“If you go slowly enough, six or seven months is an eternity—if you let it be—if you forget old things, and learn new ones. Even a week can last forever.”
Rick Bass, Winter

"In the midst of winter, I finally learned that there was in me an invincible summer."
Albert Camus

Tuesday, May 15, 2012

Part II, Day 35: My Friend has a Hole in her Heart Now

Dear reader,
Although the subject of mortality is part of this blog's job description, I haven't been talking about it much lately.  Of course that's partly because my object is to seize every day and not waste precious time worrying about the inevitable, but recently I was reminded that part of preparing for that day is to accept that it will come.

I used to think that if I did everything right, gave Zoe a great diet and lots of exercise and a great life and didn't let her play in traffic, she would live to at least 14.  It would be painful to witness her slow decline.  I would get a ramp to help her get in and out of the car, she'd get finicky about her food, and I'd probably have to spend a lot of time wiping her bottom.  Whenever I thought ahead to losing her, I would try to figure out how old I would be that year, what I would be doing at work, and whether or not I had a leave of some kind coming up so that I could spend three to six months in bed grieving without completely disrupting my professional life.  The big question then would be whether or not to take medication.  As someone with mental illness in the family, I think it's a miracle sometimes that I survived my tumultuous youth without anything stronger than B-vitamins and aerobic exercise and yoga and herbal tea, so it would be a tough decision as to whether or not to get a prescription for Zoloft.  My hope was that my friends and husband would do an intervention if my grief got out of hand, if things got too bad.

It was entirely in keeping with my lifestyle then that I thought I had to plan ahead to schedule a nervous breakdown.

I've grown up a lot in the past few months.  I've had to work on myself to become the person my dog deserves.

Lesson Number One: The day Zoe was diagnosed with bone cancer she missed the memo that she and her people were supposed to be sad.  As some of you know, I'd brought her into the Canton Animal Hospital in desperation after she had been limping for two months and two different vets had diagnosed mild arthritis.  (One suggested Zoe would feel much better if we gave her a daily aspirin.)  By the time Zoe was properly seen to by Dr. Amy Thompson, who is now her vet, cancer had eaten up a big part of her ankle.  She had borne the advance of this aggressive disease with grace and patience.  Bone cancer is the most painful cancer there is, I've been told, and Zoe still savored her twice daily walks and meals and still took pleasure in watching the river from the balcony and in chasing squirrels up trees.

After Dr. Thompson delivered the news, she looked at Zoe, who was still sleeping under anesthesia, and back to the ugly dark matter in her x-rayed bone and said with something like awe, "She's so strong.  She's so strong."

And here's the thing: when Zoe woke up, and Dr. Thompson took her back out to the lobby, Zoe bounded over to us, her tail thumping overtime, as though this was the best moment of her life.  She was thrilled to be reunited with us, thrilled to go home.  We had just gotten her death sentence, the worst news possible, but now we had to dry our eyes and smile because the dog would not have understood.  Why the long faces? she would have said.  She was happy to be with us, so we had to be happy too.

Zoe's contentment with the quotidian is the balm that keeps me strong.  I can't plan ahead to guard against future loss and sorrow.  I simply enjoy our days together.  That's all I can do.  As I have written before, Zoe, as all dogs are, is a zen master with a tail.  Zoe has helped me become the person I need to be to be the person she deserves.

This spring my amazing, loving, funny college roommate, C., lost her beloved dog, Harpo.  He had been suffering from leptospirosis, a disease that affects the liver.  Dogs can get it from drinking puddles of water in the woods that are contaminated with rodent urine.  If ever a dog loved the outdoors, it was Harpo.  My friend and her husband brought water and a bowl for him on their walks, but to stop him from lapping up the rain water he found himself would have deprived him of one of his great joys in life.  

He was ill for 20 months when they finally had to put him down.  He was taking 10 pills a day, near the end, but he never complained.

Harpo was the dog who introduced me to the delightful world of oodles.  One of my friend's sons was allergic to pet dander and after conducting some research he found out that dogs that are part poodle are fine if they inherit the poodle's hair qualities. I loved learning the names of the most popular hybrids.  The golden doodle, which was Harper's breed; the labradoodle, which sounded charmingly Mary Poppins the first time I heard the word; and my favorite of all, the schnoodle.  I wanted to get a schnoodle just so I could say this word daily.  A schnoodle seemed like the kind of dog you'd want by your side as you feasted on blintzs or strudel, and then you would take a nap together and canoodle.

