Sometimes we only know the true measure of a person when death stares us in the face. There, at the end of everything, is the simple, plain stark truth of it all.
Sometimes the truth is sad. It hurts.
Sometimes it exhilarates.
This is a story about veterinarians. Four of them. Told in four parts.
Starting with the simple fact that my beloved Murphy is dying. A Cavalier King Charles Spaniel, she’s 13-1/2, and had some serious health challenges early on, most caused not by her breeding but by poor veterinary care and some really bad luck. That doesn’t matter now.
What matters here is that in December 2011, only a month ago, we accidentally discovered that Murphy has a splenic tumor. I needed to figure out as much as I could about it, so Murphy and I could decide what to do. That’s what we’ve always done: find out what’s going on, what can be done about it, and choose our course.
Those of us who live in multi-species families know we have to make decisions for ourselves and for our animal family members. We know that the human-animal bond isn’t just cookies and games: it’s food, and socialization, and medical care. It’s choice. These days, choice is harder because we have so many options: the same complex and often questionable devices and procedures we use on humans can now be used on our animal companions.
It makes choice harder. Really. What is enough? What is too much? What can you live with? Should you?
The human-animal bond is how you define families and living together. It’s the choices you make that honor the commitment to family life.
All the choices.
I read. I think. I ask people’s opinions about things.
As an intuitive I can also ask other beings what their insight is.
I can ask my animal family members what they want. We can figure out what to do together. Food choices, play times, easy. Life and death, not so much.
It isn’t easy deciding what to do about a dog’s splenic tumor. The choices were clear: operate and remove the spleen and tumor or don’t operate. There is no certain way to determine if the tumor is cancer without taking it out, because of how insidious a cancer like hemangiosarcoma is. If that’s what it is.
They examined the tumor with ultrasound, making the diagnosis as clear as possible: Murphy probably has cancer. Meaning that she isn’t going to survive long, as surgery and chemotherapy would only buy her a few months. If it’s not cancer, the tumor is still going to grow and rupture at some point, and she’ll die anyway.
Without surgery, we don’t know what it is, only that it will most likely kill her.
We discovered the tumor because Murphy had a slight cough, and I thought that with a recent diagnosis of minor heart issues, she probably needed heart medication. Blood tests were funky, and they put her on antibiotics for an infection, probably a UTI, possibly a bronchial infection. But I insisted on a chest x-ray: which confirmed a bronchial infection, and spotted an abdominal mass.
So, naturally, I called our long-term vet, a wonderful person who has dearly loved sweet Murphy and cared for her for 11 years. A vet it takes us all day to see, since it involves a long drive and two ferry rides across Puget Sound in Seattle. All worth it to see someone who figured out Murphy’s eye issues 11 years ago and helped give her a wonderful quality of life. Someone of integrity and concern. Who was strongly attached to Murphy. A friend who wanted to do the right thing. We valued her.
I called her just so she’d hear it from me. That Murphy had a splenic tumor. Before I ordered the ultrasound or did anything else. Before I really knew what it meant or how Murphy and I wanted to deal with it. Just to tell her.
She expressed condolences and then insisted that I tell the vets that I wanted Murphy as long as possible and that they absolutely had to operate and take out the tumor.
I said I wasn’t sure yet what we were going to do.
She was quite insistent, and then the phone connection went dead.
I thought she’d hit the proverbial tunnel on her cell phone. But she didn’t call me back. And hasn’t for the last month.
So there’s the clear message. One answer to a perplexing problem: there’s an awful lot we can do these days, for humans and animals. But what is the right thing to do, and who’s the one who decides?
The right thing as a vet is to evaluate the options with you. To give you the best information possible. To answer questions. To honor the human-animal bond, which is a family matter. Paternalism is rampant in veterinary care, even among female vets.
Our long-term vet didn’t evaluate the options. Thinking back on it, I realize that somewhere along the line I somehow gave her the idea that she could decide for us what we should do in our family. She clearly stated it in the end: surgery to give me as much time with Murphy as I could get.
But is that really the right answer? What about Murphy’s quality of life? What about her choice? What do we put animals through because of our feelings, disregarding theirs?
Yep, if it’s cancer, surgery and chemo buy Murphy a few more months. But at what price?
Financial difficulties for a family on pinched means, as most of us are today (the recession is the great equalizer, isn’t it?): could we afford it?
Physical impairment, as caring for an old animal recovering from surgery, dealing with stairs, my own disability and health issues, the pain and exhaustion for my dog: is it worth it?
Emotional devastation, from the shock of hearing that your beloved dog may have cancer and won’t recover anyway, or may just have a benign tumor that will kill her if it ruptures, if she survives the surgery itself: how do you manage that?
That day in December I was in shock, grieving, appalled. I had only just learned of the tumor. I hadn’t investigated it yet, found out what our options were. All I was doing was calling our friend, to courteously tell her what was going on. We hadn’t made any decisions. I wasn’t sure what the best answer was.
My frank admission got me what?
Abruptly cut off.
As the days passed, I realized how much I appreciated that hang up. A long-term relationship built between our mutual love of my beloved dog was suddenly at an end. Perhaps we had outgrown each other, the vet and I. Or perhaps I had finally realized that what I thought was my family’s choice all along was being dictated by someone else. Or perhaps something else. Not sure.
No longer matters.
What I am sure of is that the old medical model, in fact, life model, of how we live in community has to change. The old paternalistic structure has to end. We have to respect individual choice, and family choice.
Now at the end of my beloved Murphy’s life, I absolutely insist on it. I am sad that I had to learn the truth of our relationship with our long-time vet at a time when my family needed love and support. I am exhilarated in that I was strong and brave enough to do the right thing, to give Murphy her choice, to honor her life as an equal being in a heart-bonded family.
I am grateful that my family has found its way to its choice. In the next three postings, the vets we have turned to, and how we found our answers.
© 2012 Robyn M Fritz