Rod Azama

Colonel Rodney Saku Azama and his wife, Susan Azama, traveled from Maryland to Oregon in March 2023 so she could use medical aid in dying to end her suffering from stage 4 cancer’s breakthrough pain.
Rod Azama and his wife Susan dressed up and out to dinner.

“Medical aid in dying allowed my wife to end her physical suffering and cross into the next life the way she wanted, on her own terms, with grace. But she shouldn’t have had to travel out of state to do it.”

Col. Azama shared his story in March of 2024.

In March 2023, I flew with my wife, Susan, from Maryland to Oregon so that she could end her suffering from breakthrough pain caused by her incurable stage 4 cancer that had rapidly spread throughout her body. It was a tough trip, one that wouldn’t have been necessary if medical aid in dying were an end-of-life care option in Maryland. Because this option is not available in Maryland, however, Susan couldn’t pass away peacefully at home. Her dog and her close friends and family couldn’t be by her side. It was just me holding her hand as she departed from this world.

I initially arrived in Maryland in 1977 while I was in the Army. Over the course of my 24-year Army career, I served as an airborne infantry officer, a U.S. Special Forces officer, an intelligence officer and a foreign area specialist. I was stationed at the Pentagon when I met Susan through a classified ad in Washingtonian magazine. 

It was a blind date, and I know she was annoyed at me because I showed up late after doing some repairs at home. But we recovered, dated and fell in love. We were married in June 1991, just before I was assigned on an unaccompanied tour in South Korea.

Susan was attractive and kind with a strong-willed, principled personality. As a database specialist and computer scientist, she received a commendation from NASA for her work supporting the Hubble Space Telescope. She loved European history, classic movies and the pets we acquired during our marriage, especially her last dog, Sunny. She and Sunny spent an entire year training on the weekends to get Sunny certified as a therapy dog, and once they did, Susan and Sunny visited nursing facilities regularly on weekends. 

In 2022, Susan discovered a small lump on her chest wall above her breast. Following an ultrasound, the lump was diagnosed as benign. But later that year, a procedure to remove the cyst proved challenging to the surgeon and caused Susan to scream in pain. A biopsy showed that earlier she had been misdiagnosed; Susan had a rare, incurable, high-grade, small-cell cancer that was diagnosed as neuroendocrine carcinoma. 

Susan underwent ultrasounds, PET scans and MRIs that uncovered cancer not only on her chest wall but also in her breasts, her lungs, her bones, her brain, her liver and elsewhere. It was so widespread that it was difficult to determine its origin.

When Susan asked her first oncologist how much time she had left, the answer the doctor gave her was unsatisfactory, even if technically correct: “Only Jesus knows.” That didn’t help Susan at all. She knew she was terminal, so we decided to get a second opinion on her prognosis and the recommended treatment from a team of oncologists at Walter Reed Medical Center. They were very responsive, and in early January 2023 the team verified Susan’s diagnosis. As to Susan’s primary concern, an oncologist with over 30 years of experience said, “With your condition, the median amount of time you have remaining is about three months.” When Susan asked about treatment, they informed her she might buy a small amount of time with chemotherapy and radiation. 

Susan thanked them. She had seen a relative suffer greatly at the end of her life, and she didn’t want that for herself. Neither did she want to be in a vegetative state. 

She reached out to the Death With Dignity National Center in Oregon to see if they could help her coordinate accessing Oregon’s law as a nonresident. We subsequently traveled to Oregon in late January to see doctors who verified that Susan was in a terminal stage and had the mental capacity to make this decision voluntarily for herself, and we completed the necessary paperwork. 

The question before her was when she would take the final step. 

I was supportive of her desires, but being her husband and wanting her to be around as long as possible, I initially delayed making the trip to Oregon. This created some tension because Susan was concerned that she might deteriorate physically so much that she couldn’t fly out there or might no longer be cognizant enough to self-ingest the medication.

Back home in Maryland, Susan received in-home hospice care with nurses and a social worker coming fairly frequently and a doctor, chaplain and therapist periodically. Susan’s pain was intensifying. The American Cancer Society calls pain like this, which overrides all medications including comfort-level morphine, “breakthrough pain.” One night I woke up to Susan on the floor, writhing and screaming in pain. She kept saying, “God, let me die. Let me die. Let me die.” She started mumbling something, and after I got down on the floor next to her, I realized she was repeating the word “heaven.” 

We agreed to fly to Oregon on March 6. She would take the medication on March 8. 

I found us a nice Airbnb through the Death With Dignity National Center. Our boarding was delayed because of a shortage of airport personnel. Then we endured an arduous journey from Baltimore to Portland. Susan was very uncomfortable en route. An extra seat that I had purchased for her was mistakenly sold by a gate agent, and the plane was totally filled. On top of that, navigating the airports with her in a wheelchair while I carried our luggage proved quite onerous, but we toughed it out. 

Once we settled into our cozy rental, I picked up some food and supplies, contacted the attending physician, and arranged for the pharmacist to deliver the medication. When it arrived, I followed the doctor’s instructions on preparing it, mixing it with apple juice to make it more palatable and getting some popsicles to soothe her mouth. I also tried to make the bedroom as pleasant as I could. Since Susan’s beloved pet couldn’t come with us, I had brought Sunny’s favorite toy. But when I carried it into the room, Susan said, “Please take it away.” 

I was surprised. 

“I love Sunny,” she said. “I’m so thankful and blessed to have had her. But I have to prepare for the next world. And Sunny won’t be there, at least not right away.” 

So I moved the stuffed bunny out of the room, helped her relax and talked to her. I brought in the medication. I put it on the nightstand and sat down beside my wife, stroking her arm. I was not in any hurry for her to take it. But she turned to me and said, “Rod, let’s get it over with.” 

I gave her the medication, and she drank it. I sat next to her and held her hand. I could tell she didn’t want me to get emotional, so I just squeezed her hand, and she squeezed mine back. She fell asleep in about three minutes. I just lay next to her thinking about our time together, listening to her breaths as they grew further apart, weaker and weaker, until finally, two hours later, she drew her last breath. 

I called the doctor to examine her, and he verified her death. I kissed her, closed her eyes and hugged her. When the funeral home workers showed up, I watched them put Susan on their gurney. They were very professional. They asked if I wanted to do anything else, and I said, “Take good care of her and let me kiss her one more time.” 

Then I was alone in the house with my thoughts and fond memories. 

My flight back to Maryland the next morning was lonely; I was happy to get home and see Sunny and Susan’s sister. Because there was a backlog for cremation, however, I had to schedule a flight to return to Oregon about three weeks later to collect Susan’s ashes and bring them home to Maryland with me. We had been married almost 32 years. I wouldn’t let them ship her ashes. 

Susan valued life and believed in an afterlife, that she would see her parents and favorite relatives and close friends again, and when Sunny passes away she’ll see Sunny again. Medical aid in dying allowed her to end her physical suffering and cross into that next life the way she wanted, on her own terms, with grace. But she shouldn’t have had to travel out of state to do it. People in the final stages of their lives should be able to be comfortable and at peace, and medical aid in dying is one option that can help make that happen for folks facing a similar situation as Susan. People in Maryland and everywhere deserve this option. 

 

Read More

AP – “‘I’m dying, you’re not’: Those terminally ill ask more states to legalize physician-assisted death” (4/11/24)

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