A living wake: Why this Charlottetown man chose to talk about his medically assisted death

In the weeks leading up to his death, Craig Mackie's breathing mirrored the short, sharp strokes he was making on his laptop keyboard, documenting his final days.

"At this point in my fading life, I'm struggling to breathe every day," Mackie said from his kitchen table in Charlottetown, in early October2022.

A rapid decline due to pulmonary fibrosis had left Mackie, 71, endlessly gasping for air, requiring near-constant support on oxygen.For months, he used his remaining energy to writeat length about hishealth, drafting dispatches from the confines of his home and sometimes a hospital bed.Then he sharedthese thoughts publicly, on a blog and through social media.

"The feedback I've been getting is that the way I write is it seems to speak to a lot of people. So I'd like to keep that going," said Mackie.

The writing continued as he looked into the possibility of a medically assisted death, determined not to die the way his mother had. She too had pulmonary fibrosis.

"She literally suffocated to death," said Mackie. "And I thought, if I ever have the choice, that's not what's going to happen to me."

Starting conversations

Medical assistance in dying, or MAID, has been legal in Canada since 2016.

Mackie'sapplication was approved in September, and having thatoption offered him comfort. Throughout his life, he had taken on leadership roles including at CBC Prince Edward Island and as theformer head of Immigrant and Refugee Services Association P.E.I and sharing his thoughts online about MAIDbecame a way to continue using his voice and connecting with others.

"I wanted to have people understand that in Canada we have this choice andit's very special, that it could easily be taken away," said Mackie.

"As we know from [Roe] v Wade in the States, these things can be legislated and they can be taken away. So I want people to understand that it's it's a compassionate, human choice."

MAID remains contentious in Canada.Proposed legislation to extend access to peoplewith severe mental illnesshas come under fire, with changes now delayed until 2024 as the federal government, provincial and territorial partners, and medical communities assess the best way to move forward.

On P.E.I., only a handful of doctors and nurse practitionerswork in this area of health care.Dr. Megan Miller, a family physician with extra training and experience in palliative care, said the focus is on helping patients who want to learn more about MAIDunderstand their options.

"It's a very rigorous, extremely careful process that, as practitioners, we take extremely seriously. And we do that work in a very, careful and considerate way," said Miller.

"There is never any pressure for patients.They can withdraw their request or change their mind at any time and we would all 100-per-centsupport those decisions."

We are born. We live. We die. It's what you do with the middle part of that sandwich that matters to me. Craig Mackie

In P.E.I., there were 111 MAID deaths between 2016 and 2021, with the numbers growing each year. Miller describes it as a complex and immensely personal choice, withmore people applying for it than actually going through with it.

But either way, she says, talking more openly about death and MAID helps us all.

"I think it can be an isolating experience for some patients and people experiencing it," said Miller.

"I think there are a lot of people in the public who don't know how to support those patients or talk to them because of the awkwardness around it, and we are all better off if we can share some vulnerability and share the uncertainty and have conversations about it."

Opening people's eyes

By early October, Mackie was ready to set a date for MAID. Just as he had been open about his medical journey so far, he continued to write about his final choice.

"I'm not afraid of death. It is a natural part of the cycle of life. We are born. We live. We die. It's what you do with the middle part of that sandwich that matters to me," he posted on Oct. 21.

ForMackie's friends, following his regular postsbecame a way to stay connected in his final weeks, and add their own comments, photos andmusic. His Facebookpagebecame a daily destination for those wanting to read his latest accountand see what others hadshared.

"I think by Craig being so open about it, it's opened a lot of people's eyes to the process," said Peter Murdoch, a friend and former competitive curling teammate of Mackie's.

"By Craig doing this, I think it's going to make the conversation, at least among his circle, a heck of a lot easier for people."

Mackie's partner Mary Phalen often shared the posts, hoping to keep friends and family near and far updated on his condition.

"I'm glad that people are getting comfort or maybe starting conversations in other households.I think that's a good thing," she said.

"And that's been very therapeutic for him, I can see that. I also see how much he's suffering. So, as hard as it is to say goodbye, it's hard to see someone suffering. You know, there are worse things than death."

For Mackie, having the chance to share his experiences and insights and connect (and re-connect) with friends, loved ones, and acquaintances near and far filled those final days with unexpected warmth, laughter, and joy.

"It's been both a humbling experience, but an uplifting one as well, to have met and engaged with all of these amazing people" said Mackie.

"Somebody described this whole process as kind of like a living wake. And I went: 'Yeah, that's kind of what it's been like.' It's justreconnecting and remembering has been just an overwhelmingly positive experience."

'A natural end'

In the days leading up to his death, there were fewer posts. His final thoughtwas short, reading simply: "Death is a natural end to life. Ending suffering is a compassionate end of life choice."

That post came on his final day: Nov. 2,2022.

In the time since, his Facebookpageremains a destination for some,to remember him or say "I miss you."

"I think how you face death should be at least as important as how you face life," said Todd MacEwan, Mackie's friend and former colleague.

"It is going to happen to us and, you know, seeing the bravery and courage that Craig demonstrated during his illness is something that I think has touched a lot of people."