But I digress.

I fell in love with Harpo at first sight, this big golden retriever with a perm who liked to sit on people's feet and reach up whenever possible to chew on their chins.  Every August his family took him on vacation in the Adirondacks.  He swam and hiked up mountains, and at night, as they relaxed after a long day outdoors, he would slow dance with each family member.  Once, he danced with me.  He put his big, furry paws on my shoulders and we moved about to our own music, and I said, "I want a dog."

A year later, I took Zoe home.

When I found out that they had to put Harpo down, and he was only ten, I cried and cried. 

I told C. that I was glad I didn't know about leptospirosis and how a dog can get it or I would have been utterly paranoid every time we went into the woods, which is every day of our lives.  She replied that what they learned was that their dog was a happy boy, and his happiness made them happy, and there was no way they could deprive him of his favorite thing to do in the woods.

Lesson Number Two: You can't control every thing your dog does, no matter how much you try.  Sometimes when he follows his bliss, he might be hastening his decline.  It's a delicate balancing act between acting as Captain Safety and Fun Human Sidekick, and their dog was probably glad when they chose to do the latter.  Also, sometimes what makes dogs sick is the natural world itself.  How much can we do about that?

For a week after I heard about Harpo I brought Zoe water on our walks.  She refused it every time. Zoe prefers to drink river water--river water that is no doubt polluted, that other critters have peed in, that has all kinds of nasty sludge.  All the dogs around here do.  And although I try to stop her, she has been known to eat gross dead critters she finds in the woods.  I've seen her with deer legs, squirrels, fish.  And then she's sick for a day or two afterwards.  But do I want to keep her on the lead all the time?  Deprive her of the joy she takes in being a hunter or stop her from foraging for her own water?  No way.

A few weeks later I took Zoe to her oncologist in Canada for her check-up, and while I was there, a couple named Gabriela and Jerry arrived with Tucker, their sweet German shepherd, the gentle giant.  I spent the afternoon with them.  The vet techs had put us in touch with each other a couple weeks earlier because ours were the only two dogs of all their patients who had this same kind of awful cancer, osteosarcoma.

Gabriela and I were facebook messaging and e-mailing and on the phone a lot during the week leading up to us meeting in person.  Two weeks before, some very small lesions had shown up on Tucker's lungs.  Dr. Bravo sent them home with Palladia, which is given orally: the same protocol of metronomic drugs Zoe was on.  Zoe's lung lesions had appeared six months ago, but she was--and is--still doing just fine. The tumors have to become quite huge before the dog feels any discomfort.

But Tucker wasn't eating.  He had started limping more and one of his paws was so swollen and painful he couldn't put weight on it.  All he wanted to do was lie on his bed and rest.

Now, to get to the animal hospital in Ottawa we have to drive 90 minutes each way, cross an international border, and present paperwork and passports.  Sometimes, this can take longer than I'd like, especially in the winter.  I thought Zoe and I had it bad, but Gabriela and Jerry had to drive two and a half hours to get to our animal hospital, and they are Canadian.  That just shows you how few clinics there are in North America to choose from if your dog gets cancer and you want to extend his or her life.

The day I met Gabriela and Jerry, Tucker didn't have an appointment.  That morning they had brought him into their local vet, but she couldn't figure out what was wrong.

As we waited together, we tried not to speculate, but of course we did.  Maybe he had a hairline fracture in his paw from that time when the noise from the construction project next door was so loud he ran into the bathtub and claimed it as his bunker.  And wouldn't the pain of a fracture take away his appetite?  We didn't know all the things that could go wrong.  We'd been told to watch out for a cough.  We'd been told to watch out for loss of appetite.  The lesions in the dog's lungs two weeks ago had been very small.  There was no reason we knew of for him to be suffering.  But what we didn't know is that the cancer could spread like a wildfire in no time at all, and that's what happened to this sweet, noble dog.

When they left Dr. Bravo's office, Gabriela and Jerry were sobbing.  I stood with them and we all held each other up as we wept.  They had the verdict now: their sweet dog was afflicted with hypertrophic osteopathy.  The disease had run through all the tissue of his body, especially his legs, and he was in great pain.  The only thing they could do for Tucker was to give him a shot of heavy-duty, time-released painkillers, and send him home.  

