 I'm Marcia Joyner, your host for Navigating the Journey. Navigating the Journey is dedicated to exploring the options and choices for the end of life care and to assist people to talk about their wishes. It's time to transform our culture so that we shift from not talking about dying to talking about it. It's time to share the way we want to live our lives at the end of our lives and it's time to communicate about the kind of care we want and don't want for ourselves. We believe that the place for this to begin is not in the intensive care unit. Together we can explore the various paths to life's endings. Together we can make these difficult conversations easier. Together we can make sure that our own wishes and those of our loved ones are expressed and respected. Today we had the rare opportunity to talk to John H. Ratcliffe, a very special friend, a pillar of the Hawaii community with terminal cancer. Ratcliffe was diagnosed in June 2014 with incurable colon cancer that has metastasized to his liver. He is currently undergoing his 44th round of chemotherapy. He has been in the emergency room 15 times and had three extended hospital stays. John is venturing down a path along the journey that we have not had the privilege to discover. Aloha John and welcome. Thank you Marsha. Thank you very much. It's a pleasure to be here this morning. I am so happy to have you. For anybody that doesn't know, I can't imagine that there's anybody in Hawaii that doesn't know John. He has been here since when, 40 years now? Well, yeah. I came here in 1975 to run the State Teachers Union and I did that for 13 years. And following that, ran for Congress in 1988. I lost, which was a very good thing for me. It really helped me a lot in life. And then I settled in and started operating the University of Hawaii Professional Assembly, JN Musto and I pretty much ran that organization for 17 years and he for 30. And then I retired from that and I've been a lobbyist for since around 1990 or so. So I do a lot of lobbying. And I've been at the legislature now for your right 41 years. Yes. Have I known you at all? I guess it has been. I think so. We've known each other a long time. A long time. We were doing civil rights stuff together back before when we were trying to get a Martin Luther King Day here when it was very tough to get people to come out. It was. And we also did a lot of stuff for gay rights and stuff when it was not very popular. Are we always on that side? Well, yes, Marcia and I are both card-carrying Democrats and liberals, so that's just the way that is. Well, we want to talk about you today because you are venturing down a journey, a path that most of us have seen, have had family members, but we don't get to talk about it. Now, the paper said that you actually had your chemo treatment while you were the guest at the legislative opening of the legislature. That's what you said. So how does that work? Well, it is something, it was hard to see it. I mean, you could see it on me if you looked, but I didn't make a big deal of it. What happens is that when I have chemo, it's three days of chemo, not just a minute. So I go down on a given day, in this case a Tuesday, and I put about five hours in when they infuse me with these chemicals, and then they take the infusion stuff off and they plug me into a machine that meters chemo into me every 90 seconds for two days. So that's what I was doing on the floor. I'm sitting there with a bag here that meters chemo directly into my system, and then the next day I get it removed, and then I get sick for a few days, and then about today, after all that goes through, that was last week, now by today, I'm pretty good. I'm tired, but I'm pretty good. You look great. I'm pretty good. It's a lot of chemo. I don't know how much more I'll be able to take, but right now it's working. With cancer, there's a reason that it's called the Emperor of Diseases, because it has a thousand or million ways to transform itself, to move itself around in your body and do things to you. So you have to be constantly watching for things. I mean, it might be fingernails, it might be swords, it might be, you know, eruptions, it might be skin eruptions, it might be terrible pain in your gut, it might be anything. You could go, you know, half blind and stuff. Various and sundry things happen to you when you have chemo because there are side effects, and they're not very pleasant. The question about life here, and the thing that we all should be thinking about is, what's the quality of it, how long can you stand it? I've argued that what I've gone through, and what I know that others have gone through who have suffered and suffered much worse than even I have been suffering, painful, terrible, terrible things. Where was I going with that? I can't remember where I was going with that because it gets me in the head. But you know, I realize that that happens and people don't talk about that, the quality