Isabella

I took the above photo of my beautiful friend Isabella Gamk on the day of her MAID (medical assistance in dying).  MAID is a process by which a person is able to receive legally sanctioned assistance in ending their life from a medical practitioner like a nurse or doctor.  In this narrative, I will talk her process of getting MAID, what it was like to anticipate her death, and what it felt like to be with her on the day it happened.  I am doing this to raise awareness about MAID and hopefully help other people who may have a friend of family member who is considering, waiting for or have already passed from MAID.

Isabella’s MAID day took place on November 2, 2024.  On that day, I spent the morning photographing her final hours with her friends and dogs.  I did not release the photos or write this story for two months because I needed time to grieve.  As well, I was hesitant to present the photos of her MAID day to the world because I thought it perhaps was too intimate of an experience to share.  However, after consulting with Isabella’s friends who were with me on the day, we decided that it was important to share the photos and story as a part of her legacy. 

The application process for MAID takes at least two weeks but folks can wait several months for their appointment – Isabella waited a year for her appointment and had to go through various consultations with medical and mental health professionals.  Some requirements for MAID include having a serious illness, disease or disability that cannot be reversed, experiencing unbearable suffering and having the ability to give informed consent.

Isabella Gamk was a transwoman living with a physical disability, a long-term AIDS survivor and anti-poverty advocate.  I met her at Pride Toronto a couple years ago and we became very close friends.  I live with HIV myself and having her as a friend helped me to feel more accepted as I have experienced stigma due to my status.  I also suffer from chronic depression and whenever I would feel down, she would invite me over to her house to talk and hang out with her two emotional support dogs, Sparkle and Glisten.  I would greet her with a peck on the lips and say goodbye to her with another kiss – I often joked that she was my wife even though I am a gay man.

When she told me close to the end of 2023 that she was going to get MAID, I was sad but I accepted her decision.   Due to the effects of AIDS, she suffered from chronic debilitating nerve pain that required her to use a wheel chair.  I had witnessed her many times writhing in pain when having to do simple actions like lying down or when I would give her a massage.  She also dealt with daily mental health struggles due to trauma and abuse in her youth. 

The months leading up to her MAID appointment were difficult for me.  I experienced anticipatory grief thinking about how I would exist without her in my life.  I feared what it would feel like to watch her pass and whether or not I would be able to cope.  I felt angry about how social oppression and her life circumstances had led to her to this situation and how unfair it was for her to have to turn to MAID to end her suffering.

I was also angry at Isabella because I saw her choosing MAID as a way of abandoning me.  However, I never brought these feelings up with her because I did not want to burden her with guilt or add to her stress.  In the months leading up to her MAID, I visited often, just sitting quietly and listening to her talk about the process and how it was making her feel.

She expressed to me that she felt no fear about dying and that she was looking forward to the relief of not having to experience physical pain anymore.  However, she felt stressed about having to put her affairs in order, like giving away her possessions and finding new home for her dogs and arranging their vet care after her death.  She also felt sad about how some friends were not showing up for her during her limited time left on earth.

We would often make jokes about her MAID to lighten the mood.  One time, we came up with a plan to make me money – she would get a loan from the bank, give me the money, and then there would be no way for them to get back the money because she would be dead.  We laughed and of course we never did this….but maybe we should have.

The night before her MAID, I slept over at her apartment.  I had hoped that night that she would allow me to cuddle her or hold her hand while she fell asleep.  I thought that’s what she would have wanted and the sentimental part of me wanted to have a memory like that to comfort me in the future.  However, she was very nonchalant and went to sleep alone as if it was any other day.  I slept on the couch that night sad but happy to know that her last night alive would not be one where she was in her home alone.

The next morning, I lay on her couch, quietly cuddling one her dogs to my chest while Isabella took a shower.  The dog looked sad and I believe he knew what was going to happen.  I could hear Isabella in the bathroom screaming and crying.  She was upset because many of her friends and followers on Facebook were sending her last minute messages telling her not to go through with her MAID. 

