Joe came to see me in the outpatient clinic of the hospice for the first time in April. He was in his 40's with metastatic gastric cancer. Over several clinic appointments we were trying to sort out his pain and nausea. Joe came from the Caribbean and had a strong wish to return there to die. He had some family there but also a long term partner and a young son in the UK. He hoped to wait until his son had completed the year at school so that the three of them could travel together in the summer.  

His physical deterioration from April to May concerned me and I explained that I thought this would be too late and he might be too unwell to fly if he didn't go soon.  

He sent a postcard from the Caribbean a month later and his partner wrote in July to say that he had died looking out to the sea with his family around him.