.

I've gone across Canada in a NV2500, and it went well but in retrospect I should have gone with a Ford or GMC

If you're in the middle of nowhere and something breaks, a Ford or GMC will be easy to get parts for and repair vs another brand

Sad. We need to cure cancer. Delete the disease from the source code of reality.

I won't respond to midwit cancer-is-good-actually responses.

Yes I agree. I have an unpopular opinion: I don't want to die. I wish I could live a 1000 years. I wish I could be immortal yet able to die when I decide so. Somehow these ideas are considered madness/evil by most people. I think they are just unreachable rather than evil and people play the Fox with the grapes (https://en.wikipedia.org/wiki/The_Fox_and_the_Grapes)

Not sure why in movies the guy whose looking for eternal life is evil and usually have to gain eternal life by killing others. I respect life, my own and the one of others, sacrificing others to extend my life would not be acceptable.

Ya know in the recent Pirates of the Caribbean films the character Captain Jack Sparrow is essentially pursuing eternal life in each movie. I wouldn’t say he’s the “bad” guy that kills others but he does make some questionable ethical choices at times.

I don't think that's a very unpopular opinion. Pretty much every religion gives you hope that you will not cease to exist, that death is just a transition. Some of them even promise you everlasting life on Earth. And that's a very strong motivation for their adherents to keep believing.

Those are all lies though! :D

I would rather increase my life-expectancy of 5 years with science than believing in an immortality based on religions whose fundamental books are full of things we have disproven.

Bible "on the seventh day God ended his work which he had made; and he rested on the seventh day from all his work which he had made." No dude, if there ever was a god it would have not taken 6 standard rotations of our sun around our planet. There are billions of stars in our Universe, our Sun doesn't matter to God, home sapiens alone wouldn't particularly matter to God. That story is just completely nonsensical once you know basic astronomy.

So given how ridden of easily disprovable things are religious books, why should you trust them about anything at all? You shouldn't.

Throw away the fairytales books from thousands years ago and stop brainwashing next generations with it.

> Somehow these ideas are considered madness/evil by most people.

The way I see it is that we play a game with a set of rules, these rules are mostly unbreakable, I believe that wishing to break these rules is a one trip ticket to continuous disappointment. It's like wishing radio waves didn't exist, no matter how much you'll want it to happen it won't.

I think we should compose with what we have and make the best out of it instead of continuously wishing to have more, if not cancer it'll be dementia, cardiovascular disease, an accident, &c. you might tweak things here and there (vaccines, medicine, healthy lifestyle) but you'll never escape the inevitable; I actually don't believe most people really wish to live longer, there are many ways to lengthen/optimise your lifespan/healthspan and it is obvious that the vast majority of people aren't putting any effort into that, what's the point of living to 1000 ? we can already live to 90 but most people let their body rot well before they get to even half of that

I understand that nobody wants to die but it's a fact of life, it doesn't matter if you want to be immortal or not, what matters is how you approach death, do you let it consume your every thoughts or do you make the best of your time while awaiting it peacefully. Do you take it like a toddler: "I want Y !!!!" or like an adult: "X is happening, it is out of my control, I have to handle it and my the best out of the situation"

> No man can have a peaceful life who thinks too much about lengthening it. Rehearse this thought every day, that you may be able to depart from life contentedly; for many men clutch and cling to life, even as those who are carried down a rushing stream clutch and cling to briars and sharp rocks. -Seneca

From a health and lifespan perspective, we've been breaking these rules since the advent of modern science and medicine. 'Natural' things like incredibly high infant mortality and the death of the mother during childbirth are now relatively rare in developed countries. 150 years ago, a family may have accepted that 2 of their 7 children wouldn't live to age 18, but that's because they were ignorant of what is possible. More of a Stockholm syndrome than a rational belief.

Agree. It is my conclusion after a lifelong pursuit of knowledge, that life continues on the so called other side. We mess with the entrance and exit of this world at our own peril. I have myself been very close to death. So I know what it feels like. Do not let the fear of pain choose your path - and even inflict death on yourself or others. As a stoic myself, I can only support listening to Seneca. Life is precious. But do not cling to it. Live life and have passions. But do not get caught up in them.

> play a game with a set of rules, these rules are mostly unbreakable.

Our longevity isn't some fundamental law of physics.

Our longevity isn't the speed of light or absolute 0F.

There isn't written anywhere we are supposed to die at 20 or 40 or 100 or 1000.

I agree.

Come over to r/transhumanism mate :)

Don't mind if I do! :D

ah sweet immortality

Tell Helen Lacks that.

You mean Henrietta

Yes, I do.

"When the sun goes down, the stars come out."

