The Gift of Pets: Stories Only a Vet Could Tell (30 page)

Lisa’s therapy took on a life of its own. The awful weekly visits and the flushing of toxic medical sludge through an already-ravaged body assumed a sort of routine, as if it was normal, which, for Lisa, it unfortunately had become. Throughout the process, Lisa maintained a positive outlook, calling on stockpiles of courage she had not known she possessed. Most of the time she felt well, despite days when waves of nausea washed over her and crashed into her seawall of resolve and determination. Somehow that wall held. Early on, there were only a few days when she was too ill to come to work, and when she was there, her work was largely unaffected.

For weeks this pattern repeated itself: a round of chemotherapy, followed by illness, doctor’s visits, blood work, follow-up MRIs, then another round of chemo. Lisa was placed on antibiotics when her white-blood-cell count dropped; at these times she stayed away from the potentially contagious things to which she might be exposed at the office. The medications helped in large part to keep the creeping nausea at bay, except for a day or two after her treatments. Her hair thinned noticeably but did not completely fall out. She resisted shaving her head, falling back on wearing hats instead.

Despite Lisa’s fears, Dave was a constant and ready source of help and support, though I cannot imagine the torment he must have endured in doing so. Steven and Melanie were stalwart in their support, although they were often absent. Steven’s assignment in the military prevented him from spending much time at home, though he called often and committed his few free weekends to his mother. Melanie had moved on to a job in New York, the city that never sleeps, where, it seemed, neither did she. Besides Dave, Susan was Lisa’s real ally, always ready with a meal, a shoulder, a word. She fed the horses when Lisa could not get out of the house. She ran errands to the pharmacy or the grocery store. She kept Lisa centered at those infrequent times when her mind veered unavoidably toward the morose.

I tried to be available for Lisa, but our daily interactions really didn’t change much. They focused mostly on the ongoing flow of animals that eddied around us for treatment or surgery. Occasionally, Lisa asked me for clarification of some misunderstood medical terminology her doctors had used or wanted me to look at the latest X-ray, but usually the subject of her illness or its treatment was not broached. This left me feeling oddly guilty that I was not doing more for her, but I assuaged that guilt with the hope that if she needed help from me, she would ask. The fact that she had not done so, suggested to me that I was providing for her a sense of the normal, ordinary, mundane flow of “real” life that staked her to her world and allowed moments of blissful forgetfulness of the shadow within.

I discovered a surprising emotional response to the situation when I shared news of Lisa’s plight with others. It startled me how often their initial reaction to news of her lung cancer was to ask if she was a smoker. It should not have surprised me. I had done so myself—many times, in fact—when presented with a similar scenario. But from my new perspective as someone intimately connected to the afflicted person, these questions struck me first as insensitive, then as offensive. The intimation was that since Lisa had engaged in such risky behavior, the resultant illness was a foregone conclusion, an expected and therefore an acceptable outcome—as if cancer in a smoker is somehow less tragic. It is true, of course, that smoking is often at the root of lung cancer. But even if a person’s poor choices lead to an awful disease, the tragedy for that person is no less intense. The family is still ravaged, the souls still tattered.

This realization was an epiphany for me, one that gained credibility when I learned a few statistics regarding the occurrence of lung cancer in people. I learned, for instance, that 90 percent of lung cancer patients are or have been smokers. This was not a surprise to me. It came, in fact, as a self-righteous confirmation of many long-held assumptions. Serves them right, I would huff, gathering around my shoulders the blankets of assurance that, as a nonsmoker, my own chances of a similar diagnosis were minuscule. But the statistics that followed took me off guard. Only 10 percent of smokers develop lung cancer. My first thought was disbelief. Certainly that number was too low. But then doorways of deeper empathy and sensitivity were opened for me, swinging much easier on the hinges of my friendship with Lisa.

Smoking is not an immutable sentence of lung cancer. It is, like any number of other things, just a risk factor for it—a very significant risk factor, to be sure, but nothing more. To assume more is simply an unthinking, self-absorbed response to our own fear of mortality. Though an understandable reaction, it diminishes in our minds the very real catastrophe for the stricken person, a mistake of enormous consequence, for it becomes an unconscious and unintended demonstration of insensitivity.

