Cancer Chose Me, But I Chose How To Die - by Chika Kapadia

Chika Kapadia was diagnosed with terminal cancer in May. For every day after that, he wrote this diary. He chose to die at Dignitas in Switzerland on August 23 in the care of the doctors at that clinic.

The Diary

Starting today, May 15th 2022, I will begin a diary to note how I feel both physically and emotionally, as the Carcinoma spreads.

I will grade it on a scale of 0 to 5, with 5 being the most severe.

History

The doctors say that I may have had this condition for 4-6 months. I first noticed the pinch in my neck in early April, but always associated it with the root canal on my right side.

On May 2nd, my dentist suggested that I get the lump on my neck checked out. I saw my doctor at Bombay Hospital and sequentially, within the following week, had the Sonogram, Biopsy, PetScan, CT Scan and finally the Oncopathology reports completed.

On May 10th at 8 pm, a reputed Cancer specialist informed me personally, that I did indeed have Anaplastic Thyroid Carcinoma (ATC), that it was untreatable at Stage IV, that the metastases had reached the lungs and that I should address end of life issues immediately. Others' prognoses had estimated an approximate span of 3-4 months of life expectancy after diagnosis. 

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Daily Diary:

May 15 (DAY 1)

Physically: I start at a 0.3 because I do feel a pinch on the left side of my neck, and clearly it's progressed since I entered India on April 23.

Emotionally: I start at 3.5 because I'm still a bit shell shocked and although I'm handling this with pragmatism, it does consume my every conscious moment, and that's stressful enough. When one has no right to dream anymore, the end is inevitably nigh.

May 16 (DAY 2)

Physically: I remain at 0.3 because I had a pretty normal day with my meal consumption. Breathing was a bit laboured upon waking up, but eased up by mid morning.

Emotionally: I'm dropping down a teenth to 3.4 because I spoke to Dr. Amish Dalal who mentioned that because my growth was on the left side instead of the center, it might take a little while longer before it spreads.

May 17 (DAY 3)

Physically: I'm up a teenth to 0.4 because I do notice now that burping does not come as easily as it used to, clearly an effect of the thyroid issue. My Adam's apple has moved an inch to the right and that looks odd. 

Emotionally: I'll drop a teenth to 3.3 because thanks to Aryka and Eshika we're one huge step closer to Dignitas acceptance. 

May 18 (DAY 4)

Physically: I'm up two teenths to 0.6 because the thyroid on the left part of my neck feels hard, which I'd never noticed before. Digesting food is getting slightly more laboured.

Emotionally: I'll drop another teenth to 3.2 because I'm more accepting of what's to come. I went out to the Willingdon Pub tonight with my ex wife Nandi and had 4 large pegs of bourbon. Although I rarely ever drink hard alcohol, that actually felt good. But tomorrow I begin an Ayurveda treatment for 27 days and am told to stay off any alcohol. 

May 19 (DAY 5)

Physically: I'll stay at 0.6 - no appreciable change since yesterday.

Emotionally: I'll stay at 3.2 because I've rediscovered my love for ice cream which I have every chance I get. The cool sensation in my throat has a very soothing effect. 

May 20 (DAY 6)

Physically: I'm up a teenth today to 0.7 because the left thyroid swelling mass is now noticeable to me for the first time. Taking my evening pills is becoming more difficult and I wonder how long before I can't swallow those pills anymore. I wonder also if I should bother with Cholesterol, HBP pills still, but for now, I'll continue. The digestive track is far more blocked than it was when I came to Bombay on April 23. The Ayurveda treatment begins on Monday for 27 days. 

Emotionally: I'm down a teenth to 3.1 because of the support I've gotten from family and friends lately. Those bits of communication are so incredibly reassuring. Today's my last day in Bombay and I did see about 5 different sets of friends who were effusive with their praise about how I was handling this.

Additionally Dignitas has written back that they've received the application and will revert back with an answer in 2 weeks. Can't wait to have this issue settled. 

May 21 (DAY 7)

Physically: I'm up a teenth today to 0.8 because eating is noticeably more laboured, so mushy foods and ice cream are in order. I'm eating 'what the hell' chocolates more these days. Transit day normal fatigue did set in. 

Emotionally: In a departure, I'll go up a teenth to 3.2 because driving over the Sea Link bridge on the way to the airport, looking back at my beloved Bombay for the last time, was draining. If life does flash before one's eyes, I'm doing the long, slow version. 

I'm looking forward to tomorrow and the serenity that defines my life back home in Bali. I hope my cats have missed me as much as I've missed them. 

May 22 (DAY 8)

Physically: Surprisingly I had a good eating and breathing day today so I'll drop a teenth to 0.7. 
I figure that there will be good and bad physical days now so really I shouldn't be too alarmed by what presents like a particularly bad day, or a seemingly good one. 

Emotionally: I'll trend back down a teenth to 3.1 because I'm back in the friendly confines of Ubud after a whole month and with sheer delight, despite being cats, both greeted me way more affectionately than cats are wired to. 

The end of life issues with the lawyers begins in earnest tomorrow with the transferring of contracts to ensure no complications later. Here's a thought: a man gets hit by a truck and has no time at all to tie up what he might have, given time. I have time, with all of my faculties. How fortunate am I. 

May 23 (DAY 9)

Physically: Back up two teenths to 0.9. Today's harsh condition compensated for yesterday's good one with a pendulum swing way the other way. The constriction of the esophagus seems to be underway now and it's just mushy food for me from now on. I have no idea how rapidly this will progress now, but I'll look forward, very much, to another good day soon. 

Emotionally: I'll trend up a teenth to 3.2 because of the reason mentioned above. I'm counting on 3-4 months for me still. Anything earlier will put a serious damper on my plans. I'd feel much better if I had the Dignitas seal of approval now.

Side note: 2 nights ago I was at the Willingdon Pub with an old high school friend whom I hadn't told, or planned to. He actually offered me a cigarette. "No thanks", I said, "I already have terminal cancer." 

"Yeah right", he replied, convinced I was joking as usual. 

May 24 (DAY 10)

Physically: Great day today with both breathing and digestion, so I'll drop down a teenth to 0.8. Maybe I shouldn't pay so much attention to good or bad days because this pendulum will swing both ways. I don't fear things getting worse; I fear things getting worse without an acceptance from Dignitas.

My Adam's apple has moved even farther to the right; it looks more odd than it feels. 

Emotionally: I'll drop down two teenths to 3.0 because of the reasons mentioned above. I just got back from dinner with my two besties in Ubud, Max and Tariq. So we're three guys, a Hindu, a Muslim and a Jew who get together often to solve all the world's ills, beginning with instilling in me the veneer of normalcy today. And it felt good.

Ayurveda: I started my first of twenty-seven days worth of an oral regimen, which I plan to take very seriously. My mind says this will work, and I expect my body to follow. 

May 25 (DAY 11)

Physically: Another great day on both fronts, breathing and digestion so I'll stay at 0.8. It seems so normal, yet not normal. 