A beautiful way of signing off reminds me of Bowie's Blackstar album.

"Something happened on the day he died. Spirit rose a metre, then stepped aside. Somebody else took his place and bravely cried, "I'm a black star, I’m a star’s star, I’m a blackstar"

-David Bowie

I would highlight this paragraph: "A wise man once said, disease intensifies narcissism, especially if it is terminal. Interpreting that as advice rather than critique, I’d like to be self-indulgent for a moment, and share what I hoped my life would be. I trained as lawyer, and had wanted to go into human rights. Things don’t always turn out the way you expect, and I ended up in corporate law, living a lifestyle unworthy of myself, and making the world worse year on year. On a dark day, I sometimes wonder if this is the universe’s way of balancing the wrong I did. I tried my best to be a good and kind person, but ultimately, I know my job was one that made rich motherfuckers even richer. I’m sorry."

Nobody lies on their deathbed wishing "oh, but if only I'd been able to increase my employer's stock shareholder dividends a few percent more...". Go live your life before it's too late.

> Nobody lies on their deathbed wishing "oh, but if only I'd been able to increase my employer's stock shareholder dividends a few percent more...".

I'm reminded of this: https://pbs.twimg.com/media/B5-lDJWCUAAwfya.jpg

> Nobody lies on their deathbed wishing "oh, but if only I'd been able to increase my employer's stock shareholder dividends a few percent more...". Go live your life before it's too late.

Plenty lie on their deathbed and worry for the financial well being (among other things) of loved ones being left behind. You can’t take it with you, but it would be nice f your kid didn’t have to worry about affording college.

I'm more worried about leaving my kids in a world that will face widespread famine at this point.

But they might lie on the deathbed wishing "oh, I wish I'd made more money so I could've bought a house by the beach, that convertible Mercedes 190 SL, travelled more, eat more fine food, and been less afraid of splurging on expensive marvels of art and engineering".

And someone else might have told them:

And you think those things would make you happy? A "convertible Mercedes 190 SL" and "expensive marvels of art and engineering"? You trully didn't learn much your first time around...

I have a non-terminal, but life limiting illness. I've got an expensive and silly car, and it brings me great joy whenever I drive it (like when I drove to the office this morning!). I haven't sacrificed other things that would bring me deeper fulfilment to own it though, and I think if that's the case then yes, silly material things can bring you some happiness.

Without my illness I'd probably be saving the money instead, so that I could have silly material things in retirement. Because I know that my retirement is likely to be a struggle I do these things now while I can still enjoy them.

I am naturally a relatively frugal person, and I don't like to waste resources. I like to reuse and repair things of value. I don't like to buy new things unless I really need or want them. My wife says I am the hardest person to buy gifts for.

I don't regret buying a new Mustang within a week of starting my first job out of school. I'm still driving it 12 years later, and my 3 year old loves it. In 2020 the nerves on my heart failed, and on night 4 in the ICU I promised myself I would waste a bunch of money on building a Zen 3 desktop when it came out. I finally just got a proper GPU for it last week. Playing Titanfall 2 on max graphics settings at 80FPS made my evening.

I have every intention of living well into retirement age. All my doctors seem optimistic that I will, although I'm up to 5 specialists and was just today reading about how my latest medication inadvertently alters DNA to be significantly less UV-A tolerant... As long as I can afford it, I'm not going to sweat wasting money on hobbies or overpriced cups of coffee.

I think what people value is subjective. You might not care for cars, real estate, fine foods, art, or engineering - and that’s ok - but it seems perfectly reasonable to me that someone else might derive a lot of happy memories from those things. Especially when shared with people you love. They certainly wouldn’t make me less happy, that’s for sure!

Food is essentially an experience, and everyone tells you time and again, to pay for experiences not things. If you've enjoyed it, especially with others as you said, there's no way you've wasted that money.

>I think what people value is subjective.

Yes. Like taste. But not all subjective choices are good. McDonalds will harm you more than healthy food.

I think that McDonald’s is also fine in moderation.

There’s life-affirming value in those things, in fact.

Or, a person could be old and broke, and regret all the money he blew on toys when he was younger instead of saving it for a more comfortable old age. No easy answers, because nobody knows how long he will live.

Or just I wish I made more money so I could afford to have a wife, a house, and kids.

If those are important life goals, you sort of just have to trudge ahead and make it work without thinking about it too much. Otherwise it will never happen. Buying a house perhaps less so, although paying a mortgage rather than rent means you're getting slightly wealthier each month rather than poorer.

99% of everyone can afford a wife and kids as long as you don’t insist on the luxury version.

It's hard to find a wife who has any interest marrying someone who makes $1,000-1,500/month when you're in your later 30's, 40's or 50's. It's also hard to support a family on that income.