of life that's left to you at the end. Are you going to lay there in bed, exhausted and in pain and suffering or not? When you get better, how long can you stay better? That sort of thing. So, you know, I get out and walk as much as I can, I exercise as much as I can. I think people can see that I'm making an effort, I do not want to die, but I'm dying. So I'm not a fool, I think we have to understand what the thing is and deal with it. And I'm dealing with it. It's unfortunate in life that not a lot of people want to confront this, I guess, ugly fact. I am willing to do it, I've always been willing to be the guy if I have to, to do it. So, there you go. I'm a cancer survivor and I know that pit of your stomach when the doctor says this is what it is. And it's really a difficult mentally as well as physically, mentally to deal with this is what's going on. And so I'm really honored to have you to talk about it, your willingness to talk about it. And you are, as always, which is in your DNA, to lobby for the ability to have medical aid in dying. So let's talk about what is medical aid in dying? What it is is a legal prescription that will allow a patient to personally take that medicine, not being given to it, but have to take it themselves. The, it's not the doctor that does it, you do it if you feel you need it, when you feel you need it, with your family around you and so forth. That's what that's about, so that the doctor doesn't go to jail for doing that, okay? What do you mean go to jail? Well, right now it's not legal for doctors to prescribe medicine which will end a person's life. It's just not legal in the state of Hawaii. It's legal in six other states, not legal here. This being, it's in approximately 20 more legislatures this year, in addition to our own, so that's almost half the states in the union are involved in this, and it's something which is moving nationwide, because as in some other issues that have occurred socially, this is one in which the minds of America have changed over the years. For example, we've done a poll here in Hawaii just recently which indicated that 80% of the people of Hawaii would like to have this, 20% have problems with it. Only about 12% of people in Hawaii are adamantly opposed to having this option. Now, I guess, how is it okay for a doctor to turn off the ventilator in the hospital? How is it okay for the doctor to prescribe morphine, give her as much as she needs? How is it that they can do terminally sedation, and that's okay, but to write a prescription for a person to take it themselves is not okay? I think we have a situation in which medicine has become better over the years to such a degree that we can be kept alive indefinitely for a very, very long time anyway, with nothing else going on than artificial stuff keeping you going. That's what we can do, but we still have a prejudice against allowing people to control their own lives at the end. That is just a prejudice that is in the medical field. I understand it. It comes with the Hippocratic Oath, do no harm, but a little common sense would be useful with the do no harm part. I think most of the doctors that I talk to support this option. None of them that I know of except for Chuck and a few others are willing to come out and talk about it. Chuck is your doctor? Yes, Chuck. He's the other guy in the suit with me. Let's talk about, you just said suit. You are suing? We are also suing in court to determine what the law is. We have had two attorneys general in the state of Hawaii, the last one, David Louie and the current one, Doug Chen, who have indicated that the current status of the law does not allow doctors to proceed with providing that medication and be assured that they were not going to be prosecuted. We are going to the courts to say, is that the way you see the law? The attorney general opines this, you be the judge, so you say. I saw Mr. Louie say, well, he did backtrack and he said, well, if there are enough safeguards, then he felt it would be okay. There are plenty of safeguards, this is a very specific legislation. The legislation, you have to be of sound mind, you have to have less than six months to live and there have to be two doctors that have to say that. You have to have two doctors willing to say that they are going ahead with this. There are all sorts of safeguards in it. It would be pretty much like the Oregon law, which has worked now perfectly, perfectly for 20 years. Good. Well, we are going to take a break and then when we come back, let's talk about the law, what is in the law, what the safeguards are. We'll be right back. Thank you. Hi, I'm Tim Apachella. I'm the host for Moving Hawaii Forward and this show is dedicated to transportation and traffic issues in Oahu. We are all frustrated by sitting in our cars in bumper to bumper traffic and this show is dedicated to talking with folks that not only we can define the problem, but we hopefully can come to the