Sunday, September 16, 2012

Never Too Old for Surprises

Saturday, September 15, 2012

By the time you reach your fifties and sixties you think you know yourself pretty well. You've been through the crises of growing up, starting a life, managing a career, getting along with friends and family and co-workers. You've survived a few tragedies and disappointments, and learned to live life day by day. You think you know how you'll react when the end point comes. I cared for my mother and younger brother. I thought I knew how to listen to the patient, and how I felt about end of life care. I was wrong.

Two or three months ago our dog, a shelter Lab mix, started losing weight. He'd been my mother's dog, and we brought him home to live with us after she died. The cat refused to have anything to do with him, but he settled in. He never had any medical issues until this spring and summer, when he started losing weight and developed diarrhea.

Right now I have a kitchen table cluttered with pill vials--red, blue, green plastic bottles, a plastic bag with packets of powders, and a box of capsules (this doesn't include the other pills we returned for a different dose), and cans of special diet food--none of which we could get down him for more than a few days at a time. He's had an ultrasound, an internal exam, an x-ray, and numerous visits to the vet. He would have started on homeopathic treatments this week if his body hadn't made it clear that no more effort should be made. He can't get to his feet on his own, can't eat, and can barely drink water. His body has stopped shedding--gone are the clumps of black hair I find whenever I vacuum. He also smells different.

As I look back I'm surprised how many times I was willing to try just one more visit, one more possible treatment, one more test. The ultrasound terrified Rob, and why not? He was held down on a table while a stranger shaved part of his body and then ran a cold piece of metal and plastic over his bare skin. He had an x-ray. Both tests showed exactly nothing. He had no tumors, no noticeable cancer, no unexpected growths or decay. He had arthritis in his spine and hips, but we already knew that.

Rob is going to the vet's this afternoon for the last time. And I am going to spend the rest of the weekend (and longer) wondering what is it about a pet that pushed me to try three doctors and scads of medicine when it was obvious where the dog was headed. I wonder if it's because he can't speak. He can't tell me where he thinks he's going (and sometimes as I watch him standing on the sidewalk, I'm not sure he has any idea where he's going or wants to go). I wonder if it's because he seems so helpless that I'm driven to help more. We had no diagnosis because we didn't know what was happening to him; the various tests turned up nothing. The observation that he's old (13) and his body has decided it's time to quit is too simple and too non-medical. What was the trigger that told his body to quit?

Two or three weeks ago I sat on the floor beside him and was surprised to find myself starting to cry. Even if I couldn't admit it to myself, I knew.

It rained this morning when we got him outside for a short walk, but that didn't seem to bother him. Usually he dislikes the rain. He also dislikes the ocean, which is odd for a water dog. He wandered along his usual route, seemed to forget where he was going, turned around, wandered some more, which is when we brought him home. He's ready, and he's probably been ready for weeks.

Pets teach us many things--unconditional love is the one people usually cite. But Rob taught me something about myself. He didn't want treatment, and I had trouble catching on to that. He only wanted to lie on the grass in the backyard and watch the squirrels and rabbits and birds pass by. That's another lesson to remember.

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