Tuesday, April 20, 2010

Taking a Whack

After trying unsuccessfully to concentrate on work all day today, I came home to the 'stead and took another  "whack" at pruning the cherry trees. Normally I like to listen to the sounds of wildness around me, but today I wanted some noise (and a glass of wine).  So I put one earbud in and left one ear open, took a glass of wine and the clippers out to the cherry trees. It was good to do a little work and let the peace of this place seep through me.
After pruning the cherry trees (again), I started the lawnmower (on the first try!), and ran it around for a few minutes, then took a walk around the yard with Maggie the dog and Pancho the cat.  I have to start putting dates on these beautiful sunset pictures, there are so many.  I felt kinship with the fact that the darkening sky is just about the most beautiful thing ever, but there is one, small black cloud floating there.

Desmond was in surgery until about 9 pm.  He came through fine - no good or bad surprises.  I should be able to bring him home Thursday night.

I've been thinking about how back-and-forth I've been today, questioning my path with Desmond. Wondering to what extent my choices on this have been marked more by what other people believe than what I believe.  I don't have strong, dogmatic feelings either way, so tend to listen to others' opinions more than I would on something I do feel strongly about.  The part where I feel strongly is that I will do my utmost to remove pain from his life, and that is what I believe I have done.  I'm certain that I will have more opportunities to make this decision (or another one) with Desmond in the months and years (hopefully) to come.


My sister sent me a wonderful email on the "what-to-do-at the end of life" question that I'm going to post below in it's entirety:

Back when I was pregnant with [my first], our cat got sick (Picca).  She had always been a vomiter, but was vomiting more and more often.  So I took her to the vet to get a check-up.  As you mentioned, it was one test after another, each one not so expensive, each one promising an answer or a resolution, so at each decision point, I was inclined to proceed one more step to see what the information/result would be.  Because it seemed unreasonable and unfair to not do just one more test/procedure.  We ended up spending something like $5000 on it, and the conclusion was that she had cancer (pancreatic, I believe).  In theory, it could have been operable and she could have gotten chemo, but even the vet said that was not reasonable.  In hindsight, I wish I had just let things take their natural course from the beginning, and I have resolved to never go down that road again.  Even before taking her to the vet the first time, it was clear that she was simply getting old and ill.  She could've had a perfectly fine peaceful and loving resolution to her life without all the human-imposed interventions.  The whole medical journey was driven by my human guilt ("If I can do it for her, how can I not?" etc.) and urge to just 'fix' the problem and the inclination to take just one more small step (to do a test or procedure).  I wonder if being a parent has made part of the difference in my position on this issue; there are so many times in which as a parent you must steel yourself against the most emotional begging and pleading in order to do what is right or required.  I wish now that I had had that resolve to withhold my interventions as my cat died from illness and just love her and comfort her and let what must be, be.  I wish that I had taken her back to the vet to be put to sleep earlier than we did.  I also think, now, that I would feel better about her final weeks/months with us had I been stronger about making the necessary decisions to let things take their natural course

Anyway, we each make our own decisions, and they are difficult.  But I just wanted to put in my two cents that it is not weak, it is just as brave and righteous, to decide not to intervene.

6 comments:

  1. So well said by your sister. I agree totally.

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  2. Your sister's e-mail is beautiful.

    I did not speak up earlier about my perspective on pets' diseases, illness and death because I thought you had made up your mind and you know best what is right for you.

    I love my dogs, but I have never decided on surgery at the end of their lives. The reasons are many. I am very active with my dogs and I know each of my dogs loves most to play. My experience is when dogs get older, any internal disease or illness is usually only part of the story. One problem leads to other complications.

    I think any decision you make is right. As your sister said, it can be just as brave and righteous to decide not to intervene as life takes its course.

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  3. The same could be said for prolonging the life of people who have no quality of life to ease our own guilt. Your sister is very wise.

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  5. I'm fairly new to your blog, but I wanted to add my $.02, too. I agree with your sister in what she wrote. We have a yorkie, his name is Max. I've written about him on my blog. In fact I wrote about this episode.

    In July 2008, we wound up having to take him for surgery on his eye. It wound up costing us between $3000-$4000 all-told. It was a situation that we either had to have the surgery or we had to put him down. He was otherwise perfectly healthy, and we elected for the surgery.

    In hindsight, I'm not sure I'd make the same choice. I'm not sure I wouldn't make the same choice, either. I just don't know.

    Max is my first dog. He is a member of the family and I love him dearly. He's been fine ever since, yes, but since we know he is predisposed to lens luxation, we know that any day we could wake up to find it's happened in his other (good) eye. We discussed at the time of the first surgery that we would not do it again. So. I wait. He could die of old age before his other lens luxates, but it is still always there to me, lurking. He'll be 11 this August.

    And I also wanted to say that the Emergency Vet we took him to (DC suburbs around Gaithersburg) for the eye problems has a HUGE oncology practice. I have seen people burst into happy tears when hearing the bloodwork results after the latest chemo round to keep their dog alive for another month, week, day.

    After seeing this, and knowing some of the anguish those owners are feeling first-hand, I have decided in the future to ask myself: Am I doing this for Max or for me? I'm still not sure I can/could answer that question, but I hope when the time comes I'll know. The most comforting thing our regular vet told me is that we obviously love him and know him best, any choice we make will be the right one.

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  6. Hey Judy - thanks for sharing. I think I'll adopt your question as well. I like how it clarifies things.

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