I know several guys in their late thirties to early fifties who make that much money, would love to get married and have kids, but haven't been able to.

I also know someone who made 65k a year but his wife didn't feel like that was enough to raise children on. I really think a lot more than 1% of the population where they feel like money is an obstacle that keeps them from having a family.

The old man lost his horse, but it all turned out for the best [1].

[1] https://en.wikipedia.org/wiki/The_old_man_lost_his_horse

The trouble with that horse story is that its message negates free will, and it's used to dismiss and short-circuit the entire history of the scientific endeavor to discern cause and effect. It's the perfect story for an age stooped under the weight of brutality, suffering and ignorance. Voltaire skewered its European version with his mockery, not coincidentally right when Western civilization truly began to emerge from mystical superstition. "All is for the best in the best of all possible worlds," says Pangloss.

Whatever inspiration can come from confronting one's own mortality, I'm all for it, but keep in mind, if you're not on your deathbed, you probably have rent due next month.

I had a near miss with illness six years ago, spent some fun time getting my affairs in order. At the same time, a close friend went from fine to a withered corpse in six weeks from aggressive cancer.

I decided to throw everything to the wind, bugger the consequences, as my worst and best realisation was that my own impending doom filled me with relief at the prospect of release from my grinding existence.

I still don’t quite know what was cause and effect, as my illness was spontaneous multiple organ failure for no good reason anyone could discern - but I resolved that if I lived, it would be to live, not to endure decades more of living death - and not long after that resolution, I improved, and found myself discharged, and incredibly grateful for the absolute basics of human existence - senses, mobility, possibility.

So yeah. I had rent due the next month, but I decided to go live in a cabin in the woods instead. It’s six years now. The sky didn’t fall - in fact, I have never been so content, or so healthy - and on a way, I did die in 2016 - at any rate, the person I had been for the preceding 32 years did.

Anyway. I ramble. My point was mainly that facing the mortality of someone close to you, or yourself, can have dramatic effects.

Happened to me, in ‘96. Brain tumor.

I’m still here. I have work to do. Got a lot done, since.

Whether or not it’s real, it’s a good story. I have known folks that have had similar stories. Last summer, I (and a bunch of friends) sat with an old buddy as he “pulled the plug,” and died from renal failure. It was sad, but it was also an Honor to have been part of it.

Reminds me a bit of this old gem: https://www.imdb.com/title/tt0097487/

That's quite the story! Fantastic to see you be able to turn your life around like that, some of what you wrote is eerily familiar to me, food for thought.

I stopped leetcoding after realising this a few years back lol

No, but someone might say "I wish I worked another few years to pay off the house so my spouse doesn't have to worry after I'm gone."

I struggle with how to respond, knowing this.

Corporate lawyers and their ilk are usually serving to hurt others because their employer want more and only that. This person actions, indirectly, could of caused 10x more suffering and cruelness in the world than the person parked next them at a waystation.

I think the lesson I took from this is, that if your path isn't leading to good for others in someway, you are on the wrong path. If you wish for a peaceful death, that nagging feeling of regret will tug at you, making that tranquility much harder to find.

Although it is completely your decision, I wanted to refer you to a contact at MSKCC who is developing mesothelin-targeted CAR-T therapy. It is worth calling or emailing to see if you could be considered: Roisin O'Cearbhail, MD 646-608-3742 cart@mskcc.org

As a pharmacist who works in research, if I had a refractory cancer, this is the kind of therapy I would want for myself as a last shot at survival.

I assumed it was the older fellow in the 4th pic, but I guess it is the younger woman since they say 26 years flew by at the end?

I also read it assuming it was the man but yeah it's the woman: https://imgur.com/gallery/305Y0Y0.

This is one example of many where a wrong diagnosis could destroy a life...

I'm sure OP wouldn't decide to end their life of it was a disease that'll cite itself.

It's a good day to cry, apparently

Very nice and emotional read. I cried.

> My flight to [undisclosed sensible European country] has been booked for 19 April, and all that remains is to say my goodbyes.

The implication being going to a country which has physician assisted suicide for terminal patients. No need to go to Europe for that, it's available in Oregon.

She is already in Europe.

To be fair, if I were merely vacationing somewhere right before I died I wouldn't disclose it either. Internet weirdos bothering me during my final weeks would be crap.

Fuck cancer

The only reason right-to-die isn’t something universal is because the dead can’t vote. They suffer immensely and the usual feedback loop that mitigates societal problems and suffering is cut off. So every day thousands of people suffer terribly for absolutely no reason at all.