This perspective is not some macabre defense of smoking in any way. There are reams of documentation linking cancer and a host of other maladies to smoking. High blood pressure, emphysema, coronary artery disease, chronic bronchitis, laryngeal cancer, asthma, and any number of other diseases have been shown unequivocally to be caused by smoking. I have, though, been struck with the realization that to lay the blame on the victims of lung cancer, or these other diseases, is useless and patronizing and compromises our ability to truly empathize with those who find themselves in the position that we most fear. I found myself saying in the face of statistics and risk factors and scientific associations, “Yeah, those are all true. But this is Lisa we’re talking about here. She isn’t a statistic. She’s my friend.” It was only at this point that I could really begin to care.

For a time, it appeared that the enemy within Lisa was being beaten back. Lisa’s shortness of breath improved, in fact, as did her intolerance to exertion. Even the cough abated for a while. For a few months, it seemed that the war might have been won. But it is often easy to mistake winning a battle with the harder task of victory in the war. After a few months of apparent victory, it was as if the powerful medicines became no more effective than waving flimsy branches at the attacks of a lion, a pride of lions. It became apparent that to continue the feeble offensive was not the height of bravery, but would be instead the foolishness of cowards, afraid to face the certainties of defeat. Lisa was no coward. When the time came to acknowledge that her treatments were not working, she was able to do so with the same strength and resolve with which she had endured them.

The intent of her therapy changed at that point from attempts at cure to efforts at minimizing the impact of her disease. Medications to diminish the intractable discomfort and pain replaced those that inflicted short-term suffering in hopes of long-term resolution. Lisa’s interactions with her family began to focus on equipping them for the inevitable; with expressing to them her visions for how she hoped their lives would unfold. She displayed an awareness of issues deeper and more overarching than those to which her day-to-day routines gave voice. I’m sure she must have grappled with the fundamental questions common to us all, but hers were private thoughts. Dave was a source of strength for her, remaining by her side even when she demanded, for his own good, that he desert her.

One evening after work, I drove to Lisa’s house and sat down with the two of them. She had asked that I come by to discuss a few details that were important to her. She was completely in control of the discussion that evening, indulging in neither sentimentalism nor self-pity. It is a conversation that I relive with a sense of disbelief, wondering if I could be so endowed with dignity and rationalism if I was presented with similar constraints of time and future. I sat on the edge of an overstuffed chair in her living room, facing the two of them on the couch. Grizzly lay at their feet, looking up at me suspiciously, as if I was there to inflict upon Lisa some of the same insults, injections, and probing I had imposed upon him through the years.

“How are you doing, Lisa?” She knew it was not a casual non sequitur, and she didn’t treat it as such.

“For the most part, I’m still doing okay. But I can tell things are going downhill.” She responded with an openness and honesty that smarted. “They tell me that the tumor has spread to my liver and kidneys.”

“Have they seen that on MRIs?”

“No, they quit doing those. There’s really no point. They can just feel the liver getting bigger. I can, too, if I press a little bit.”

“Are you in pain?”

“Not really. The morphine does a pretty good job most of the time.”

Dave sat beside her, holding her hand and nodding in agreement and affirmation, seeming no more affected by the articulation of these realities than when they remained an unspoken, although very constant, presence. Expression, in fact, seemed to minimize the impact for both of them. The disease was their abiding companion, having become now a familiar reality. It was a cheerless presence, to be sure, but it was not for them what it was for me: a faceless Evil with whom I was only distantly familiar, the source of a dreadful, unarticulated fear whose confluence I was unaccustomed to confronting.

“Doc, there are a few things I’m going to need your help with from here on out.”

“You know I’ll do anything I can for you anytime.”

“I’m concerned about Grizzly.”

I had suspected he would be one of her priorities. He was advancing in age, though not yet truly geriatric. He had been suffering recently from a series of undiagnosed pains. His neck was the source of significant discomfort. To avoid shooting pain, he kept it still and rigid, moving only his eyes instead of his whole head. There was muscle wasting over his hips and shoulders for no apparent reason, as if he was tiring from the chore of carrying the vast weight of Lisa’s world. He had developed a grouchy, unpredictable attitude around everyone but Lisa, whom he continued to idolize. I suspected that the degree of her illness and the limits imposed by the physical and emotional trauma of her treatment were not lost on Grizzly, inflicting their toll not on Lisa alone but on this noble and devoted soul, as well.

