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Blog addressed how to live with incurable cancer

The beginning of the end of Ethan Remmel's life began just over a year ago with an ache in his abdomen.

He didn't think much of it at the time. After all, he was fit, he ate well and he was only 40 years old. But the pain worsened, so he went to a doctor. Later, after a colonoscopy, he got the word.

"The word that stops time and shifts your life onto a different track. Cancer."

Those words are from Remmel's first post in his "Living While Dying" blog for Psychology Today.

Soon after learning in June 2010 that he had incurable cancer that had spread to his bones, Remmel, an associate professor of psychology at Western Washington University, began a personal blog to update family and friends.

Ira Hyman, a psychology colleague at Western, received the blog and told Psychology Today editors they might want to add Remmel to its roster of bloggers.

"He wrote so well and so thoughtfully," Hyman said. "He was living, yet he had cancer and knew he was dying."

Remmel agreed to the idea, and wrote his first blog for Psychology Today on Feb. 6, while on vacation in Hawaii with his partner, Grace Wang.

"He wanted to tell his story," said Wang, an associate professor of environmental studies at Huxley College of the Environment.

Psychology Today has more than 700 bloggers, but Remmel's was the first to focus on the writer's terminal illness, said Kaja Perina, editor in chief.

"We immediately thought there was merit in his message," she said.

If a good writer is someone who transports the reader to a new place, experience or perspective, then Remmel is a good writer. He recounts his medical and personal ups and downs with detail and thoughtfulness, including why he ultimately chose to end his life June 13, with a lethal medication, under terms of Washington's "Death With Dignity" law.

Remmel loved to play basketball. He hiked, traveled, volunteered in local schools, coached youth sports, and spent time with his two sons, Seth, 8, and Miles, 3.

"A really great dad," Wang said, "and so, so smart."

With so much to live for, Remmel nearly died the first few months of his new life with diagnosed cancer. But chemotherapy and painkillers brought him back from the edge.

While undergoing treatment, Remmel roller-coasted from periods of debilitating fatigue to periods of bearable pain when he could even play basketball and go dancing.

Chemotherapy left Remmel sick to his stomach and deeply tired, so much so that he periodically stopped chemo to regain enough energy for trips and visits with friends. But his bone pain worsened when he stopped his chemo.

"The fatigue is worse than the pain, because the fatigue robs me of my mind and thus my identity," he wrote in his blog March 23.

Two months ago, Remmel obtained a "Death With Dignity" dose of lethal medication, but hadn't yet decided whether to use it.

"I do not think of using the medication as suicide, and I don't think others should either," he wrote April 10. "It would be part of a dying process that has already begun, not of my choice."

Remmel's last blog was June 10. He had decided to take the lethal medication.

He spent his last full day alive, Sunday, June 12, at Clayton Beach with Wang and his sons.

"He played in the water with the boys," she said. "It was great."

The next day, while the boys were out of the house, Remmel lay down on a lounge chair on the deck of his house overlooking Bellingham Bay. A good friend stood near. Wang held Remmel in her arms. His parents held his hands. He took the medication.

"I'm so glad he died the way he wanted to," Wang said. "Even though it was so hard to let him go, I still think it was the right decision."