Doctors will actually euthanize patients by giving them morphine. They can only legally do it if they are using it to treat pain. They slowly increase the dose as needed. They will hover over an unconscious patient and claim that they are in pain and therefore the morphine dose needs to be increased. They repeat this until the patient dies. It’s a workaround. Because everyone is selfish and stupid, nobody wants to confront reality and just formalize it.

It’s not that simple. Granting a right to die shifts a heavy burden of responsibility onto the patient. The current situation in most countries is that euthanasia is not legal. That means the patient’s family had a sense of obligation to support a terminal patient as best they can for as long as they can (and in geographies with universal healthcare “family” extends to a much broader definition of society). Granting the patient the right to die also puts them into a place where they have to make considerations about how much of a burden they are to those around them. The status quo allows a terminally ill patient to be selfish without guilt (well, modest amounts of guilt) because the alternative is illegal. It comes at the cost of undue suffering for many at the end. The alternative shifts this and risks people who’d have otherwise been able to eek out some continued enjoyment from what remains being forced into a thought decision out of a sense of guilt and obligation to not burden those around them.

It’s a complicated issue with lots of unsatisfying trade-offs. I’m personally conflicted about which path is better. It’s definitely not as simple as obvious as to which way is better that people want to imply.

Hard disagree. People already kill themselves. They already reason about how much of a burden they are and they already kill themselves because they think they are too much of a burden. People already do everything that you said.

The only major difference between the two worlds is that in one, death is grizzly, painful and traumatic and usually preceded by an enormous amount of suffering — and in the other death is none of those things.

You are clearly very naive and you clearly have never been in the position of needing to die.

I found his opinion enlightening and pointed, unlike your own, rather barbed, post.

Also, being in a "position of needing to die" isn't an absolute predicate for debating this issue.

Apparently it is because the only people who find themselves advocating it are people for whom the topic has become real rather than just words on a screen. Just like everything else in life. Nobody gives a shit until it’s their own skin.

>Nobody gives a shit until it’s their own skin.

I hope that your life improves and one day you can meet emphathetic people who do give a shit about others skin. Maybe that day, you can make good posts online.

Interesting. The fact that people already do kill themselves regardless of it being permitted or not seems to me to be an argument against legalizing it because it being illegal doesn't stop many people... but it may help them avoid being coerced into it.

I wouldn't care to argue that case-- I think assisted suicide should be legal, but the concern that the legality of it can lead to people feeling pressured into it seems quite legitimate to me.

There's a huge difference between attempting suicide and succeeding. Also, there are people who aren't physically capable of trying.

Legally forcing people to live just to suffer is wrong.

You're arguing we should force people to live against their will in terrible pain so that a few people don't have to feel guilty?

How many people have you watched die? By the time you get to the point anyone is talking about hospice or refusing life saving care that person's life has been nothing but misery, pain and suffering for a while.

This kind of comment is exactly why I'm glad you don't have the option of deciding that my life is not worth living.

I'm not sick or anything right now but people who say things like this terrify me.

Everyone is going to have to depend on other people's judgement sooner or later, and by the numbers, most people still think there is some kind of soul or afterlife, or at least don't assume there isn't! The only protection from people like that is for there to be no mixed messages and no option for them to commit what they believe to be mercy.

> I'm glad you don't have the option of deciding that my life is not worth living.

The comment you are responding to is not asking for the option to decide if your life is worth living. It is asking for everyone to have the option to decide for themselves if their own life is worth living.

> I'm not sick or anything right now but people who say things like this terrify me.

Things like what?

He is also saying that you don’t have that option either.

I made no such argument. I even specifically called out how conflicted I am in how to even assess what the right answer is.

To answer your question: numerous, with a multiple of that impacted in terms of the long painful witnessing of someone dying and/or carrying the emotional and physical burden of supporting the patient. Which is precisely why I am so conflicted.

Though I feel like your question was rhetorical and not an actual attempt to engage in understanding an alternate perspective.

Your experience must be vastly different from mine.

Did you have the experience where people were talking about end of life care before the afflicted individual was ready to go, and you believe if euthanasia were legal they would have pressured the individual to go through with it?

Yeah... if you continue that idea, you just might end up with a society where everybody customarily commits suicide at the age of 60 to avoid being a "burden to society", like in this Star Trek episode: https://en.wikipedia.org/wiki/Half_a_Life_(Star_Trek:_The_Ne...

This would greatly increase our ability to enjoy our earnings instead of having to save a retirement fund large enough to take us to 90. Sixty is silly, though; my parents do more for me than I do for them and they're 70.

> It’s a complicated issue with lots of unsatisfying trade-offs

I can't see it as complicated. The absence of a safe, legal exit for the terminally ill is unethical.

