A brutal way to die

Metastatic breast cancer has no cure. Only treatment. I've had good years of it. But I've come to know what's coming for me. And that's where bravery fails.

Four separate medical institutions predicted how my cancer will kill me: bowel obstruction. When tumors block bowels, the body doesn't stop. It reverses — vomiting through the mouth what it can no longer pass.

Insufferable pain can take up to three days to control, even in a hospice setting. Medications that might offer relief slow motility, accelerating the ejection. Symptom management can last for weeks while I remain conscious and fully aware.

Lack of bodily autonomy doesn't just frighten me. It retraumatizes me. The disease is one assault. The treatment it demands is another. Both land on a bedrock of sexual assault older than either — and the through-line is violation, the loss of control over my own body.

The fear I carry isn't of death. I've made peace with death. It's the violation my home state won't let me escape.

So I've chosen Medical Aid in Dying for when my time comes. I'll leave Alaska if I have to. But I shouldn't have to — not from the place that holds my life, my people, my heart, my light.

Forcing the dying to move isn't compassionate policy. It's a geography lottery, and the people who lose it are the ones already carrying the most. That's what I'm clear-eyed and unbowed about. That's what I refuse to dress up in soft language.

Treatment has staved off the need for now — and I am grateful for every day of that. My choice is made all the same — not from despair, from clarity. I have talked about it with my husband, my oncologist, and my nurse practitioner, not because it's required by law, but because that's how adults make informed decisions.

It's insulting that this decision — informed, careful, personal, medical — is one the state forbids rather than permits.

I'm a naturalist. I've spent my career watching wild things live and die. We'd never let a suffering animal endure what we force on suffering people, then call it mercy.

You don't have to agree with my choice. You only have to believe that Alaskans facing the end should be able to make their own — at home, in the place they love, the way I want to and can't.