She went live on Facebook and told her followers  to stop harassing her about her decision to get MAID.  She told them that if a person has already chosen to get MAID, their decision needed to be respected and that trying to change their mind would only cause more psychological harm.  Later that morning her friends started arriving at the apartment.  Her MAID appointment was at 1:00 pm and they were there to spend her final hours with her and help prepare her last meal.  She lived with severe IBS and therefore wanted her last meal to include foods she had been forbidden to eat – lasagna, bacon and a chocolate cake (which I had baked for her).  I had no appetite but everyone else enjoyed the food with her.

We all spent the morning chatting, laughing, cuddling with the dogs and supporting each other while waiting for the MAID doctor to arrive.  I could tell that Isabella’s friends were sad but were holding their feelings inside to spare Isabella anymore psychological distress before her death.  I observed them with a smile on their face while conversing with Isabella.  When the conversation ended, the smile would disappear and be replaced with an expression of sorrowful contemplation.  Occasionally, a friend would take Isabella aside and she would simply hold them and comfort them while they cried.  Nevertheless, the mood was kept celebratory – Isabella wanted her last day to be as happy and peaceful as possible.

The weather outside was beautiful and the sun lit the room making the rainbow coloured flowers on her coffee table look especially vivid.  I had bought her those flowers the a couple days before and she had exclaimed that they were her “pride flowers”.  We talked about how it seemed like Mother Earth was giving her the perfect ambience and setting for her passing.  As a photographer, capturing Isabella’s final hours on camera was a novel and strange experience.  I was feeling very sad but my emotions were being held at bay by my photographic mind.  It felt odd to be a participant in a very intimate and emotional event while at the same time being an observer viewing the situation through a technical lens and trying to compose and light each photo properly.  

A part of me was wondering if it was insensitive for me to be creating art out of someone’s final moments before death.  However, another part of me felt that it was my duty as a photographer to tell Isabella’s final story – over the past two years, Isabella had been my muse and I had captured her in many situations like her cuddling with puppies that she had fostered, speaking at protests and performing poetry in a talent contest.  As well, I think a part of me wanted to captures as many photos of her as possible on her last day as a way of preserving her and keeping her with me.

At around 1:00 p.m., the doctor finally arrived with his MAID kit and Isabella was ready.  A few moments before her death, I gave Isabella a hug and I thanked her for being my friend and supporting me over the years when I was struggling with my mental health.  As I held her one last time, I couldn’t hold back the tears I had been trying to hide all morning.  I continued crying as I photographed her saying goodbye to her friends with tears in her eyes and as she walked into her bedroom for her MAID.

She lay down in her bed, surrounded by all of us and her dogs, and I held her shoulder while she received her final injection.  As she fell asleep, one of the words I heard her whisper was “prophet”.  I sobbed as I felt her life force dim and float away.  It was all over in a matter of minutes.  However, I stayed by her side for 15 minutes after, just holding her hand and crying.  When I had finished crying, I stayed at her apartment for an hour, trying to process what had just happened and comforting my fellow mourners.  And then I went home.   Later that afternoon during a walk, I looked up at the sky and exhaled with relief, knowing she was at peace.

The grief process has been difficult.  There are days I feel nothing and other days where I breakdown crying.  Sometimes when I get depressed, I remember the many times I had gone to Isabella in the past for support and I feel sad knowing I don’t have her as an emotional anchor anymore.  However, I continue living and engaging in social justice work and art because I know that’s what she would’ve wanted for me.  I also remind myself that she doesn’t have to suffer anymore and knowing that she is free beings me comfort.  It has been helpful for me to process my grief by talking to my friends, family and a counsellor. 

When loved ones in the past have died, I have kept them with me by continuing to talk to their soul and even getting hugs from them from the other side – this is due to me being a Christian and believing in God and the soul.  However, Isabella was a militant atheist and hated Christianity so for a while I felt guilty trying to summon her for support from the spiritual realm.  However, I have come to believe that when we love someone, that love never goes away and continues after their death.  This love is manifest in memories and the legacy and impacts of their love that continue in the lives of those who they touched.  Isabella’s love made me a better person and I will continue to spread her love by making a difference in other people’s lives and the world.  I think of that love when I feel sad and when I call for Isabella, she comes.  And I know she is still here with me.  R.I.P. Isabella, I’ll love you forever.