I understand that death affects more than just the individual passing, but that doesn't give anyone a right to force them to suffer.

If this issue is personal to you, I am sorry. It is for me as well.

Nurses will do it, too.

My Mother worked in the palliative unit and shared stories about how the staff regularly collectively decided to inform the patient that the button to administer morphine was in their control, and that they controlled enough dosage to peacefully end a person's life and so to be careful with it. Patients routinely ended their lives. This would have been in the late 80s, in Canada.

Since then Canada has legalized medically assisted dying; and I wonder if the increased regulation has made it _more difficult_ for patients to access it. No longer can a ward of palliative nurses simply opt to inform patients of their ability to die, but now those patients need the approval of doctors to do so.

Yeah this account of mine has been kept separate from my true identity as well as I could, but I think I've observed this when my SO passed. They were also in palliative care from cancer.

I'll never forget that last night, I slept next to them on an extra cot.

I won't go into details because of the survivors but my SO had a new machine that was keeping them awake.

They were suffering.

The nurse gave them a very strong sedative. They curled up in their favorite sleeping position and went to sleep. Just a couple hours later they stopped breathing.

At the time I was in shock but I remember thanking the nurses when we left the ward and calling them angels.

> to inform the patient that the button to administer morphine was in their control

Sometimes (I don't have a statistic) in Israel this is used for placebo effect. Patient doesn't control anything, but still might feel a relief.

Typically its not that they have no control, in the cases you're talking about, but the machines do have specified dose limits still. You can press the button as many times as you like, but it typically won't let you hit yourself with a gram of morphine or something. So in that case, I can see the button being an applied placebo effect.

Is there any reason why the new law would make it harder for the nurses to do that?

Probably because now that there is a protocol, an ethical nurse would feel compelled to follow it.

I recently heard about this in my stage 4 support group. No doctor will go on record that they do it however. God forbid there be dignity in choosing when to shuffle off the mortal coil.

Being a doctor must be tough. My brother is a doctor, though we aren't close or even on speaking terms. But I hear his tales via our mom.

A recent tale is that a family member got a bad cancer. Our mom called him to get the scoop, who he'll only give to her, apparently. He said 'Mom, she'll be dead in two years. She'll initially respond really well to treatment, then just get worse until the end.'

Doctors know these things, but many won't tell the patient because it's depressing, and also there's a tiny chance they're wrong.

Of course neither told said family member, and she's currently in the responding well phase. It's shattering hearing their hope, so I guess their doctor wasn't blunt either...

My mother spent thirty years in the OR saving cancer patients, so I know a thing or two about this topic. Different patients respond differently to treatment, life expectancy can vary greatly even in the terminal stage, so doctors are unlikely to know “she'll be dead in two years. She'll initially respond really well to treatment, then just get worse until the end.” Delivering that information when there actual is non-negligible hope left would be imprudent.

I think the pendulum might be swinging the other way - me and a lot of other folks in my stage 4 support group got given a very grim diagnosis and subsequent prognoses from our oncologists even though the 5 year survival statistics are outdated.

It was quite depressing in the beginning but after connecting with some people who have survived years past their onc's expiry date, I feel hopeful.

I'm hopeful for you!

Apologies if my previous comment was doom and gloom - was just thinking about the things doctors do and perhaps even know and have to decide... sounds incredibly stressful. But of course that was one specific case, and every case and person is different.

Anyhow, stay strong, and best of luck to you, truly.

> My brother is a doctor, though we aren't close or even on speaking terms

Given the nature of this post, maybe consider working on this relationship and at least getting back to the point of talking to each other.


Rereading what I'd written sounded awkward, I guess I was trying to explain it was third hand information without being evasive/mysterious.

Didn't mean it as a complaint or even bad thing. Last time we saw each other he kept making incredibly racist comments about and even to my (nonwhite) wife and kid's face - it was the first time they'd even met!

> Last time we saw each other he kept making incredibly racist comments about and even to my (nonwhite) wife and kid's face - it was the first time they'd even met!

Well, that's certainly unfortunate. I honestly do not know how you can bridge a gap that wide.

Yes — my grandfather, who had a chest infection aged 99¾, was given an increasing amount of morphine for the pain (instead of antibiotics). The death came at the point he could no longer recognise his children, where his quality of life was basically nil. It was a release.

There is nothing illegal about causing death in the pursuit of treatment or reducing pain and suffering. It's obviously a fine line, but giving a patient who is in severe pain so much morphine it hastens their death is not illegal.

God bless you.

I always felt reason right to die isn't universal is religion. It makes it hard to argue logically when the other person has orders from above that suicide is a sin.