Emotionally: I'll stay at 3.0. Emotionally I'm doing fine, I haven't once asked "why me?" I'm here. I'm dealing. I can hope my immune system withstands. I can hope Ayurveda works. I can hope this scourge decides to leave voluntarily. I'd like my thoughts, along with the ability to make future plans back please. 

May 26 (DAY 12)

Physically: Things are good for the 3rd straight day so I'll drop a teenth to 0.7. 

Emotionally: I'll stay at 3.0. 

Ayurveda is going well after 3 days. 

May 27 (DAY 13)

Physically: I'm up three teenths to 1.0 today because I had a novel episode this afternoon, a clear precursor for what is to come; a constriction of the esophagus along with an intense left side headache, like I haven't had before. I've had this intermittent headache for about two weeks now, but it is gaining in intensity. I took a 2-hour nap, felt fine after and went out for a bike ride. 

Emotionally: I'll raise to 3.1 after today. My nephew Miheer and his wife Diana flew in from Adelaide this morning and it's a joy to have them over. This afternoon's episode was a jolt to them too, but clearly it seems I'm going to need more sleep, especially in the afternoons. 

May 28 (DAY 14)

Physically: I'll stay at 1.0. I had a pretty uneventful day today, which is good. 

Emotionally: I'll drop a teenth down to 3.0 today after having a constructive conversation with my nephew and his wife out at the picturesque Tagalalang Rice paddies. The clearer the situation gets, the easier it is emotionally. And conversations help. 

May 29 (DAY 15)

Physically: The headaches have stopped so I'll stay at 1.0. I'm taking more naps during the day. 

Emotionally: I'll stay at 3.0 today. All's quiet on the southern front. 

May 30 (DAY 16)

Physically: I'll stay at 1.0 again despite the good day I had today, again. Forgot to take the afternoon nap but was no worse for it. Had a vegan wrap at the movies today and had difficulty digesting. 

Emotionally: I'll stay at 3.0 again today. I spoke to a doctor friend from Long Beach this morning and he said that with an Anaplastic Carcinoma confirmed, end of life issues were certainly in order, and that the Dignitas option was a good one. He did mention that when the constriction of the esophagus would begin, it would accelerate rapidly. I wish I knew when that might happen. Am I days, weeks or months away from that? Is it gradual or sudden. Knowing would sure help me plan. There's no behaviour manual for something like this, and for a condition this specific, google doesn't help. Not knowing is also stressful. I think I need to consider more than one plan B. 

May 31 (DAY 17)

Physically: I'll stay at 1.0 again today. Fatigue does creep in daily, but maybe it's just the Bali tropical heat. When I raise my hands over my head to put on a T-shirt, the constriction around my esophagus accentuates. 

Emotionally: I'll drop a teenth to 2.9 today for the following reason. Right after diagnosis on May 10, every time I'd wake up in the morning, my very first conscious thought of the day was that I was terminal. That was a brooding thought to start the day, with a sense of defeatism that left me unable to think of much else. The period of shock was interrupted only by sleep, but to rear back far more heavily upon my first waking moment. Well, not any more. These days, now that I'm over the shock, I awake, turn on the music, and start planning all the end tying issues necessary for completion. Emotionally I'm doing much better than I was right after diagnosis.

June 1 (DAY 18)

Physically: I'll go up a teenth to 1.1 for the comparison below. Between May 1 and June 1, if I ask how I've progressed adversely, honestly the change is measurable, just with constriction alone, which I fear most. How fast it will progress between today and July 1st, is an unknown for the lack of a primer for this affliction. I so want to negotiate for a date farther down, but only my immune system, the virulence of this strain, and possibly the abatement through Ayurveda will determine that date. With no more Allopathic treatment options on the horizon - come on Immune system/Ayurveda - buy me till December. 

On that vein, I had a dear doctor friend from Long Beach suggest this experimental therapy called Radioactive Iodine which is a prophylactic syrup or pill that abates the cancerous cells in the thyroid to allow more time to see what's on the horizon with newer therapies. But my trusted lord of all things cancerous, an educated doctor from Bombay and someone whose opinion I trust unequivocally, after conferring with his oncologist counterparts, wrote back with a 'nope, waste of time if it's an Anaplastic Carcinoma' response. So I'm back to Ayurveda and immune resilience. I didn't have my hopes up anyways, but it was worth a shot. 

Emotionally: I'll drop down a teenth to 2.8 because I had a lovely dinner with one of my besties here in Ubud, the jew bestie, and conversations such as this one, matter. This conversation reaffirms my need to remain consistent with my approach since diagnosis. Specifically that my personality that existed before diagnosis, should continue after, and beyond until the end. I'm finding out, through this experience, that I know no other way to deal with this scourge.

Ayurveda: Today marks the 9th day, a third of my first 27-day regimen of this treatment with another two-thirds to go. It feels great so far and with every sip of this concoction, I negotiate with the unwelcome swill within, to please leave voluntarily and allow me my life back. Allopathic is spent; Ayurveda a thousand years older, is my refuge now. 

June 2 (DAY 19)

Physically: I'll go up a teenth again to 1.2. Digestion is getting laboured, and fatigue is more of a factor. 

Emotionally: I'll stay at 2.8. Uneventful day. 

June 3 (DAY 20)

Physically: I'll go up four teenths today to 1.5 due to an episode I had yesterday that convinced me that the Carcinoma march had begun. It began at 3 pm and lasted till bedtime at 10 pm. I'm beyond being freaked out at this point but it was something novel, a shot across the bow if you will, to warn of what's ahead. And for that I'm grateful. It's pacing forward and letting me know politely, that it's there and it's growing. I get it. 

Then this morning, it was gone like it never existed. But it did. And it will come back. And soon. Of that I'm sure. Hence the jump of four teenths. 

Emotionally: I'm doing much better today having my brother Pradeep here so I'll drop down a teenth to 2.7.

June 4 (DAY 21)

Physically: I'll stay at 1.5. today. No headaches yet for the second day in a row. 

Emotionally: I'll drop down a teenth to 2.6 today. Pradeep is here and we had a hectic day visiting 2 temples and having dinner with friends. 

June 5 (DAY 22)

Physically: Another uneventful day but I will raise a teenth to 1.6 for what transpired over the day. Someone noticed a bulge in my neck today, which was a first. The pinch in my neck is getting steadily worse but I'm getting used to it. I'm losing my appetite slowly and the scale affirms that I am losing weight.

Emotionally: I'll stay at 2.6. I once saw a Belgian film called "The Brand New Testament" where every human in the world was informed, on their cell phones, exactly when they would die, as a prank by God. The film was poignant and hilarious. I would give anything to know the date that I will eventually pass; it would help so much in taking care of end of life issues. Tomorrow it's all about Lawyers, Wills and Banks with Pradeep and hopefully the process goes smoothly. 

June 6 (DAY 23)

Physically: I'll raise another two teenths today to 1.8. Had a painful episode again last night so I called Dr. J in Bombay and asked if I should take a Combiflam. It worked almost instantly. I think this fella in my neck is making his move, and I'll need plenty more Combiflam in the near future. 

