Sera Passalaqua

On January 9, 2023, Sera Passalaqua’s sister Christina used California’s End of Life Option Act to escape the relentless and excruciating pain caused by pancreatic cancer.
sera passalaqua and her sister christina

“Our family is grateful for the control and peace Chris found in the option of medical aid in dying.”

Sera shared her story in March of 2023.

On December 14, 2022, I said goodbye to my sister as if this was the last time I was going to see Chris after we had spent almost a year navigating her diagnosis and treatment of stage 4 pancreatic cancer. But a week later I received a call letting me know she, her husband and our older sister Theresa made plans to bring her back home to California and that she would see me in a week.  

My sister Theresa called me within the next few days to ask me to make arrangements in order to facilitate Chris’ wishes to use California’s medical aid-in-dying law. I reached out to a cancer foundation contact that I thought may know how to help, and they connected me with Compassion & Choices.

Compassion & Choices provided information on options of how to proceed and were available to us every step of the way to answer questions that came up. I don’t have the words to express my gratitude for all of their help. Their guidance helped make my sister’s wish a reality. By January 9, 2023, all the boxes were checked, and my sister had an aid-in-dying prescription in hand.

Chris’ experience with cancer started at the end of December 2019 when she was diagnosed with breast cancer. She chose the oncology group at Sutter Health/PAMF (Palo Alto Medical Foundation) as her care team, and her treatment plan included a double mastectomy, chemotherapy and radiation treatments. During this time, she visited Durango, Colorado, and fell in love with the small mountain community, and shortly after she finished treatment she moved her family there in May of 2021.

Unfortunately, this was not the end of her journey with cancer. Early 2022, Chris started having some abdominal pain, and preliminary imaging and tests in Durango showed that she had a mass on her pancreas. She returned to California to reconnect with her oncology team at Sutter Health, and a week later, on February 22, 2022, Chris was diagnosed with stage 4 pancreatic cancer — the cancer had already spread to her lungs and spine. The news was a shock to everyone.

Knowing that the five-year survival rate of pancreatic cancer is only 1%, we had to get Chris into a top cancer center. Every day for nearly two weeks I called 10 top cancer centers to ask if they had any cancellations. Twelve days after her diagnosis, MD Anderson Cancer Center in Houston picked up and asked if Chris could be there the next day. Immediately I replied yes and booked flights for Chris and our eldest sister.

We felt incredibly fortunate to have MD Anderson, ranked as the nation’s top hospital for cancer care, providing care to Chris. For months we were filled with hope as the chemotherapy stopped further cancer growth and spread. But in July there was suddenly an increase in activity of the tumor on her pancreas, and Chris started having pain and difficulty eating. In response, her medical team started her on intensive radiation targeting the tumor followed by an additional round of chemotherapy.

In August, severely fatigued by treatment, Chris was ready to talk about medical aid in dying, a topic I had raised to her in April hoping to provide her a tool to keep in her back pocket, but she wasn’t ready then to talk about it. I kept informed so if it ever felt like an important option for our family that I could be of help. Chris was still pursuing treatment, but wanted to share her thoughts with her husband and children. She wanted them to understand that if she decided to go this route that it wasn’t because she was giving up on them or on her fight; it was so that they wouldn’t have to see her suffer. She didn’t want her family to see her in agony as she slowly succumbed to cancer.

christina passalaqua and her family

Christina’s loved ones gathered around her on her last day

For a short period, the treatments seemed to be effective as Christina’s pain diminished and she was able to eat again. But in October she started experiencing pain in her back and neck. An MRI showed that the metastases in her spine were spreading. Following the news, Chris told her doctors that she didn’t want to go through treatment anymore. Treatment became more problematic than the disease, and she was done putting herself through demanding procedures.

Instead she focused on living, and there were numerous victories given the circumstances. She made it to Thanksgiving; she got to see my daughter turn four; she spent Christmas with her beloved husband and children; she made it to her 50th birthday; she and her family did a beach tour in an RV, and she even made it to New Year’s Eve. But obtaining an aid-in-dying prescription was likely her biggest victory. Chris was incredibly dedicated to her family, and it was her deepest wish to minimize the suffering her children would have to watch her endure. Chris had been deteriorating for a while. She was down to 80 pounds, and her breathing had quickly taken a turn for the worse. Doing it on her time instead of on cancer’s time was empowering.

Back in California, Chris was surrounded by people who loved her. People really cared about her, and finally she was close enough for her lifelong friends and extended family to visit with her. Our priest also visited her regularly, and every visit had a calming effect on her — she was finally able to find peace and acceptance. During the same period, Christina reconnected with her care team at Sutter Health to officially start the request process for an aid-in-dying prescription. They were ready to facilitate Chris’ wish and connected her with a local hospice (Mission Hospice) to lend support during her last days.

About a week later we received the medications. On January 9, 2023, at 11 a.m. our cousin Gianni came by with a Disneyland Magic Castle painting and 30 Mickey Mouse ears because she knew Chris wanted to go to Disneyland before she died, so Gianni brought Disneyland to Chris that morning. When the hospice doctor showed up, he put on the Mickey Mouse ears and said this was not like any other scenario he had experienced for a planned death. Though the law doesn’t require a medical professional to be present, it was psychologically helpful to our family to have the doctor prepare the medications and be available in case of any needs. There were literally 30 people waiting with bated breath, with Mickey Mouse ears on, as my sister made her final decisions in life, and she wanted every one of us to be part of it all.  

She took the anti-nausea medication about an hour before the main attraction. Before the hospice doctor handed Chris the aid-in-dying medication, Christina’s son, Sam, asked him to explain how it would all pan out. The doctor explained that Chris would fall asleep within just a few minutes of drinking the medication and pass away gently hours later.

Chris moved forward with her plan. She drank the meds quickly, a sign to me of how ready she was for her pain to end. She fell asleep in what felt like a minute. Despite the doctor telling us it would potentially take two to 15 hours for Chris’ heart to stop, her body was ready and she was gone just 37 minutes later. 

Chris was the sweetest, most reliable and thoughtful person. She was a dedicated wife, wonderful mother and grandmother, loving sister, beloved daughter, loyal friend, animal lover — she couldn’t go anywhere without finding a stray dog, especially a pregnant stray dog — a kind soul and so much more to so many. Over 400 people attended Christina’s funeral; she was deeply cherished.

Our family is grateful for the control and peace Chris found in the option of medical aid in dying while facing such a dismal situation. Chris didn’t want her kids to see her suffer more than they already had. Dying quietly in your sleep is a luxury, and to be able to provide that to yourself is huge.

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VICTORY: Colorado Gov. Jared Polis signed the improved End-of-Life Options Act.