“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

Monday, June 11, 2012

Part II: Day 54: Treating the Patient's Codependent Pepes

On Saturday Zoe's integrative vet, Dr. Don Thompson--Dr. T., Don, I never know what to call him--comes to the house at lunchtime.  It's Zoe's monthly acupuncture house call.  I am in my studio writing and Kerry is in his shop turning a bowl when we hear Zoe barking wildly, and we know the visit has already begun.

gold star if you can find the needles
Zoe appears to be happy about this shoulder needle, for some reason.
I have never seen this man look quite this tired.  I was planning on calling the other Dr. Thompson, Amy, Zoe's local vet, to come over and join us as she has on the two previous visits.  She is following an acupuncture course herself, and Zoe is her patient, so these house calls are an opportunity for her to learn more about her craft with a dog she knows fairly well.  But when we texted each other early this morning she told me that her husband would be working on a fence today and she would have to bring her young daughter with her.  Zoe is still a little afraid of children who are too young to write papers and meet a professor in her office hours--the pre-verbal, pre-driving demographic still spooks her a little--which could be distracting and disrupt the calm vibe, but I thought maybe my husband and I could play with the child while she and Don got down to business, all in the spirit of Bring it On.

But that's not going to happen.  This man is exhausted.  He left at 3:30 from Stowe, Vermont this morning to drive to the North Country and he is only halfway through the 15 house calls he has to make today.  The next one is in Harrisville, which sounds far, even though I don't know where that is, exactly.  Not our county, anyway.  He won't get home until 11 PM tonight.  I offer him tea, but he's worried that he'll overload on caffeine and get the shakes, so we settle on Strawberry Serenity Kombucha.  I'm so suggestible myself that when I drink this stuff the word "serenity" works on me before I've even finished a bottle, but I realize that not everyone reads a word on a label as a command, so I just hope for the best.

After he puts in the needles, we fill him in on all that has happened with our dog in the last month.  Namely, the bad news we got on May 18 about the size of Zoe's lung tumors, how the biggest one was now 4.78 centimeters, and the oncologist's prognosis then: one month to three.  We're a week away from a month already, but Zoe's still full of zest.  She's supposed to head out with us next weekend for a short vacation.
She relaxes for 20 minutes with the needles in

He tells us, "This dog is not going away any time soon."  He doesn't mean travel.  He means die.  "From what I could see, with that greeting she gave me in your driveway, she's still very engaged with life.  She's got lots of time left."  He says he doesn't need to press the will-to-live point, for example, because her will is very much in evidence.

"This is how it is for us," I say.  "We think she looks great.  And then we get these grim numbers and the grim prognosis.  And I get all upset, and try to hide it from Zoe, but I know she senses it, and then she probably wonders what she did wrong when she feels my sadness, and then when she sniffs out unhappiness, she's not so happy either.  It's one of those feedback loops.  But those dips never last long.  We get back into our routines, and all is well, and Zoe sees you, and I start to think . . ."

(Not long ago I wrote a post about the dog's codependent pepes.  Even my very rational husband agrees that this is our affliction.)

"That's the difference between Western and Eastern medicine," Don says.

He asks about the India trip.  On a previous visit, I asked if he thought it would be okay for me to leave her in late July and early August for a two week work trip.  He has said consistently that he thought Zoe would be in good shape then, that it would be okay for me to leave.  If I went by the oncologist's prediction, I would be gone for Zoe's last two weeks of life in the most optimistic of her scenarios.

"The trip is being postponed to sometime after Christmas," I say.  "It's better this way."  I explain that my husband is having surgery in July, and of course I don't want to miss a minute of the time Zoe and I have together this summer.  Except for a short trip coming up this week, I'm hunkering down.

Don shoots me a look, but doesn't comment.  The way I interpret it, he thinks that Zoe will hang on that long, and that I'll be in more conflict about traveling then than I would be this summer.  But I really can't read minds, even though I try to all the time.

Today's acupuncture points, which he writes down for me, are just the general tune-up points that go with treating a dog with cancer who is in overall good form.  Stomach points.  Spleen points.  Bladder points.  Six in all.

He pets her, and we point out all the lumps that have sprouted overnight, it seems, since she started taking the new drug, Kinavet.