Emotionally: I'll stay at 2.6 again. Today was a good day with the Lawyers and the bank. Our process will be streamlined quite a bit. The house goes on the market next week and its sale will mean a lot. Tying up possession loose ends and getting accepted into Dignitas will do wonders for my emotional state, and ease the process to culmination. 

June 7 (DAY 24)

Physically: I had a really good day today physically, so I'll drop down two teenths to 1.6. 

Emotionally: I'll drop down a teenth to 2.5 for the fine conversations I've had today. Also chilled soy chocolate milk = Esophagasm.

June 8 (DAY 25)

Physically: I can't figure out why I have a series of good days after every one bad day, but it's becoming a pattern so I'll drop down a teenth again to 1.5. 

Emotionally: These days, every time I see a person much older than me, I wonder how they came through so unscathed through life and why this cancer chose me now. The doctors have convinced me, all of them, that there was nothing I did or didn't do in my life to get this. In fact, for this virulent strain of Anaplastic cancer, the origination was probably some muscle, tissue or bone somewhere in the body, not the thyroid. So why not ten years earlier or later? We'll just never know. But the string of good days makes me feel like I'll see December. However unfounded, I'll take solace in that and drop another teenth to 2.4. 

June 9 (DAY 26)

Physically: Another fine digestive and healthy Ayurveda day will keep me at 1.5. 

Emotionally: Lately my dreams have been vivid and very violent and I can attribute this shift to only the knowledge of my terminal illness. I've never put much stock in dreams, because they're dreams, but the murder and mayhem that invades my subconscious daily now, here in serene Bali, throws me for an emotional loop. As my eyes open each morning there are a few moments that serve as a bridge between the subconscious and reality. I much prefer reality which I can handle with far more poise than I can my dreams. The abject violence of my subconscious has shifted my kilter emotionally enough for me to raise two teenths to 2.6. 

June 10 (DAY 27)

Physically: I'll go up an entire point today to 2.5 because the situation has probably taken an irreversible turn. Constriction has progressed rapidly overnight and for the most part I've lost my voice. I'll miss my voice. 

Emotionally: I'll raise half a point to 3.1 because last night was quite a turning point. Today marks exactly one month since Dr. J gave me the diagnosis of ATC (Anaplastic Thyroid Carcinoma) and with it, I figured that no matter what, the end was near. People often use expressions like "fight the cancer" when in reality, without being a defeatist, acceptance and planning are far more productive. 

Each of my six doctors has assured me that there's nothing I have done - or not done in my life - that has led to ATC. Some gene mutation somewhere in my body, around six months ago, settled in the thyroid and grew. And it just happened to be the worst of all the cancers. 

What do people do when they have adversity in their lives, adversity of any kind; business, romance, financial or for that matter health? They negotiate. They negotiate with whomever they have to, to settle upon that comfortable feeling that sounds like 'this too shall pass'. And it does always pass. Except this time, for me. The finality of this adversity leaves room for planning only a dignified death and nothing more. 

At 60, I know I'm serving as an example for those who will follow in later years. I didn't choose to be this example; this example chose me. And I'm doing all I can now to leave with dignity. 

June 11 (DAY 28)

Physically: I'll stay at 2.5 today and hope for a much needed good day tomorrow. The voice is hoarse most of the time but sometimes slips back to normal unexpectedly. I need to rest the vocal chords from here on out. More writing, less talking. 

Breathing is clearly more laboured now, as is drinking any liquids. 

Ok admitted TMI here, but the lack of the ability to burp has been replaced by wanton flatulence much to the dismay of both cats who tend to lie smack dab in the trajectory. This, they won't miss. 

Emotionally: Today brought the Dignitas issue far more to the forefront than ever before. The good news is that I've gotten a provisional green light with only a few docs left to deliver with the payment. I'm still hoping for some good days ahead to push the Dignitas D-Day out as far as I can. But there's no anxiety on my end whatsoever. I'm good with whatever outcome is in store, and at whatever pace. So I'll drop down a teenth to 3.0. 

June 12 (DAY 29)

Physically: Surprisingly, I had a pretty good day today so I'll stay at 2.5. Breathing and eating are fine but drinking often goes down the wrong pipe, starting a coughing fit. 

Emotionally: I'm doing fine emotionally so I'll drop down a teenth to 2.9. I know where this is headed; I've known for 33 days now. And someday soon I'll press that button at Dignitas. From this moment to that one, there's nothing that gives me fear, anxiety or the slightest bit of nerves for what is to come. Death will be upon me soon and I get it. When it's time, it will be time, because I'll want to go then. I don't feel anxiety; I guess I'm just not wired to feel that sentiment. But I didn't know this until I found myself a terminal patient. And that's not a bad thing to discover about yourself, despite. 

June 13 (DAY 30)

Physically: Had another good day physically so I'll stay at 2.5. Had only my 3rd Muscle reliever in 10 days. Not much pain yet. 

Emotionally: Staying at 2.9 today. Here in Ubud, I went out to a friends place for a heavenly meal with that never ending joint being passed around all night. It felt great. I'm still buzzed. Ate way too much. These are the moments to remember. 

June 14 (DAY 31)

Physically: Pretty uneventful day, so I'll stay at 2.5. My voice seems to come back to near normal in the evenings. 

Emotionally: I'll drop down a teenth to 2.8 today because the Dignitas final acceptance is within reach. 

June 15 (DAY 32)

Physical : Today started out very poorly but once I took a Combiflam things were better. The constriction trudges along at the speed of grass growing but soon the bustle in the hedgerow will be due its spring cleaning. If you had the choice, would you want to know when you would die? Most probably not. But for us terminals that information is indispensable. We know where we're headed, I even know how but I'd be most thankful to know when. Even if I could narrow it down to a week in the future. I'll raise a teenth to 2.6.

Emotional: My days are filled with things to do so much these days, I often miss my afternoon siestas. So I'll drop down another teenth to 2.7. 

June 16 (DAY 33)

Physical : And here's another fine day I'm having, with nary a Combiflam to boot. I've gotten used to being lulled into health complacency only to have every 5th day drop the bomb on me. My voice was stronger today than yesterday. What if this is just a sore throat? What if the Ayurveda is working? What if I'm still writing this blog a year from now. 

I'll drop down a teenth to 2.5. 

Emotional: And I'll drop down a teenth to 2.6 here too, for the following reason.

96% of the human body is comprised of just four elements: Oxygen, Hydrogen, Carbon and Nitrogen. It so happens that celestial bodies in all of the universe are mostly comprised of the same four elements. Stars die, we are born. We die, stars are born. We are dead stars. And if I do die prematurely, I have a small army of no less than ten Nephews and Nieces, primed and ready to replenish the same strain's cosmic junk forthwith. 

June 17 (DAY 34)

Physical : The persistent nightmares are most annoying. When I awake to conscious thought I'm fine, but the gory gloom and doom of my dreams, in anticipation of what will surely come, is unfair to a personality that is far more grounded during consciousness. 

