Why Choice is an Illusion?

Monday, June 11, 2012

From Afghanistan to Activist Against Assisted Suicide: "These are things worth fighting for"


By John Coppard

To view the original publication in Brain Tumour Magazine, click here.
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It was early summer 2009 and I was on my second “tour” in Kabul, Afghanistan, this time as NATO’s civilian spokesman.  I was responsible for representing NATO to media from the Alliance’s 28 member nations - regional powers such as Iran, Russia and Pakistan, and other troop contributing nations to the International Security Assistance Force, as well as Afghanistan’s own emerging media.  While my military counterpart handled military-specific issues, I was responsible for explaining the political and diplomatic aspects of NATO’s support to this brave and tragic country. With lukewarm support for the mission in many contributing nations, and a traumatised Afghan population bombarded by Taliban propaganda and wary of Western intentions, the stress of the job could be intense.

I felt up to the challenge.
But in the spring of 2009 I began to feel periods of light-headedness, bordering on faint, and experienced strange tastes and smells, later identified as small seizures. I first chalked it up to heat exhaustion and
maybe stress, something my relatively junior military MD supported. But it wasn’t until two friends confronted me and told me that “something was seriously wrong with me”, that I aggressively sought treatment.  I still believe one of them, a young major, may have saved my life by confronting me the night before she left for Canada. I went back to the doctor the day after and was advised that a team of US military neurosurgeons had just arrived from the large US military hospital in Langstuhl, Germany, with a CT scanner. They were at the nearby Baghram Air Base, outside Kabul, in anticipation of an influx of US and Polish combat casualties from a major operation in the east of the country.  I was told that if I got in to see them right away, I might be able to get a CT scan.


John Coppard
After a high-speed, hair-raising drive in a private Toyota Corolla with my brave and devoted Afghan interpreter and country advisor (a trained but unemployed radiology technician it turned out), the doctors detected a tumour the size of a pool cue ball in my right temporal lobe.  Not to worry they said, it may be benign.

Unfortunately, that wasn’t so. Several days later after being medically evacuated to Brussels and operated on, my Belgian neurosurgeon gave me the news. He had successfully removed most of a 5 x 5 x 4 cm brain tumour, but it was malignant: an aggressive Grade IV Glioblastoma Multiforme (GBM).

What surprised me was how upbeat he sounded when he gave me the news that I had a 20% chance of surviving five years according to the latest edition of the British medical journal, The Lancet.
“What’s so good about that?”  I thought, not realizing that had I received the same diagnosis before a
relatively recent treatment combining temozolomide and radiation had been developed, my prognosis would have been measured in months.

I underwent the whole six-and-a-half weeks of the combined treatment, then returned to Victoria, British Columbia, on the west coast of Canada, to be with family and friends. I began to stabilize and became more optimistic, particularly given the professionalism of my doctors. The brain tumour experts all seemed to know one another, whether in Canada or in Belgium. It was an encouraging sign.

Unfortunately, after about six months my body built up a resistance to temozolomide and my tumour reappeared.  Again, however, a recent development in medical science gave me new hope. My oncologists consulted with an esteemed neurosurgeon in Vancouver, a gentleman known personally to my Belgian neurosurgeon, who put me on a combined treatment of Avastin and etoposide, the latter being a chemotherapy capsule. The combination knocked the cancer back immediately. That was over a year and a half ago and I’ve been doing great since. That’s why when I heard that a high profile court case was challenging Canada’s laws prohibiting assisted suicide, I felt the need to speak out. The case, should it succeed, proposes something quite radical whereby anyone with a “grievous and irremediable” illness such as cancer, or even diabetes, could be legally “steered” or counseled to take their own life, even by a potential heir, their own medical system, or a nurse, doctor, or caregiver. They would then have ready, legal access to a prescription dose of death-inducing drugs, and assisted in taking their own lives by anyone, even an heir, without a physician or an independent witness present (see the Carter Amended Notice of Civil Claim at www.epcbc.ca).

John Coppard Speaking Out
I had experienced periods of great distress during my two-and-a-half year journey with brain cancer and realized how my rights could have been abused had such a system been in place when I was in the early stages of my journey. I believe my country’s anti-assisted suicide laws exist to protect me and people like me from abuse when we are at our lowest and most vulnerable. I have been given a second chance at life due to highly professional medical support from a system dedicated, and legally bound, to treating me.

As a retired Navy man with 24 years’experience in the Canadian Forces, speaking publicly about myself and my periods of vulnerability was not easy, even with my training as a spokesman. But I believe those of us who are living with brain tumours, and have the ability to do so, should speak out on health, legal and
political issues that affect us.

I believe we owe it to those who no longer have a voice due to physiological or psychological reasons to protect their rights as much as we can, and ensure they, and we, have the opportunity to avail themselves of the best treatment possible.

I was personally overwhelmed by the positive response I received for speaking out, and remain hopeful that as medical science continues to advance, all of us who live with brain tumours may benefit from systems, societies and laws that protect our rights, serve our interests, and give us the best chance of living long and happy lives.

These are things worth fighting for.

(John Coppard - 29 July 1966 - 5 March 2012)