Gabriela and Jerry had done everything for their dog that they could.  When Tucker lost his appetite, Gabriela served him a raw chicken from a recipe she'd read on the web.  She gave him slippery elm bark to sooth his stomach.  She tried smoothies with nutrients.  She massaged him for hours.  She called everyone she could think of who might have a cure.  I tried to imagine that two and a half hour drive: Jerry, who suffers from serious back pain from injuries he sustained in the military, drove, while Gabriela got on the phone to make arrangements for their vet to come to their home the next day to put him down.  It must have been the saddest 150 minutes of their lives.

Tucker's ashes are now in an urn in their living room.  

For a while, Gabriela and I wrote each other every day.  Their kids are grieving with them, but their friends and relatives don't understand how much they are suffering, and why.  Many well-intentioned friends told them they thought it was a big mistake to try to extend Tucker's life with chemotherapy.  "It's just a dog," people think, but are usually too polite to say.  "Why are you falling apart like this?" 

The suddenness of Tucker's decline shocked me.  I didn't know this could happen.

Lesson Number Three: Sometimes it happens fast.  And the last act of love you can do for your dog is to ease his suffering, as soon as possible.  

Then, just last week, a dear friend in Minnesota wrote me to say that her ten-year-old dog, Halley, had died suddenly.  The dog had gone on a walk with my friend's husband, come home, and a little bit later, just collapsed.  

It turned out this sturdy dog had a tumor growing right over her heart.  She showed no symptoms at all that she had anything wrong with her.  She went on walks, ate her food, wagged her tail, and loved up her people day after day.  She enjoyed every minute of her life.  And then one day she fell and couldn't get up.  Her aorta burst, and there was nothing they could do to save her.

My friend said, "My dog had a hole in her heart, and now I do too."

I must have read that sentence three times.  I sat down, closed my eyes, and cried, trying to take this in. 

Lesson Number Four: Sometimes it happens so fast that the word "fast" no longer signifies.  Sometimes you get no warning at all, and your perfectly healthy-seeming pet collapses before your eyes.

Can we live every day of our lives prepared for the catastrophic loss that happens in a nanosecond?

I think I need to start meditating for longer than 20 minutes every morning to begin to even understand the question.

Two days after my friend lost her Halley I texted my vet and asked her if we could talk about "end days."  "We need something resembling a plan," I said.  And on Sunday, when she came over to watch Zoe's acupuncture session, we agreed that when we think it's time, she'll come to the house.

Amy said, "Now that I'm learning about acupuncture, I've heard a lot of different theories about how dogs fail in the end.  If you are giving your dog acupuncture and doing everything to keep her in balance, she might just be fully functioning to the very end.  We think of human beings and how there's often--but not always--a gradual decline.  That's true for dogs sometimes too.  They gradually lose their appetites.  They start to move less.  But sometimes we hear of dogs who have lots of energy and seem completely healthy, and then they die in their sleep."

I said, "I suppose some of us would think that's the ideal death.  For a dog, or a human."

My husband was sitting beside us as we had this conversation.  He later said that he thinks a situation like the one Amy described would distress him more.  If Zoe didn't wake up one day, he would be more upset, he thinks, then if he had the chance to say good-bye.

I don't know what I think: either scenario is awful.  Mostly I try not to think about the end.  To be honest, I still live mostly in denial.  Zoe looks good, runs well, eats hearty, and has more energy lately than ever.  But I know the day will come when we will have to say good-bye.  I don't know if I'll have much warning.  And I know I'll feel like my friend above with the hole in her heart.  

One of the reasons I number the posts in this blog is to honor the fact that Zoe's days are numbered and that I don't want to miss a single one of them.  I use the model of the 108 beads of a Buddhist mala to remind me that every day, every moment, every bead is precious.

Thinking of time in this way always makes me think of my friend who lost her husband without warning in the fall of 2010.  She kissed him good-bye to go to a meeting, and when she came home three hours later, she found him in his favorite soft chair.  He'd been eating an apple when he died.  When he went to the kitchen to get it, he must have thought he would eat every bite of that apple.  He didn't know he was spending his last morning on this earth. 

I have no words to make sense of what happened to my friend.  No words to imagine the shock to her heart, the suddenness of this inconsolable loss.  But since it happened, I have learned so much from her.  She is tender and open about her own suffering, and she reminds all of us who know and love her to appreciate everything we have, to inhabit our own lives as fully as we can.  