I'll stay at 2.5. 

Emotional: I'll stay at 2.6 again although altering my voice this way, so soon after diagnosis, was unfair again. 

I'm articulate, I take effort in framing my sentences, I'm an engaging speaker and I love to talk. ATC is just a mean, mean fella. 

June 18 (DAY 35)

Physical: Constriction continues at its own pace but so far breathing and digestion are manageable. I just hope it continues gradually, like it's been doing. No overnight surprises. Be nice ATC. 

I'll stay at 2.5. 

Emotional: I'll drop a teenth to 2.5 and hey the physical and emotional meet at 2.5 for the first time. I always knew I'd get stronger emotionally as the body deteriorated, so this meeting point was expected, coincidentally at 2.5. So, am I half way there just 39 days after diagnosis? If so, that's way too soon I say. 

June 19 (DAY 36)

Physical: I think this is my 6th good day in a row. I'm feeling great. No complaints at all. 

I'll drop down two teenths to 2.3. 

Emotional: I'll drop a teenth to 2.4 tonight. I went to a party with my two nieces here in Ubud Bali, got stoned again, on some really nice stuff, and had some great conversations despite my raspiness. Nights like this make me implore for more time. You guys have no idea how good you have it. 

June 20 (DAY 37)

Physical: My voice seemed stronger today than it's been in a week, which was a pleasant surprise. I am losing weight though, I was 76 kilos in early May and now I'm 73, despite my 'what the hell' diet. The tumour is the size of a lime, and now it's hard and visible. My Adam's apple is off the coast in Nantucket. Otherwise, another strong day.

Despite all, I'll drop down another teenth to 2.2. 

Emotional: I'll drop a teenth to 2.3 today. 

About 3 weeks ago I joined a Facebook forum for just ATC patients and found a treasure chest of stories there. Mind you, these are not cancer patients or even Thyroid cancer patients, they're just ATC patients, and so, Terminals like myself. Only a Terminal knows what another Terminal is going through. 

I've exchanged messages with some and more than anything, I've found that I now have irreplaceable company on this journey. They share their deepest discomforts with me almost as a primer for what's in store, as I progress. They're patient, and loving, effusive in their personal experience and also, in a subdued sense, resigned to the inevitable outcome. Often times I read a thread from the beginning until the last one reads "my mother passed away in her sleep last night...".

I posted my story there because the difference with me is that I'm only 60, with no medical help whatsoever, while most of them are Americans over 65 with Medicare. Most were surprised and eagerly curious about Dignitas. It hurt me to hear cases where ATC patients chose to opt for chemo or radiation upon a persistent doctor's advice, only to find themselves in a vegetative state, a burden to their loved ones, and alive indefinitely, without vigour. 

To be fair, I did hear of two success stories; Ellen, a 74-year-old woman who beat ATC over a yearslong battle and now walks 5 miles a day while continuing her Chemo, and 62-year-old Michael, a 19-year ATC survivor who at age 43 had two Radiation treatments daily, 5 hours apart, with Chemo squeezed in, for 7 straight months and in his words, every time he swallowed his own saliva it felt like a blade was going down his throat.

Dignitas suits my personality best. I'm not giving up, I'm just not agreeing to be debilitated now, so I can live longer in a compromised state, only to die of ATC a bit later. So why isn't the option of Dignitas more available worldwide? If it were, would some of these undeniable Terminals, opt for a more dignified way out, for themselves and their loved ones? It's an option; an option societies deny the needy, behind the clever veneer of providing the best care for the sick. And insisting we comply, without even the option. 

June 21 (DAY 38)

Physical: And the voice is gone again. What concerns me more is the loss of appetite. I have to force myself to eat. The scale doesn't cooperate though. I can't afford a precipitous drop in weight now. Otherwise, today was a good day again.

I'll hold at 2.2. 

Emotional: When I have a string of successive good days I wonder if I'll beat this thing. But I'm not that naïve. I'll drop down a teenth to 2.2. 

June 22 (DAY 39)

Physical: I could get used to these good days in a row, eleven straight now. I had a particularly strong day all around.

I'll drop two teenths to 2.0.

Emotional: Songs on the radio throw me for a loop now. The lyrics resonate differently. I woke up to Bachrach's "What the world needs now, is love sweet love, it's the only thing, that there's just too little of..." and any other time, I'd be belting it out with him. I could hold that tune solidly. I miss that very much.

Still, I'll drop down a teenth to 2.1. 

June 23 (DAY 40)

Nothing eventful today for either, so I'll hold at 2.0 and 2.1 for Physical and Emotional respectively. 

June 24 (DAY 41)

I've had a rather shiddy day today all around. The Swiss government is being way too Swiss, with all their rules. Why does the process of seeking to die with dignity have to be so paperwork cumbersome. Surely they must get that they're dealing with someone who is terminal. You'd think after 6 weeks of spoon feeding them with all they've asked, paid their fees, received a provisional green light, that they'd offer their final stamp of approval. Sheesh!

I'll raise to 2.2 and 2.4 for Physical and Emotional respectively. 

June 25 (DAY 42)

Had a better day today than yesterday, so I'll stick with 2.2 & 2.4 respectively. 

June 26 (DAY 43)

Physical: Something's been up all day today. Fatigue has set in as has some pain when I cough. Hopefully Dignitas gives me the final green light this week. I might need their services sooner than I'd originally thought. But I'll hope for a better day tomorrow.

I'll raise .2 to 2.4.

Emotional: Crucial week upcoming here; I will talk to 2 doctors to navigate the path ahead. Although I pretty much know the answers already, some clarity and closure would do me well. 

I'll raise .1 to 2.5. 

June 27 (DAY 44)

Physical: Swallowing pills is getting increasingly difficult. I've stopped taking pills for other stuff because my cholesterol issues aren't going to kill me. But I do need a Combiflam almost daily now and I have to concentrate hard to get it down just right. 

I'll stay at 2.4. 

Emotional: I asked myself how much time I had left. Honestly, I don't think I'll see September. That's what my body tells me now, quite definitively. 

I'll drop .1 to 2.4. 

June 28 (DAY 45)

Nothing eventful today, so I'll stay at 2.4 for both. 

June 29 (DAY 46)

Physical: I had a marvellous day today with nary a Combiflam. What gives? Hey, I'll take. The cough is consistent but so far, so is good breath work. Eating is still an easier process than drinking, I say as I sip a beer. 

I'll drop .1 to 2.3.

Emotional: When I was in my 20's I took a strong liking to the author John Irving and after devouring "Garp" and a few other Irving novels that followed, I landed on what I still think is his seminal work in "A Prayer for Owen Meany" which is about a man who knows through a divine message on Christmas Day, exactly when he will die. The crescendo that built had a profound effect on me then, as it does to this day. 

Around the same time I remember watching a 1957 black and white Swedish film directed by Ingmar Bergman called "Wild Strawberries" again about an aging professor contemplating his life on what he knows to be his last day.

