The 84-year-old woke up one day with excruciating back pain, was rushed to the emergency room, and was promptly asked by a doctor if she wanted help killing herself.

That’s because Miriam lives in Canada, where physicians are encouraged to ask patients in agony if they want MAID—medical assistance in dying.

“I was stunned,” Miriam writes in her essay today. “No one had even told me what was wrong with me.” She responded to the offer with a firm: No, thank you! And soon, she had a simple diagnosis: She had fractured her sacrum, the tiny bone at the base of the spine. With bed rest, the break healed.

“But being offered MAID changed something in me,” Miriam writes. Before, “I had assumed that in my 80s I would simply slow down: read my books, watch some television.” But the experience “made me want to lean into living.”

So she traveled to Cuba, where she sang, danced, and played piano with locals. Still, she’s haunted by what’s happening in her country, where nearly 1 in 20 deaths is a result of MAID.

For everyone who is considering assisted suicide, Miriam has a message: “Think very, very carefully about what you’re giving up,” she writes. “The world is way bigger than you can imagine.” That’s what she found—after she chose to live.