Everyone has different ideas about how they’d like to go out at the end of their lives, although most people are content with the idea of passing away peacefully in their sleep. One of Dr. Stefanie Green’s patients, however, had a slightly more unusual approach.

Green is a doctor based in Canada who specializes in Medical Assistance in Dying (MAiD) — that is, euthanasia. After switching her specialty from maternal and newborn care to MAiD in 2016 following its legalization in the country, Green became an advocate for the right of terminally ill individuals to die on their own terms, working with groups like Dying with Dignity and advising British Columbia’s Ministry of Health MAiD Oversight Committee.

She even published a book, This Is Assisted Dying: A Doctor’s Story of Empowering Patients at the End of Life, about her first year providing MAiD care, and there’s one story in particular that stands out — that of Ed, a self-described free spirit who had terminal metastatic cancer who was the first person who told Green that he wanted to die alone.

On the day of his death, Green met Ed in a small hospital room and chatted with him a bit before he excused himself to go to the bathroom, returning wearing a full clown suit: “tie-dyed pants and T-shirt, a colorful clown wig and a red nose.” “He told me he hadn’t been sure if he was going to use the nose or not, but in the end, he’d decided to go for it,” Green explained.

It was at that point Green realized that Ed was an amateur clown, something that hadn’t come up in their previous conversations. When she asked why he’d opted to wear his costume on his last day, he told her that he wanted to go out laughing, and he figured donning the costume would be the best way to make that happen.

Unsure how to grant Ed’s last wish, Green went outside and spoke to his friend Maggie, who he’d introduced to clowning. She told Green Ed’s favorite joke. After administering the first medication, Green simply asked him, “Ed, why don’t cannibals ever eat clowns?” To which he responded, “Because they always taste a little funny.” Both doctor and patient were grinning from ear to ear. Ed then chuckled, closed his eyes and fell asleep.

In the end, he did go out laughing, but not before making a huge impression on Green, who concluded, “When a person knows the hour and date of their death, they can plan their final words and actions with profound intention.”