Over the decades since, I've spent many moments thinking about both the book and the film mentioned above and sometimes when I take my bike out to the rice paddies at sunset watching the farmers tend to their crops with swaying coconut trees in the periphery, I wonder if Owen Meany and the old Professor were meant to have this very camouflaged effect on me during these times. 

I'll drop .4 to 2.0. 

June 30 (DAY 47)

Another generally uneventful day today although the Combiflams are an everyday necessity now. I do have pain meds called Tramadol, but haven't felt the need for them yet. 

I'll stick with 2.3 and 2.0 respectively. 

July 1 (DAY 48)

Physical: The voice is getting more hoarse by the day, as is the constant cough. Otherwise, a normal day. 

I'll raise .1 to 2.4. 

Emotional: Exactly 60 days ago, on May 1st I went to my dentist for a root canal and upon his urging, completed, within the following week, all of tests that culminated in an ATC diagnosis at 8 pm on May 10th. 

In 60 days I've gone from a toothache to planning to set a date for Dignitas. The biggest difference pre and post diagnosis is that once the line is crossed, the host can plan for only one outcome. Strangely, I'm grateful for being given this lease, as short as it might be. That said I will attempt to eke out as many good rice paddy view days as I can, from here on. 

I'll stay at 2.0. 

July 2 (DAY 49)

All's well today. I'll stick with 2.4 and 2.0 resply. 

July 3 (DAY 50)

Another fair day. I'll stick with 2.4 and 2.0 resply again. 

July 4 (DAY 51)

Physical: A slight fever lingered all day, a first, and an annoying development. I sure hope this is temporary. 

I'll raise .1 to 2.5. 

Emotional: I'd like to write at length but with this headache, I'll push to a lengthier post tomorrow. 

I'll stay at 2.0. 

July 5 (DAY 52)

Physical: The fever's gone but I do feel the constriction progressing. Taking a pill is an arduous process these days. I have to place the pill on my tongue, tilt my head just right, take 3 sips and hope it goes down the right chute. Then I wait, and take 3 more sips to wash it down. I learnt this over the past week before which I was coughing up. I'm going to have to take pills in Zurich. How pray?

I'll raise .1 to 2.6. 

Emotional: I'll drop .1 to 1.9 today.  

There are those who talk about the clichéd 5 stages of grief; Denial, anguish, depression blah and blah, which are just fine for selling books, but they simply don't apply to the pragmatist. Allow me to explain, with a large dose of conceit. 

For a week leading up to May 10th I was being introduced to new words like "Sarcoma", "Neoplasm", "Spindle cell" and "Carcinoma" but it was clear that the most dreaded of them all was "Anaplastic". Cancer was playing Chess with me while I was playing Checkers back looking for words like "Benign" or "Malignant". 

Then at 8 pm on that fateful day, Dr. J, after some preliminaries, said simply "It is Anaplastic" and in an instant I went from being hopeful, to being terminal. Those words, I knew without a doubt, spelled a premature end to my life. But I still had an enormously important conversation at hand. It became clear to me, like a pivot table on a spreadsheet, that I had to follow through with the three questions I'd rehearsed for the past day:

Q1: How long do I have?

Q2: How will my body deteriorate?

Q3: Does India accommodate Assisted Suicide?

Dr. J gave me a vague answer to Q1, and disregarded Q3 because of that oath Doctors take. But for Q2 he answered in detail about how the cancer's objective was to envelope the oesophagus, constricting slowly and further explained how excruciating the process would be. I began researching Dignitas in Zurich within the next hour. 

For others in my position, my point is this: those blah blah stages of grief are not only unnecessary but each of those take away from immediate acceptance, clear thought and the planning required to cherish the time left. 

July 6 (DAY 53)

Nothing much to report today. I'll stick to 2.6 and 1.9 for Physical and Emotional resply. 

July 7 (DAY 54)

Again, nothing much to report today. I'll stick to 2.6 and 1.9 for Physical and Emotional resply. 

July 8 (DAY 55)

Physical: The discomfort is getting more acute, border lining on pain, yet the mighty Combiflam keeps things at bay. Fatigue, I've noticed lately, is quite prominent; sporadic cat naps fill the day. 

I'll stay at 2.6. 

Emotional: Things will go very well emotionally if my Pathology slide blocks recently DHL'd to Bombay will produce a compliant match for a new therapy called BRAF600V. I find out early next week if I'll have a new lifeline. 

I'll stay at 1.9. 

July 9 (DAY 56)

I'll stick with 2.6 & 1.9 respectively today. 

July 10 (DAY 57)

- - -

July 11 (DAY 58)

Physical: Turns out I will have to wait another week to find out about eligibility for the BRAF600V treatment. I realise I have a lot riding on this and without it, I'm looking far more seriously at a one way to Zurich. I don't have my hopes up but I will be ecstatic if I'm eligible for Braf which they say could buy me some serious time.

I have clearly moved from Discomfort to Pain now, and it's a constant throbbing pain that's exacerbating by the day. I dread to think of how it will have progressed a month, or even a week from now because it's pace is relentless.

It's not about good days or bad days anymore, it's the good and bad parts that make up each day. 

I'll raise .3 to 2.9. 

Emotional: The prospect of having to select a Dignitas date, probably within the next 2 months, really brings it home. I'm still handling this with all the courage I started out, but the recent lapses in health, with constriction specifically, make me feel weaker emotionally than ever before. It had to happen sometime. 

I'll raise .2 to 2.1. 

July 12 (DAY 59)

Physical: And then a full good day decided to present itself with pomp and serenity. 

I'll stay at 2.9. 

Emotional: I'm hanging way too much hope on Braf, without knowing how much of a difference it can make. 

I'll stay at 2.1. 

July 13 (DAY 60)

- - -

July 14 (DAY 61)

Physical: So I'm not a match for the BRAF mutation. I was so hoping for some good news here but there was only a 40% chance and it didn't work out. 

My niece has always said that we should leave no stone unturned. Looks like we're out of stones now. 
Otherwise, today was a good day. 

I'll raise .3 to 3.2. 

Emotional: I know where I'm headed now, and that does make things easier. Giving hope to a terminal is a dangerous thing because we want to believe, and cling on to that hope. Since diagnosis, I've known how this would eventually end, and no, that's not a defeatist sentiment. 
Now it's a straight march there. 

I'll drop .1 to 2.0. 

July 15 (DAY 62)

- - -

July 16 (DAY 63)

Physical: On a positive note, I'm fully accepted into the Dignitas program now, so no matter what, when things get worse, I have a dignified way to deal with the end of life. 

The non-acceptance of the BRAF mutation therapy was quite a blow emotionally and with no other allopathic option left on the horizon the final approval by Dignitas couldn't have come at a better time. 

The pinch in my neck is more acute, the left clavicle seems to be seeing the beginning vines envelop the bone, the tumour is the size of a lemon now, on its way to growing to avocado girth. 

I'll raise .1 to 3.3. 

Emotional: I'd like to say a few words in support of Dignitas and against the groups that work diligently to fight their efforts. These opposition groups are all religion based, in my case the trifecta of Hinduism, Christianity and Islam; the countries of my birth, my citizenship and my residence respectively. 

