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Jean Marmoreo - The Last Doctor : Lessons in Living from the Front Lines of Medical Assistance in Dying

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Jean Marmoreo The Last Doctor : Lessons in Living from the Front Lines of Medical Assistance in Dying

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An urgently important exploration of the human stories behind Canadas evolving acceptance of Medical Assistance in Dying (MAiD), from one of its first and most thoughtful practitioners.Dr. Jean Marmoreo spent her career keeping people alive. But when the Supreme Court of Canada gave the green light to Medical Assistance in Dying (MAiD) in 2016, she became one of a small group of doctors who chose to immediately train themselves in this new field. Over the course of a single year, Marmoreo learns about end-of-life practices in bustling Toronto hospitals, in hospices, and in the facilities of smaller communities. She found that the needed services were often minimalor non-existent.The Last Doctor recounts Marmoreos crash course in MAiD and introduces a range of very different and memorable patients, some aged, some suffering from degenerative conditions or with a terminal disease, some surrounded by supportive love, some quite alone, who ask her...

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MORE ADVANCE PRAISE FOR THE LAST DOCTOR Powerfully honest and compelling this - photo 1
MORE ADVANCE PRAISE FOR
THE LAST DOCTOR

Powerfully honest and compelling, this book tackles the tough questions head on. MAiD is about choice, and these stories capture the truth of those who choose a dignified departure and the wonderful human beings who make it possible. Jean is one of those. In a simple yet profound way Jean makes the case that while MAiD does take away someones life, it first gives it back to them. That is indeed the power of good. Without the brave souls who take the risky, first steps we would have no Medicare,no vaccines in this country. And without their compassion we would not have Medical Assistance in Dying to help those who want autonomy in lifeand in death.

Senator Pamela Wallin, Advocate for MAiD and Advance Requests, Member of the Special Joint Parliamentary Committee on Medical Assistance in Dying

The Last Doctor is a majestic book about the power of kindness and the language of love. It will change forever how you think about medically assisted dying. Your end-of-life self will love, honour, and cherish Dr. Jeans insights.

Dr. Joe MacInnis, author of Deep Leadership

What a truly remarkable book. Characters that come to life with the flick of a pen. Sentences that make one stop, read, reread, and ponder. Dr. Marmoreos commitment, intelligence, fierceness, frustration, humour, and, most importantly, compassion come through on every page. If you want to understand the sometimes messy sometimes tidy, sometimes simple sometimes complex, and always profound world of medical assistance in dyingread this book.

Jocelyn Downie, CM, FRSC, FCAHS, SJD, Professor in the Faculties of Law and Medicine, Dalhousie University

also by dr. jean marmoreo

The New Middle Ages: Women in Midlife

also by johanna schneller

Woman Enough: How a Boy Became a Woman and Changed the World of Sport (co-author)

Mayor Rob Ford: Uncontrollable: How I Tried to Help the Worlds Most Notorious Mayor (co-author)

VIKING an imprint of Penguin Canada a division of Penguin Random House Canada - photo 2

VIKING

an imprint of Penguin Canada, a division of Penguin Random House Canada Limited

Canada USA UK Ireland Australia New Zealand India South Africa China

First published 2022

Copyright 2022 by Dr. Jean Marmoreo and Johanna Schneller

All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of both the copyright owner and the above publisher of this book.

Wild Geese reprinted from DREAM WORK, copyright 1986 by Mary Oliver. Used by permission of Grove/Atlantic, Inc. Any third party use of this material, outside of this publication, is prohibited.

Recorded for the audiobook with the permission of The Charlotte Sheedy Literary Agency as agent for the author. Copyright Mary Oliver 1986 with permission of Bill Reichblum.

www.penguinrandomhouse.ca

library and archives canada cataloguing in publication

Title: The last doctor : lessons in living from the front lines of medical assistance in dying / Dr. Jean Marmoreo and Johanna Schneller.

Names: Marmoreo, Jean, author. | Schneller, Johanna, author.

Identifiers: Canadiana (print) 20220142327 | Canadiana (ebook) 20220142688 | ISBN 9780735241077 (hardcover) | ISBN 9780735241084 (EPUB)

Subjects: LCSH: Marmoreo, JeanAnecdotes. | LCSH: Assisted suicideCanada. | LCSH: Assisted suicideCanadaAnecdotes. | LCGFT: Anecdotes.

Classification: LCC R726 .M37 2022 | DDC 616.02/9dc23

Book design by Emma Dolan, adapted for ebook

Cover design and art by Emma Dolan

aprh60141009067c0r0 For Yolanda Martins whose generosity and grace in - photo 3

a_prh_6.0_141009067_c0_r0

For Yolanda Martins,
whose generosity and grace in her quest for a dignified death prompted an inner journey, and this book.

WILD GEESE

You do not have to be good.

You do not have to walk on your knees

for a hundred miles through the desert, repenting.

You only have to let the soft animal of your body love what it loves.

Tell me about despair, yours, and I will tell you mine.

Meanwhile the world goes on.

Meanwhile the sun and the clear pebbles of the rain

are moving across the landscapes,

over the prairies and the deep trees,

the mountains and the rivers.

Meanwhile the wild geese, high in the clean blue air,

are heading home again.

Whoever you are, no matter how lonely,

the world offers itself to your imagination,

calls to you like the wild geese, harsh and exciting

over and over announcing your place

in the family of things.

Mary Oliver

Contents
PROLOGUE
Yolanda, Part One

I was supposed to administer the drugs that would end Yolanda Martinss life at ten a.m. There was only one problem: I needed a nurse to insert the intravenous lines, and the nurse hadnt arrived.

The mood in the house had already gone up and down more times than an elevator. About a dozen of Yolandas friends and familya vivacious, urbane bunchwere gathered in this meticulously renovated Victorian in Torontos Annex neighbourhood, owned by Yolandas friend Patty, to send her off. Someone had hung up strings of white fairy lights. Someone had made coffee; someone else had opened tequila and champagne, and it seemed like every glass in the kitchen was in use. Bunches of flowers and boxes of tissues sat on the large square kitchen island, and on every other surface, too. Yolanda, who had a sly sense of humour, had made an upbeat death playlist, and she and her loved ones had spent the last hour chatting, crying, dancing, laughing, and belting out the lyrics to Forever Young and Karma Chameleon. But as ten a.m. came and went, peoples eyes started flicking to me.


By this July day in 2018, almost eighteen months since Id first helped a person to die, Id experienced repeatedly the tremendous good in it. The relief on patients faces when they give their final consent. The mournful yet joyful gatherings, like this one for Yolanda, to witness loved ones dying by their own rules, often in their own beds. The family members who hugged me afterward, who sat down close beside me to tell me stories about the person to whom theyd just bade farewell. Thats when I would cry. I almost always cry.

I first met Yolanda back in November 2017. She was one of the certain ones. She was only forty-five, but shed been sick with a rare lung disease for thirty years. Yet somehow shed lived a big life: she was a scientific researcher at Harvard; shed jumped out of planes and dived deep to coral reefs. She had a forceful personality. Her friends jokingly called her the Boss. They loved saying that what Yolanda wanted, Yolanda got. But in the last two years, that big life had narrowedit began to consist mainly of medicines, paperwork, pain. She had no money, no boyfriend; her energy was gone, her concentration dwindling. She had to move back to her parents house in Whitby, a town about an hour east of Toronto, with short stays here at Pattys. Yolanda was becoming less and less herself. She was ready to go.

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