Jane Goodall has explored the fascinating world of unspoken connections between people and their pets and the inaudible but unimpeachable levels of shared communion between them in her wonderful documentary,
When Animals Talk.
Grizzly’s physical manifestations of discomfort, his surprising and uncharacteristic change in personality, his tireless companionship with Lisa, were perfect examples of this physical, emotional, and spiritual union, a passionate iteration of his connection to Lisa’s failing body. On his heart came to rest the full weight of the sadness and loss, the unfairness, the pathos, the physical ruin, heedless to entreaties, which Lisa could neither understand nor vocalize.

Grizzly asked for no clarification from Lisa. He knew her heart, not because she had articulated it to him but because he shared it, was a part of it. Two hearts, his and hers, each assigned to separate individuals, were nonetheless one functioning unit. It is this mysterious union of hearts bridging barriers of skin, sinew, and species that is the very substance of the Gift that pets extend to us so generously, so unselfishly. The Gift is a bond between, a contract with, a promise from, and a claim upon two hearts—a circle that encompasses the very essence of those hearts. It is a circle as large as the universe; as small as the molecules of love and devotion that bind together two disparate hearts; a circle that contains all that is vital and alive, into which we can pour every whit of ourselves, unadorned and without fear of judgment or rejection. The circle is as powerful as the unbreakable and eternal bonds of love, as fragile as the cruel whims of temporal brevity and rancorous contagion.

It is the fragile circle in which I thrive; a thousand fragile circles to which I am a servant. They wholly encircle me, yet involve me only tangentially. As a veterinarian, I am a privileged observer of a myriad of such circles, entwining thousands of human and animal hearts. My perspective is intimate and personal, infused with import by its proximity to these circles. Like the circuits described by the orbits of electrons around a nucleus, these fragile circles vibrate with emotional energy and give voice to a fundamental force of the human soul. And now, nearing the time when Lisa knew this circle would have to change shapes and forms, her concern turned to Grizzly, as his had been trained on her.

“What worries you about Grizzly?” I asked quietly.

“When I go, it will be too hard on him. He won’t understand. So I’d like you to promise me something. And this is really important to me.”

I nodded but did not speak.

“I’d like you to put Grizzly to sleep so he can go with me. I’m not sure whether my family wants me buried or cremated, and it doesn’t matter to me. But either way, I want Grizzly to be with me. Can you do that for me?”

“Yes, Lisa, I can.”

“Some of my family may not want it that way. They may want to take Grizzly themselves for the rest of his life. But I’m counting on you and Dave to see that it happens the way I want.”

“You have my word on it, Lisa.” I was quiet for a moment. “And Zepp?”

“Zepp can live out his days with Mom. He’s still a memorial to Steve. And I think he loves Mom.”

“I’ll take care of Zepp his whole life, Lisa. Don’t worry about that.”

The story didn’t continue much longer after that. Lisa worsened each week. Her last days were spent in the hospital. There remains in my mind an unfading, ineradicable image of Lisa the last time I saw her, only a day or so before she passed. Her family had gathered at the hospital. I greeted Steven and Melanie and Amelia with embraces of sadness and compassion. Then Susan and I entered Lisa’s room.

The lights were low and the room was quiet except for the humming of the monitors and fluid pumps. Quiet, that is, except for the constant rasping effort of Lisa’s desperate breathing, each breath a mortal battle, one that she would have lost had she lain back restfully on her bed. In order to force the rebellious air into her overrun lungs, she had to sit upright, her face to the ceiling, her mouth open and gasping. I went to her and she gratefully leaned against me. The air she was able to consume was too costly to expend on words, so she just turned her desperate and fearful eyes to me. Yes, there was fear there. Who wouldn’t be fearful? Had she done enough? Said enough? Loved enough? Had she prepared her children adequately for the road ahead? There was also fear, perhaps, of the great unknown and unknowable. Lisa had not been a particularly religious person, after all, and had not seemed inclined to indulge those thoughts before. Fear even of the next breath itself, that she might not have the strength, the will to draw it.