In unison and for two months now, this holy trinity has made every attempt to block my path to be green lighted by Dignitas but thanks to the aid provided by the progressive Swiss government, we've overcome their obstacles. This is a clear case of religion attempting to do harm in trying to hinder my ability to die a dignified death. Would the deities of these religions agree with the careless interpretations of their minions?

May we soon live in a world where every nation has a Dignitas equivalent to help the poor, the needy, the hungry, and the terminally ill. 

I'll stay at 2.0. 

July 17 (DAY 64)

- - -

July 18 (DAY 65)

It's been a particularly bad couple of days and I'm close to making some decisions away from what's been the norm for the past 2 months. More soon on that. 

July 19 (DAY 66)

Physical: My left side is deteriorating fast. I have a drooping left eyelid and from my shoulder to my pinky on the left side, I feel a tingling that's getting more pronounced each day. One doctor felt that this was the onset of interference with my nervous system. A compromising of my motor skills would be next. And it's just gotten scary. 

I'll raise .2 to 3.5. 

Emotional: There are only two ways the pendulum can swing now; in the allopathic direction with the commencement of Chemotherapy and Radiation or it swings way across to Dignitas. There's just no in between anymore. I've chosen the former route. So I leave for Bombay tomorrow, get some tests done over the weekend and begin chemo on Monday for what will be a 10-week regimen. Bring it on, John. 

I'll drop .01 to 1.9. 

July 20 (DAY 67)

- - -

July 21 (DAY 68)

Physical: The last few days have been brutal so I'll raise .1 to 3.6. 

I've cancelled my trip to Bombay because I can't think of anything worse for me now than enduring what comes with Chemo/Radiation and with that decision, I've removed the last vestiges of hope for an abatement to this cancer. Hope, can be a very dangerous thing for a Terminal and without a Thyroidectomy, any chemo or radiation is just hope unfounded. 

The way I see it, if I have a month left to live, I would be ill advised to voluntarily choose to make my body substantially weaker, so that I can live a little longer, in that weaker state. 

Thirty days. 
Consciousness. 
Love. 
Dignitas. 

Emotional: Dare I say I'm relieved to have just one direction left to pursue? If there are three categories of people who influence me now - family and friends who always mean well, Doctors who've taken an oath to trudge along by rote, and fellow ATC terminals on that forum on Facebook - I must say that the 3rd group is the one I take most seriously. No one else gets it like they do because they're recent wide-eyed terminals too, just grasping at answers for a lengthier life. 

Unfortunately they're dropping fast, as I will soon, leaving behind a tiny contribution on that FB thread for the next crop of ATC patients. 

I'll drop .01 to 1.9. 

July 22 (DAY 69)

- - -

July 23 (DAY 70)

It's been a particularly bad day today, the worst yet with breathing constriction. I'm afraid I'll probably have to head to Zurich earlier than planned. I'm so distraught, I really thought I had had all of August, and I'm still holding out hope that I do. But the ATC won't even allow me to pin down a date. If I make it to the 4th week in August, it'll be a personal victory. 

July 24 (DAY 71)

So, I've set the date of Saturday August 27th as Dignitas Day; exactly 34 days from today. The past week has been so tumultuous with fresh ATC based developments that really the 34 days ahead, seem like an eternity.

I will do everything I can to trudge along until then, hopefully without any health surprises, so I can fulfil the final tasks just the way this planner had planned them. I have no misgivings for setting the date with finality now, all I can hope for is that I'll make it to that date without a setback, and with pretty much the same physical condition I have today.

I am actually looking forward to Zurich now. Beautiful, compassionate, progressive, world inclusive, mature, torch bearing, exemplary, worldly, standard setting, neat Zurich Switzerland. 

July 25 (DAY 72)

- - - 

July 26 (DAY 73)

It's been a couple of days of spirals, all downward. Today I booked my ticket for Zurich for this Friday and shortly after, on a date not set yet, I'll set the Dignitas date. The pain is growing incrementally each day, and the sporadic good days are illusory. I once wrote that I'd be surprised to see September, and now I'm quite sure I won't. 

In a morbid vein, I tried to imagine what the insides of my oesophagus would look like right now and I saw a battlefield of a mossy sprout of creepy bulbous vines crawling upward to envelop the innocent, previously healthy tubes that help me function normally. Hopefully, tonight I'm not the only one with nightmares. Boohoohoohaahaahaa!

I have just three more days in Bali, an island, and a state of mind I will miss very much. 

For any of you still considering coming to Zurich, I land there on July 31st and expect to be around for at least 10 days hence. 

July 27 (DAY 74)

I see a lot of doctors and other folks associated with social awareness on this list. I want to say unequivocally that all the contents of this blog are free to be spoken, shared or disseminated, for educational purposes, in any manner, by any of you.

If there is something to be learned about the swift progression of ATC cancer, from diagnosis to death, and if my experience lends a unique perspective, I'd be honoured to have these words serve an educational purpose. 

July 31 (DAY 78)

For the second time in three months I had to look back as my flight took off to leave behind my beloved Bali, home for 8 years, for the last time. Memories, love, dreams, adventure and a home like no other I've had, all encompassed in that one small spatch of green grass below.

I'm in Zurich now with the family and a friend from America. Over the next 2 weeks I have a few more friends from all over coming here to Zurich to dig into me one last time. 

Since I last wrote on this blog, I pushed the D-Day up earlier because the body is deteriorating much faster than I had hoped. Why couldn't I have had a cancer that allowed me a year at least instead of 82 days since diagnosis and a few days more.

I will be sitting down with the kind folks at Dignitas tomorrow morning to hammer out a final Dignitas day. More soon. 

August 4 (DAY 82)

My apologies for these diary input lapses, I'll be sure to contribute daily from here on. 

Today I met my doctor here at Dignitas in Zurich, a Dr. Moses, who had the best bedside manner ever. We have now scheduled the date of Tuesday, August 16th for my departure. Dr. Moses talked to me about the procedure, then went one step further to show me the blue house where the procedure would take place. I know what to expect now and am prepared for this very humane method for assisted dying. 

There must be a clear delineation made between suicide and assisted suicide. The former is either planned over time or enacted on a whim, but to a physically healthy body that might have lived decades without that host's premature life ending decision. Personally, I've found that decision to be repugnant and selfish. Yet I'm signing up for - and lauding the virtues of - the latter, an organised process with the same outcome as the former. 

Well, for those of us who choose to die through the assistance of the organised processes at an outfit like Dignitas, all were really doing is expunging months of suffering. And when you're a classified terminal, deciding not to live in pain is an easy decision because the added few months accompanying the abject suffering has no value to the caretakers, the family and most certainly not the host. 

Without Dignitas, our societies are in essence, insisting that people suffer until death. When pray, will compassion and reasoning win over the right wing loonies clutching on to their burning books while prosthelysizing?

August 5 (DAY 83)

Dr. Moses and I have been getting along well and we exchange heartfelt hugs every time we meet. He calls me Brother Krishna and I call him Brother Moshe. He's a soft spoken man, diminutive in stature with gentle eyes and a baritone voice that commands attention.