For what it's worth, I have concerns about legalizing suicide, and I'm not religious. My main concern is there's no changing your mind. A friend tried to commit suicide, and she is grateful every day she was stopped. I'm deeply uncomfortable imagining a legal and economic reality where people in distress can make such a decision quickly and permanently. This is not the same thing as euthanasia, and not intended as an argument against it. I have some concerns about a slippery legal basis, but I'm confident we could successfully separate these issues.

A friend of mine succeeded just over 6 months ago and I regret not joining her every day. I live in a gun-free country so no easy way out. I’m currently in a rural area and considering bashing a policeman’s head in to get his gun and get it over with. The alternative is synthesizing Nembutal myself. All the other techniques are riddled with risks of failure.

I know too many people who regret their suicide attempts to let this comment go unanswered: Call whatever service is available in your country to speak about your thoughts.

I’m not going to involve myself any further, because I’m afraid I’d do more harm than good.

Please don't involve another human if you have to do it.

ok i wont

I know from personal experience how seductive and attractive thoughts of ending your own life can be. Imagining and looking forward to the escape from this horrible world can be so full of joy. The calm, clarity and bliss you experience is only known to those that have been there. But you are clearly looking for help. Otherwise you wouldn't have posted this. You would just have done it. Risks of failure? Anyone can find safe and foolproof methods on the Internet. So this is clearly not what you are looking for. Seek help. Doing this always feel like failure. But you become empowered. You will grow. I did. Need a rope to cling to? Go stoic. Solid navigation methods for life and the world.

I'm sorry you're struggling so much. Having a close friend kill themself can be a major trigger if you're depressed. I've lost friends by their own hands before, and attempted once myself, so your comment worries me and I'm concerned for you.

One thing I've (personally) found helpful is keeping a bucket list, ordered from least to most dangerous/life-changing. If your job is making you miserable? Quit. Wanted to move to a different country? Get a tattoo? Go skydiving? Smoke DMT? Transition? Go for it! You literally have nothing to lose, relative to suicide.

I don't know your life, but I hope you do what's right for you.

Barbiturate synthesis isn't particularly easy, for what it's worth. Though that depends on what precursors and equipment/glassware you can get, and whether you have organic chemistry experience.

Hey, do you want or need to talk to somebody?

What is causing you enough pain to justify suicide?

Don’t forget about carbon monoxide. It would be much easier and less painful to just get a tent or car and a propane heater. Shooting yourself is way too risky in my opinion.

Legalising suicide means something different than what you seem to be implying. Legalising suicide means that we don't throw people like your friend into a prison.

Probably you are just using it as a shorthand for "legalising assisted suicide. I assume you live in a modern western country where the idea of punishing someone for trying to end their live is unthinkable. Sadly there are still countries where they would have punished your friend. Because of this it's better to be aware of the distinction between the terms.

Right to die is a fundamental human right in my book. It is but one of many rights curtailed by the sectarian majority. Abortion, kink, birth control, homosexuality… you name it. God hates personal freedom.

Sometimes I get the feeling the US medical industry is 50% people who would sell an allergy pill that gave ten percent of patients lung cancer and 50% people who would rather watch thousands of people die in screaming agony than test a pancreatic cancer treatment that caused erectile dysfunction.

No this isn't true. There are many things wrong with the medical industry, but this takes it too far.

I don't think it's appropriate to debate about policy here. Her final blog post isn't about that.

The fact that she can’t legally die in her own country even though she has a terminal illness and that she mentions she is worried that if her family and friends knew where she is going that there might be legal repercussions does open the debate to policy imo.



Survivors can vote. I got to watch my mom die of cancer like this.

I'm reminded of the line from Constantine, where he says, "Like pulling demons out of little girls. WHO IS THAT FOR?"


It’s worth voting, too. It’s one of few things I’ve advocated for in my life but I’ve actually seen real progress in my country and in many others.

I also watched my mom suffer a terrible death (a rocky 7 year decline into pain and madness), and she literally asked us to help her die many times along the way. She only stopped asking once her mental faculties left her. Her suffering was intolerable and we weakly watched her endure it out of fear of repercussions if people found out her death was assisted. It hurts so much to think, had she gotten sick only a little later, she could have left with some dignity and knowing who her family was. If only more people had supported the movement sooner!

It’s absolutely worth every ounce of support to give people (and maintain) the right to die.

So after my brother passed this was one of the things our family discussed with the palliative care doc and the therapist assigned to our family by the insurance company. The way it was explained do me, and take it or leave it as you will, was that while morphine can certainly end a life, in most end of life scenarios the morphine has two roles: it reduces pain and suffering, and it actually makes breathing easier (even while it depresses respiratory rate). In my brother's case it was her opinion that it actually extended his life.