table with some solutions. So I invite you to join me every Tuesday at 12 noon and let's move Hawaii forward. Hi, I'm Donna Blanchard. I'm the host of Center Stage, which is on Wednesdays at 2 o'clock here on Think Tech. On Center Stage, I talk with artists about not only what they do and how they do it, but the meat of the conversation for me is why they do it, why we go through this. A lot of us are not making our livings doing this and a lot of us would do this with our last dying breath if we had that choice. And that's what I love to talk to people about. I hope you enjoy watching it and I hope you get inspired because there's an artist inside G2. Join us on Center Stage at 2 o'clock on Wednesdays. Bye. Aloha, and we're back with a dear, dear friend that I will preface his name by saying Survivor. Thank you. John has been a survivor of polio. Yes. TB. Polio. Every other childhood disease known to man, but survived most of it. The worst of those was the polio. I had polio when I was eight and was paralyzed for about three months. Fully recovered from that and that was wonderful. That was the most difficult childhood thing, but it did help me become a terrific reader. Very good. So that's good. Yeah. So that's why I'm calling him Survivor and he's going to survive this also. Oh, yeah. I mean, now in terms of what you mean by survival, is my body going to survive this? No. What's going to happen is that my body is already gone. I mean, I was given six months to live almost three years ago. I've been working very hard on staying alive, but the trend lines don't go that way. The question is, and people seriously say this to me, well, what about a miracle? Yeah, I'm open for a miracle. I'm open for that. I would like a miracle. Well, let's have a miracle. Okay. It happens. That'd be great. But in the meantime? In the meantime, I think I've got to take action to, because I know it's coming. What we all, we all do. I've been there. Yeah. I mean, I've been there. We all, there is an end to it. One of these days, it's going to be the end. So you know, folks, and it's not that everybody dies, and that's not the important thing. The important thing is what did you do when you were alive? Did you do the best you could when you were alive for the most people that you could? You know? Were you helpful? Were you a good neighbor? That's the kind of thing that makes a difference. So let's talk about the bill that is before the legislature, and if, well, and simply put, what can we do? Thank you for asking that question, because Marcia and I are both smiling at that because this is an organizing question. If you believe that you have a right to determine under certain circumstances your own method of death because of pain and suffering and things that cannot be otherwise prevented, if you believe in that, then you got to organize and you got to get down to the legislature and you got to make a scene because they are going to do nothing, nothing unless there's some reaction from the people. They don't care about the fact that 80 to 88% of people in Hawaii want it, that Catholics and other Christians are now supported. It's troublesome to have to take up these tough social issues. So unless people say, take it up, they're not going to take it up. They're going to fool around. So I urge every single person out there watching this, if you know a legislator, call a legislator. Call a legislator. Talk to a legislator. Every single one of them, you know, find out how they stand on this. And if they are against it, move them toward it. If they're for it, thank them and get their vote. Just to let you know, when you know this, only in Hawaii, all of the legislators, all the city council people, all of the Ohaha trustees, their phone numbers are listed. Their doors are not locked. Go call, be there. If you feel this is something that you can benefit. Now, you know, he doesn't want to go, but it's the cancer that's taking him away from us. And so we need to not only support John, but hundreds of other people in the same condition. I watched my mother. She had emphysema, and you know, you can't breathe. Every breath she labored for a year and having to watch her, because we had her at home with hospice, it tore me up. Marcia, I gotta tell you, again, folks that are watching this, because I'm in the situation now, people call me all the time, and it's the damnedest thing. People are calling me for things that happened in their families 25 years ago, that they feel guilty about today, that people have called me that are crying themselves to sleep at night now, what they did or didn't do 25 years ago, and still with them. You know, that's not right. No. I mean, that's not fair for people, and it's just time, folks. You know, I say to people, ask your own moms and dads out there how they feel about it, and talk to them. The title of the bill is relating to aid in dying, and it's HB House Bill Number 201. Right. Is there a Senate