He was born on August 15th 1947, an auspicious day for all Indians and I reminded him about that. This year he turns 75 - as does India - the day before my D-Day, so we've decided to meet at a bar in downtown Zurich with a cake.

Moshe must have a very tough job, having to explain, in detail, the process of an assisted death to terminals far younger than himself. Yet he does this by rote to various candidates weekly, with the poise of a refined doctor of medicine. If you met him, you'd want to hug him, for no reason whatsoever.

Moshe informed me that on my D-Day there is a double booking which means that there will be another Terminal going through the same process with me, in another part of the Blue House. As one might surmise, the demand is high here.

I wonder if the two Terminals will get to meet. You know, just two folks, from different walks of life, making eye contact, shaking hands, with an hour of life left to live. Maybe I'm asking too much to think that the other Terminal will be as amenable as I am. But I sure wish we can greet each other with camaraderie as we enter the gallows. We both know why we're there. Nothing wrong with a dignified Tata for the two Terms.

August 6 (DAY 84)

Yesterday, I was called out by someone on this blog list for my comments about suicide a few days ago when I called depression based suicide repugnant but went on to justify the assisted suicide route I've chosen for myself. She called me elitist and judgemental. And she was right. So I'm here to recant those words and apologise to those I might have offended regarding my views about suicide. You learn something new everyday, even when you have just ten days left. 

And now for something completely indulgent. A few years ago I had decided to make my life pivot into a different direction so I wrote myself a note for rules to live by and called it TLC or The Life Charter. 

I know, kinda cheesy, but I ended up listing 15 points for self improvement. I'd review and tweak the list each Saturday. It did help a lot, but then I like lists that reinforce. Here are three of them flushed out. 

TLC: 

1. ON GROWTH & PERSONAL RELATIONSHIPS: Nurture all meaningful, personal and family relationships. Talk far less than others, but listen intently, and engage without interrupting, enhancing listening skills in the process. Make each conversation constructive for both sides. Promise only what can be delivered. Live each day with integrity, but critically underscore the occasional lapses. Respect all individuals' rights to be different, no matter how far they stray from personal points of view. Discourage negative trains of thought, nip them at inception. Respond to others' ignorance, with aplomb. Be constantly wary of temper; learn to recognise it before an episode. Hold ground when right, without being hurtful in response. Eat more fruit. And embrace reclusiveness. 

2. ON ROUTINE AND EXERCISE

3. ON DIET

4. ON INTOXICANTS

5. ON READING & PODCASTS

6. ON MEDITATION

7. ON WRITING

8. ON SCUBA AND PHOTOGRAPHY

9. ON FINANCES 

10. ON VILLA RENOVATIONS

11. ON MINIMALISM: Henceforth, live a minimalist lifestyle. Avoid needless purchases; carefully consider every single future purchase. Buy only essential items, and rent most non-essentials. For instance: Have a dozen favourite shirts, and don't buy any more, reducing the carbon footprint in the process. Be frugal with every expenditure. Sell as many items presently possessed for fair market value, while bequeathing many other items to the needy.Invest in moments, not in possessions.

12. ON SOCIAL INTERACTIONS

13. ON TIME MANAGEMENT

14. ON TRAVEL

15. ON LARGESS: Be sure to give 7.2 % of monthly income to Non-Profit Yayasans like YCM and others. Design and develop the Nalini philanthropic website. Find other local Ubud based Yayasans and bequeath fairly to each of them based on urgency. Think of new ways to improve their lives, like teaching, computer programming, language learning, etc. And volunteer time as well as money. 

August 7 (DAY 85)

Physically I'm really falling apart. The entire left side is on its way to paralysis, daily fevers are here, I get sudden inexplicable head flashes, fatigue is constant, and the big fella is tightening his grip on my throat. August 16th can't come soon enough. I know this all sounds so dour but honestly this is what dying feels like; not for much longer though. If anyone's still keeling score, I'm as close to 5.0 as I've ever been. 

Emotionally I'm still doing as well as I'd expected to. There's something known as a Happy Quotient or HQ. We all know people who live at a 9, and are generally happy with everything. Research has shown that no matter what adversity or good fortune enters their lives, in a short amount of time, they find themselves back at their familiar HQ of 9. If they're incarcerated or win the lottery, a year later they're right back at 9, because they have the innate ability to adapt.

I think I might have a high HQ because the personality I had pre-diagnosis has continued on seamlessly post diagnosis despite the thud of finality awaiting me in 8 days. I guess I just don't know how to feel those normal feelings of sadness for the situation. 

I remember the last time I cried, it was 9 years ago. There's a part of me that wants very much to experience another cry before I go. Not just any old cry, but that existential wail for the ages. The one that makes you want to look skyward and lament why your father ever expended the sperm to create you. I've got 8 days to dig deep to joust that emotion just right. Final checklist item: Cry. 

August 9 (DAY 87)

What if there's nothing. 

I've been thinking about the after life quite a bit lately, more so because a lot my friends remind me that they'll see me on the other side. Now of course there are many ideological planes about the other side but let's consider a popular one.

So, I die peacefully soon and the next moment I'm standing in line on a cloud waiting for a guy called Peter to check me in through the Pearly Gates. The scene is idyllic, replete with infant white, curly blond haired children playing the harp on their own tiny clouds to welcome those in my batch. And I am left there feeling very stupid because they, the ideologues who ardently believed in this thought strain, were right all along.

Or I might consider an ideology closer to home where upon my death I'm instantly reincarnated into, let's say, a giraffe, and again I'm left feeling quite stupid because this ideological strain was right all along.

But what if there's nothing. What if I die peacefully on Tuesday, I'm cremated, my ashes are put in an urn to have sprinkled somewhere and what's left is simply the memories of people who knew me. Around fifty hears hence, the last person that ever knew me or of me, dies and with that death, poof, I never existed. 

I think the ideology of nothing post death must be considered to be as plausible as the structured ideologies embraced by an overwhelming majority of societies, because we just don't know.

Although my nature inclines me to subscribe to the 'nothing' ideology post death, I fervently hope I'm wrong, and I'm left feeling stupid because they were right all along. 

August 10 (DAY 88)

In 1972 I watched a film called "Little Big Man" where the opening scene had a young Dustin Hoffman playing a 100-year-old Native American, sitting atop a hill overlooking his village as he says: "today is a good day to die and so I shall". Over the next 3 hours we watch a young man live through an integral part of American history, to end up as the Chief of his village, atop that hill at age 100. He soon realises that he can't induce his own death and so he walks back downhill and goes to sleep in his Wigwam.

If I should be so lucky.

August 16th seems like a good day to die and so I shall because dammit, I'm having it induced by professionals in Switzerland who will monitor and execute the death in a humane way, for a fee. And it's perfectly fine to call that progress.

Here's how the process will take place; if you're squeamish you may want to tune out now.