I'll never know if that was just what I was being fed, but my wife is an NP and has never shot that down, and she's not shy about correcting medical misconceptions.

I've seen this in action with a wealthy old 90+ friend of the family. At the time I was very young and thought it was odd how well timed our visit was, with him dying there only a few hours after, doctor at his side, in his home. (Perhaps it was just a nurse?) I distinctly remember the adults whispering to each other about how he was being medicated to take care of his pain, and his breathing; there was a very long pause before each inhale.

No, the problem is the slippery slope of "this patient wants to die because their life isn't worth living" to "this patient can't communicate, but it's clear their life isn't worth living, so we should end it".

I just do not see the problem. The urge to live is way stronger than a bad week. The urge to live is strong. And we already have systems in place to determine the course of medical treatment in the case of unresponsiveness, all you’d do is tack on euthanasia.

It’s not your business to determine whether or not a person should live. Why don’t you sit in the corner with people who think it’s their business to determine whether or not women have abortions?

If you think euthanasia is like abortion you're already contributing to the slippery slope by conflating different situations, but hey nuance has never been HN's strong suit.

"It’s not your business to determine whether or not a person should live.", as a member of society it sure as hell is. If some woman is suffering from post-partum depression (highly treatable) it's societies responsibility that she get proper treatment and not support for killing herself.

Violating the rights of a minority group based on a moral crusade to “save people”. It’s definitely similar. Similar also in the insane amount of suffering it causes. If you care so much about depressed people then donate some money to the effort to find a cure instead of causing innocent people to suffer with your armchair morality lectures

Wait, you're "violating the rights" of a depressed person (who isn't capable of actually judging the situation accurately) by not helping them kill themselves?

You're so far off the mark I'm not sure where you are.

The dead can't vote but their survivors sure can.

> The only reason right-to-die isn’t something universal is because the dead can’t vote

Oh cut it out. This is a gross oversimplification of an overly complex moral quandary. It misses the point on both sides of the argument -- the agency of the dying and the sanctity of life -- for cheap reddit upvotes. At least familiarize yourself with some of the literature before trying to contribute to the debate.

I think you’re right. It is too complex for a thread like this. But instead of literature my opinion is informed by my own firsthand experience with terminally ill people and my own fear of dying in an uncontrolled way. But you’re so right that the complexity of these things must be appreciated.

This comment is very black and white for a complicated topic. Personally I think people should have the right to die in a carefully regulated and administered fashion, after they have received appropriate counselling and support. The support is essential. However in real world application there are only relatively few cases where euthanasia is arguably the 'best' option. I am very much at the coalface of this issue if you are concerned I am an armchair commenter.

Doctors and nurses don't generally euthanize people. Pallative care are actively against the concept and do research showing that various strategies for symptom management do not shorten life. If someone is suffering a lot from pain or shortness of breath, they will receive escalating doses of drugs which can cause death, but the reason for administering them is not to cause death. The distinction is important.

When someone is suffering a lot, they should receive good symptom support and unnecessary investigations and interventions should be avoided. This means that all the blood tests, blood pressure checks, X-rays, nutritional support people would normally undergo don't get done. Is that a form of (perfectly legal) euthanasia, if an easily correctible but otherwise fatal problem doesn't get fixed?

There are underground euthanasia practitioners for sure. These are doctors or nurses who take it upon themselves to administer fatal doses of medication to people who want to die. Invariably this is done at home. I've heard terrible stories about when it goes wrong.

I live somewhere where there is legalised voluntary euthanasia or assisted dying as they call it. Patients go through a process where they are assessed by two doctors (who have been trained specifically) and then when it is approved they receive medication they can take themselves. It works well generally. But is not a fast process. Patients with cancer certainly die during the process. And they don't die in agony. Modern palliative care is excellent, if you live somewhere where it exists, particularly for cancer.

The part missing from your analysis is that the health care system has limited resources, and properly assessing patients for and administering euthanasia takes a lot of resources. It is not much of an exaggeration to say that it is easier to die than to see a psychologist where I live. The doctors who do the assessments are not seeing other patients. The money used to pay for the assessments etc is not being spent elsewhere (it's a socialised healthcare system). Even if the patient pays for everything, you are still using up time and expertise.

The 'easy' cases for euthanasia are people with degenerative neurological conditions where there is no treatment available, just gradual slow descent into disability. Cancer is more complicated - patients can be very well until close to the end, and they are often having ongoing treatment. It is hard to be considing euthanasia while hoping the next clinical trial will work. Cancer patients also tend to die quickly.