"It's ironic, in that that drug is supposed to be for inoperable mast cell tumors, which isn't Zoe's cancer.  But is it just a coincidence that now she's getting lumpier every day, now that she's taking this drug that shrinks tumors?"

We point to the place where he removed a lump via laser a while back.  Now a new one is growing there.

I've just been assuming they're all cysts, the kind dogs get increasingly as they age, and not dangerous at all.  Kerry's not so sure. One of them started bleeding last week.

"They're not osteosarcomata," Don says.  And he tell us not to worry.

We talk about all the good indicators.  How Zoe's appetite is strong, although she is getting pickier again.  How Zoe's still walking five miles a day without showing signs of exertion, and still cuddly and sweet when she wants to be and still bossing people and critters around in the yard.  "The other night I asked her what she wanted to do when I took her out after dinner and she pointed to the street," I say.  "In the early days, I would take her on four walks a day.  One was the after dinner stroll through the neighborhood.  We stopped doing that long ago because I didn't have the time.  She seems to want to do that again now.  So we did it twice this week."

He knows the geography here, since his family has a house around the block, and he's impressed with the ground Zoe covers on this walk, especially since it's an extra one after she's already walked her five miles.

"That's what you have to do with a cancer patient," he says.  "Just make them happy and do what they want to do, the things that keep them interested in life.  That's very important."

We talk about my husband's hip replacement surgery planned for next month, and when I mention some pain I woke up with today, Don channels his wife, who does Chinese Traditional Medicine for humans.  He shows me the points to press near my right knee for the inflamation along my left elbow, the tendon going down to my ring finger.  "That's the triple heater meridian he says."  I'm not that optimistic that we can treat it this way, but I'm open, and here's the thing: the next morning, most of the pain has lessened and as I finish this post now, Monday morning, there's just a little of it left in my finger and the rest is gone.
blissed out after the session, she rolls in the grass

Later, my husband and I dissect the visit.  He's still very worried about Zoe's lumps.  I'm trying not to be.

"Then why didn't you say that?" I ask him.  "Why didn't you say what you were thinking?"

"Because it was obvious to me that part of his job today was to treat you."  I think about this for a minute.  "He wants to make sure that you are as positive and optimistic as you can be.  Because he believes that your moods and your beliefs will affect Zoe's overall prognosis."

That's my girl!
"So maybe that's what he really means by the difference between western and eastern medicine."

Western medicine is more about what the x-rays show: the dimensions of the tumors and their location, the numbers.  The composition of the blood.  But beyond all that I don't understand about acupuncture meridians--what we really mean when we say a needle is entering a bladder point or a stomach point--integrative medicine entertains the notion that our thoughts and feelings can have a tremendous impact on our health.

I used to resist this way of thinking.  I objected to it on political grounds.  I thought it was kind of a blame-the-victim thing, like, if you get sick, it's because you're Debbie Downer.  I strenuously object to any belief system that over-emphasizes the role of the individual in health and wellness and doesn't name and critique, say, the polluters in our environment that make us sick: industry.

I'll never forget the trip I took to the site of the World Trade Center a month after the attacks.  My friend Cathy and I walked there from our hotel in Gramery Park and I smelled the damage half a mile before we arrived.  The acrid taste in my throat, the headache, the dizziness, the disorientation, the heaviness in my lungs: it hit me pretty fast, but what upset me most was the sight of all those people and dogs at work without masks.  The EPA had just put on its web site that there were no dangerous emissions at the site.  I knew in my body that this was a colossal lie.  And just this week I heard a story on the radio that all kinds of cancers are showing up for people who worked or lived near the site, and some people will be able to receive compensation.  But it's no compensation when our environment is making us sick and the agencies charged with protecting us are willing to suppress that information because of political pressure.

But on the other hand, since I started meditating I've read the science about how our ways of thinking and of dealing with stress affect the brain.  I firmly believe now that the feedback loop we create by negative thoughts, emotions, and stress can change the layout of our brain until being perpetually anxious is our new normal.  And I also believe that meditation can undo the damage.  Through meditation I've learned to witness my thoughts as though they were birds alighting on a branch of a tree.  They land, they sing, and they fly off.

Every day, the same message: it's not just that Zoe's good days are contagious, but that mine are too. We are kindred.  We are soft-wired to one another.

And every morning I search for the stillness inside to help me see the tree branch that is right before me without needing to know where and when the next bird will land.

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