I get to the Blue House around 9:30 am on Tuesday and hopefully meet the other individual who will be going through the process at the same time. The living room has a sofa on the far side for family, a bed with a smaller sofa next to it, a kitchen and a bathroom.

The nurses give me my first drink that lines my stomach to receive what will come next. For the next 45 minutes I can mingle with my family and reminisce over old times. Then one of the nurses in the kitchen will stir 15 grams of a compound called Sodium Pentobarbital in a glass of 100 ml of water and once I'm ready she will give it to me and ask, "Do you understand that what you are about to drink will kill you?" I must answer in the affirmative. This process is videotaped by the Swiss authorities to ensure adherence to their protocol.

She gives me the drink because, without any assistance, I must take the glass from her and drink the entire concoction in just one or two gulps. Then I've got 3-5 more minutes of having to say my last words. I could be in mid-sentence when my eyes shut and I slip into a coma where I will stay for around 30 more minutes until my respiratory system begins to fail, and I flatline. Painlessly.

My remains are to be taken to the crematorium forthwith and an urn with my ashes will be given to a sibling. In my will, I've chosen five of my Scuba friends to take my ashes and spread them around a spatch of coral in Johnny's Gorge an hour off the coast of Havelock island in the Andaman Sea.

Deep into one of those coral bushes in a tiny section of Johnny's Gorge is a village with a hill, with this little big man walking down to sleep in his Wigwam. 

August 11 (DAY 89)

Yesterday I had a long conversation, an interview actually, with one of the senior members of Dignitas. He is a gentle man, quite passionate about the Dignitas philosophy and it occurred to me during the conversation that it will take a small shift in critical thinking for a successful grassroots movement embracing the practice of assisted suicide, to become more prevalent worldwide.

One day we're vehemently opposed, and the next, people think about what's at stake, think some more, and before you know it the practice of assisted suicide is out of the dark room and into the spotlight; the refined, dignified spotlight, where it's always belonged.

Do the naysayers really want people to suffer? Is that what they want? Clearly religion plays an enormous role here and maybe that shift in critical thinking needs to begin at the house of worship.

Your lord, pick one, wants humans to suffer less. It's written. Heed the written word, not the crass interpretation. Come on Holland, Portugal and Germany - you're up next. 

August 12 (DAY 90)

So, how do I feel about death?

Well, I don't like it at all. I don't like that it just crept up on me like that, that it's disrupted all my travel plans, that it's depriving me of more days in the sun, or from being in love one more time, from feeling the sanctity of Scuba again, or the flushed feeling I feel after watching an Ingmar Bergman fim, I don't like death's unrelenting march forward with no pause for negotiation, or its daily smugness because it knows it'll win, and I don't like its finality replete with a date stamp.

I think death is a lousy thing, even for the person that's dying.

August 13 (DAY 91)

As my body deteriorates fast, I take refuge in the fact that I have a dignified out. How fortunate am I to have researched Dignitas, gone through their arduous acceptance process, vetted them in person, understood the entire process and chosen a date two days from now.

Imagine if I didn't have Dignitas in my corner. Aside from being very stressed, what pray would I do about my impending death? We're all clear about one thing: Assisted Suicide or not, I am dying of ATC, and soon. So, how would I deal with not just inevitable death, but the path to it; a path littered with health pitfalls that might permit me another six months of abject suffering, clawing its way to the apex of natural death.

I wouldn't deal with it. Not me. If suffering was the only alternative, I'd have to find another way. The way millions before me have had to resort to: Suicide. Conventional suicide which might involve a noose, a knife or a bridge. And that is just not like me.

The thought of having to end things in an undignified way scares me more than the act itself. I honestly don't think I could go through with jumping off a bridge, for instance. I've never had a suicidal thought in my life and to be compelled to have one would be horrific. 

Now do you see the importance of Dignitas?

August 16 (DAY 94)

Stop the presses! News flash!

Brother Moshe and I talked it out yesterday and decided to push the date for my departure out to one week from today, so Tuesday Aug 23rd it is. 

Reprieve. 

August 20 (DAY 98)

It is getting increasingly difficult to express myself with my writing, hence the lapse in posts. The mind is constantly in a fog due to the ever growing pain. The difference in my health between this week and last is measurable, and the time for my Dignitas departure of 10 am Tuesday August 23rd is cast in stone this time. 

Tuesday, will also mark exactly 105 days from diagnosis to death. Four months ago I was a healthy 60-year-old hitting the gym regularly and today I've chosen the date for my assisted suicide. 

Since I've seen the location, I've envisioned the entire process from first entry to coma and I expect my actual experience will be as fluid as I've imagined it. I hate surprises, especially for my deathday, so how about letting me plan...everything. 

For centuries our Black brethren weren't allowed to vote, and then they were. The same was the case with our women. A tiny shift in critical thinking ushered in a norm so solid that soon the pre-norm was regarded with societal scorn. And here we are, at the precipice of yet another such moment in our evolution except this time we're striving to reach farther than just a human right, and into a space where the inalienable right to end one's life is met with compassion. Is there any clearer sign of a society's maturity?

Even as I write this, I find the concept of an assisted compassionate passing so fundamentally sound that that shift in critical thinking is not only imminent, but long overdue in this patient's view. After my passing, can we all just snap out of that resistance funk to this concept and get on board to serve as catalysts for change in this regard? How, you may ask. Well, just talk about it more. Bring up the subject in conversation, at the water cooler, at a party or on your own blog. Kickstart change, the old fashioned way. We're all checking out of life at some point aren't we? I'm the youngest of five who hadn't heard of Dignitas four months ago and I get to go first because of some freak gene mutation. And there's nothing wrong with talking about that. 

Has this Diary given you some pause for thought for when it's your turn to go? Ralph Waldo Emerson once wrote: "To know even one life has breathed easier because you have lived, this is to have succeeded." By that measure if the most impactive contribution I will make in this life, is by dying such, I'll accept it and wear it like a badge. 

August 23 (DAY 101): Final entry

I feel no differently today than I did the day I was diagnosed 105 days ago. This is what I'd expected to happen. I have peace within and expect the day to go just as I have envisioned it. Mind, body and soul are in sync going forward the next three hours. 

Make an effort to understand yourself first, don't work too hard, get a pet, travel more, be generous with the knowledge you have, try a psychedelic, make eye contact always, meditate whenever, treat animals like you would humans, read a classic now, give atheists a chance to have their voices heard, have a hobby you're passionate about, mentor someone, have one fruit everyday, accentuate the positives in yourself and others and work on leaving a worthy legacy. 

Love you all.

Disclaimer: The views expressed in this blog are that of the author alone, who specifically requested that it be published by NDTV and without any changes to the content. 

NDTV neither endorses nor is responsible for the accuracy or legality of any statement made by the author; NDTV is not making an argument in favour of - or against - assisted suicide at a medical clinic; these are complicated legal, moral and ethical matters beyond NDTV's remit.

NDTV bears no liability for any loss or damage incurred by a reader who may be influenced by the blog. Readers should seek the advice of professionals, as appropriate, for evaluation of information shared in the blog.