bill? There will be a Senate bill, because a companion bill coming out of the Senate, I can't remember the number offhand, but it's out now. I think it's, today's the last day for introduction, I think it's out today. Yes. Senator Inouye. Yes. Senator Inouye's got... Lorraine Inouye. Lorraine's got a House, or Senate Bill 5, something, but I'm not sure, yeah. And the number. Yeah. So, but we do need your support. We do need you to call, to write, to visit, do whatever you need to do. There's also an opportunity at the Capitol on next week. On the 31st, I understand there is a forum coming up at the State Capitol where everybody will have an opportunity to come down and discuss this. This is a good opportunity for folks in the community to begin to organize. I got to tell you, I'm not well enough now to organize anybody anymore. I used to be a street organizer for a long, long time. A long time, yes. And that's what needs to be done. Somebody's got to get out there with a whip and get going. It is an education forum on medical aid and dying Tuesday, January 31, 5.30 to 7 at the State Capitol Auditorium. Right. So, everybody needs to be there, bring everybody you can. Right. We need you. We need this. This is not just... It's really not about me, okay? I'm over with in that sense. This is about other people. The reason I decided to do it, because I knew that other people needed to have this done. And as I sit with chemo patients all the time, you know, it's rough just getting up and walking around for most chemo patients, so they can't do this, and then they weren't going to do it anyway. I mean, it wasn't their thing. It's... You know, I'm the kind of guy that stands on the street corner and says, the people, look at this. I did it when... Yeah. This movement, I did it for the Vietnam War. I've done it for teachers. I've done it for university professors. I've done it for all my clients. Be fair, you know? And that's what this is about, me trying to help others get a fair shot. I think that just seeing you willing to talk about it, willing to be vulnerable, willing to put yourself out there so that the rest of us can say, yeah, here's somebody that really knows what they're talking about. It's not somebody that says, well, if. Right. No, this is real. Your listeners might be interested, or watchers might be interested to know that I also spent 10 years on the Employee Union Health Fund Trust Board. Some of that time is the chair of that, and that's the largest public sector health trust in the state of Hawaii. And so I know a good deal about how health insurance works and what it's about. This is extremely costly for the state as well. I thank God that I have Medicare and am able to get through this because I'm also have insurance. If I didn't have insurance, this wouldn't be an issue because it's costing, keeping me alive is costing thousands of dollars a week. Yes, nationwide, statistics say that Medicare spends more on people at the end of their lives and all of their lives. And it's estimated that one day in the hospital with what you're doing is a $10,000 a day. Oh, yeah. And I've been in lots of days. Yes. So I've been in lots of days, so I've, yeah. Now, let's separate this. We don't want you to think that, oh, it's costing so much money, so we're going to get rid of grandma. No, no, no, no. Let's do not confuse the issues. Go back and look at the legislation. The legislation is very clear. Yeah. So this isn't something that somebody does to somebody. Yeah. So let's clean that up. Don't think for a moment that... You often hear that. I know. Yeah, well, we couldn't do that, you know, because... Yeah. So no... I wouldn't trust my own siblings. Oh dear. But seriously, grandma's estate is gone by the time you get through this, the medical cost. We're not talking about grandma. So we're not doing that. Okay, so don't go there, don't even think about that. This is your choice that you get to do for yourself and nobody else gets to make that choice. Nobody else gets to make that decision. So don't let anybody scare you and say, oh, we're going to do this. No, this is your choice. And it is about your choice. It is about each one of us. We get to choose who we're going to marry. We get to choose who we go to school with, when we go to this place, when we go on vacation. We get to choose. So we should be allowed to choose when the illness has taken the quality of life away from you. When there is no choice, when there's nothing else that medical can do for you, you need to be able to make that choice. So... Right. Without this choice, my end, my choice is going to be what I'm left with, which is starvation. Well, don't do it yet. We need you for a while. So listen, please... I'm self-starter. Not yet. It has been a real pleasure having you here today. And we will see you, everybody, we want you to come out for this forum on the 31st. Again, thank you so much and we will look forward to seeing you.