In yoga class she spends extra time working on the spinal stretches that open the heart.  There's a lot of scar tissue growing over that gaping hole, but she isn't afraid of the work she needs to do to feel whole again.

My friend thought she and her husband would grow old together.  When I think of my friend I remember how fortunate I am to have a husband who is my partner in this life, and how lucky we are to be taking care of Zoe together.  And sometimes I think I'm lucky, in a way, that I know our dog won't live until at least 14, at which point I'll have to be medicated or hospitalized. Which is to say that I can't behave as though time was just opening out before us like an endless long, silk scarf.  I can't squander our time.  I have to stay awake.  Whether the ending comes quickly, or gradually, I never forget that every single day the three of us have together is a miraculous gift.

The deaths of the three dogs I just told you about, gentle reader, broke their people's hearts.  C. and her family had 20 months to get used to the idea that their dog had a serious illness.  But when the time came to say good-bye, I'm sure they weren't ready.  Tucker's people thought they had several weeks or months more to share with their gentle giant.  The mean survival rate for a dog with osteosarcoma is one year after the diagnosis, and their sweet boy only got three or four months.  My friend in Minnesota had maybe a half hour to prepare herself to say good-bye to a beloved family member.  She woke up that morning in one life and went to sleep in another--in a home without a dog.

I'm not trying to compare their grief, or the grief that I am rehearsing as I write, with what my friend who has lost her husband has lived. But I'm ending up in the same place.
I don't like thinking about death and grief.  I never will.  When I look into my dog's wolfy eyes, when I take in that fierce, intense gaze, all that life pulsing through her, I believe that she'll outlive all of us.

But what I have to say, gentle reader, is what you already know: Nothing lasts.  No one lasts.  We forget this every day; it's one of the ways we survive.  When I posted an essay called "Bark and Soul," the day after Zoe and I met Tucker, Donna, one of our oncology vet techs, wrote me to say that she had read my post and she was concerned because I sounded so sad.  She reminded me, essentially, to read my own blog, to remember once again the message Zoe keeps teaching me: that dogs live in the moment.  That they are so happy to be with us and they like it when we're really there.  They just want us to love them, and to let them help us cherish every moment we draw breath.

In that spirit, gentle reader, I want to thank you for reading this rather long post today, and I'm asking you now to kindly go on your way.  Go love up your sweetie, kids, and critters.  Walk that dog.  Give the cat a massage.  Reveal your heart's truth to whomever needs to hear it.  Ride your horse.  Get on your bike.  Look at the sky.  Watch the wind stir up the cattails and the lilacs and feel that air on your skin.  Whatever you long to do that you've been putting off, do it now.  

And pardon me while I go do the same.



  1. Oh Natalia,

    I can only respond with a slow standing ovation and tip of the hat from this corner.

    What can I say beyond thanks for articulating thoughts and feelings about the important things in life... that I struggle to accept or understand?

    Big hugs to Ms Zoe!


  2. Really beautifully put, Nat. I've probably said this before, but I learned after 9/11 that your reality can change in a second--who would think that you could go to work at your desk as you do every day and a plane could come through your window? As much as possible, you have to try to live in the moment and enjoy it. I really think that's the secret of life. Now we have a new puppy (I e-mailed you a photo--pathetically, I don't know how to link one to Facebook--and I know he'll do stuff I wish he wouldn't, and I'll probably keep him on the leash in the woods for a while because I'm paranoid about that, but he'll do something else I never would have thought of that could put him at risk. This will sound off-message, but I always think about those evangelicals who try to say "God did this because..." and I think, "If God is all-powerful and moves in mysterious ways, isn't it the height of hubris to assume you know what that mysterious way is? Are you saying you're equal to God?" Life's a mystery! When you accept that and live in the moment, you're doing the most you can to enjoy it. Anyway, thanks for writing this. It was beautiful.

  3. Dear Cindy, thank you so much for writing here. I'm so glad you have that pup, and I'll look forward to seeing him on e-mail. And I can't believe I didn't even think about 911 and what your family went through when I wrote this post. You and Harry know, having lived through it, just how much life can change in an instant. And you also know, more than almost anyone I know, how to find joy in the moment and to accept life's complexity and mystery. I'm so lucky to have you and Harry as friends, and I can't wait to meet the new addition to your family and to walk in those woods with you guys.