For major organ dysfunction like heart failure, kidney failure, liver failure, it is possible to withdraw active medical support and therapy and patients will die fairly quickly, while also receiving symptom support.

Euthanasia for mental illness I find would be almost impossible to implement. Euthanasia for chronic pain I think would also be very difficult. Euthanasia for dementia has obvious problems too, although we all tell our partners to push us off the pier when we can't do the crossword anymore.

Some people just want to die because they are too old, fed up etc despite no serious medical problems or overt mental illness. I don't know about this. I am not sure a medical system can support this kind of choice, it is 'out of scope' to my mind, a kind of medicalisation of the human condition. There is a complicated spectrum from 'Completely well and wanting to die' and 'Severe imminently fatal illness and wanting to die.'

> although we all tell our partners to push us off the pier when we can't do the crossword anymore.

Wow. Let's not generalise. We "all" definitely not tell that to anyone.

> With my speech and memory going, it’s already difficult to persuade doctors that I’m sufficiently “with it” to understand the gravity of what I’m doing

You don't need to convince them. Say nothing and just go.

Never explain yourself regarding fundamental values.

I think this means "with it" enough to pass the conditions by which the doctors will assist his suicide.

Her medically assisted death. The author is the woman in the photos.

My point still stands.

Having a nice painless euthanasia experience is really helped by professional medical assistance. Yes, there are other ways. But.

You haven’t made a point. You’ve made a declaration of your own values which don’t apply here.

I think maybe he means convincing the doctors in the undisclosed European country.

Is that supposed to be Switzerland? I heard about it being an option there. Also, there is MAiD (Medical Assistance in Dying) in Canada.

Possibly the Netherlands or Belgium as well. A couple documentaries came to mind for anyone interested:



Yes. She mentions finishing in Switzerland when discussing travel plans at some point in her previous posts, with emphasis on finishing.

One picture says Scotland.

The text surrounding the images stated that the author was sharing a recent travel experience before her health deteriorated even further.

So no, not Scotland.

When my dog’s time is up, I’ll either use CO2 or nitrogen on her. CO2 is sometimes used when cattle are slaughtered. Put the dog in a box, fill with CO2. Easy way to go.

There’s an 1940’s book/movie, Green for Danger, with a strategy for hiding your self-termination with industrial gasses.

Please don’t

CO2 causes extreme stress for a period before causing unconsciousness

Do a little research

And just pay a decent vet to do it properly.

CO2 is not great. It will induce panic and at high concentrations is very irritating to the respiratory system.

It's used in some settings, because it's a trade off of distressing the animal when you move or restrain it. But it needs to be done right.

Nitrogen is far better because there is no sensory cue that something is different.

Do not torture your dog to death.

Co2 poisoning is scary and painful.

If you care about saving the vets fees over that then I don’t know how to communicate with someone like you.

When my ageing cat was on his last legs, two vets visited our home. I held my cat, they injected him, and left almost immediately (settling the bill at a later date). My cat was 'asleep' quickly in my arms for our family to have a last moment together and then bury him.

I'm not sure why you would want your pet separated from you and in a box to die by itself instead?

I'm always amazed at how dumb intelligent people can be.

Please, please don't do this.

What makes you think GC is intelligent?

I think a good general principle for speaking with people on the internet is "the principle of charity".

You need to think of the best possible interpretation of the other posters comment, and always assume you're speaking with someone intelligent in good faith.

For instance here, my best interpretation would be that the person is both confused between carbon dioxide and carbon monoxide, and is unaware that vets will assist in helping pets pass away.

The other interpretations: that the person is a troll, that the person is needlessly cruel, that the person cares more about saving the vet fees than the feelings of their dog , or that the other person is just an idiot don't contribute to a healthy discussion.

It probably depends on what GC you're talking about. You plain old copying semi-space or or mark-and-sweep GC will be fairly dumb, but some modern ones like Metronome or C4 are pretty smart.

Most, perhaps all, people are.

I thought high CO2 levels in blood induce panic? It was my understanding that the reflex that causes us to want to breath are not based on a lack of oxygen but a buildup of CO2.

CO on the other hand doesn’t have this impact and you pass away without the panic.

That's what I understood too. Our body measures CO2 levels, and responds to them. CO, on the other hand, goes undetected, but binds hemoglobin, thus shutting us down. Please correct me if I'm wrong.

WTF just go to a vet.

I don't think you should have a dog.

I will pay your dog's vet bill for proper euthanasia for you not to do that. I'm serious, respond to this comment if you want to take me up on it and we'll work it out.

What makes you assume you will outlive your dog? I mean, you probably will, but are you facing the reality of the human condition that our life can end anytime? The author was 26

Why are you doing this? Is it to save money on the vet bill?

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