So today I’m feeling a bit sad and reflective. I have to do something I am NOT looking forward to for a number of reasons. But it does give me the opportunity to look back and realize that I am reaching a milestone in my career as a “Family Practitioner” Veterinarian. It’s almost as if my career is reaching real maturity.
Eleven years ago I
graduated from Vet school, feeling proud, hopeful, excited, and yes,
even a little relieved that I’d managed to get through it. I had an
incredible stroke of luck and found an amazing family in a small town who took me and the Hubs in as one of their own
immediately. They were looking for an associate Veterinarian for their
small-town practice. The practice and the family hiring were such a
perfect fit we flew back to VBB College Town, loaded up our meager possessions
into a Ryder truck and drove across the country on the biggest adventure
of our lives.
I was getting settled into being a Vet quite
nicely the day about 10 years ago when I met the Andersons. They are a
great couple, about my age. Joe is probably the biggest guy I’ve ever
met….the size of a redwood practically. But he’s gentle, quiet,
reserved, and when he speaks he has something to say. His questions are
probing and thoughtful. He listens carefully to my answer, mulls it
over, and GETS it. Rita is sweet and caring, the family worrier, but
also keenly intelligent. She’s funny and friendly and dramatic at times
(in a good way). I love to see them on my schedule; it makes my day
knowing I get to see them.
That first appointment was to see the
new addition to the couples’ lives, Ike and Ivan. They were brothers,
Labrador mixes- with what, who knows? But they both have pensive,
wrinkly, adorable hound dog faces and long, droopy ears. At the time
they were about 6-7 weeks old, and there was NO predicting they’d each
top 100 pounds when fully-grown. They were each small enough to fit in
one hand! Ike was nearly white-blonde, and Ivan black with white on his feet. New puppies have always been my favorite type of appointment. I
take my time- nearly an hour usually to meet the family and puppy, do a
physical exam, and talk about all the things it takes to raise a
healthy, happy, social, well-behaved family member. Our puppies visit
every week or two as they grow up so we can love on them and bond- I’d
say 95% of my canine patients drag their owners into the clinic from the
parking lot. Ike and Ivan are no exception. Ivan has always been a
bit more shy than his brother…he comes in, hides a bit behind Mom, and
peeks around her legs. Ike is the brave one….in my face schnuffling on
me the moment I enter the room. Then Ivan sidles up and says hi while
he thinks my attention is on Ike. Funny boys. They ALWAYS visit
together, even if only one of them needs to see me.
years, I’ve seen the brothers welcome two baby boys into the family (the
two-legged kind). Brendan is the baby- a bit young for me to really get
to know yet, but Joey is about 7-8 years old now. He’s a perfect mix
of his parents. He’s friendly and funny like Rita, and he asks great
questions and listens like Joe. He’s got a round cherub face and a mass
of mahogany colored curls. I think he’d be a great Vet. One time he
brought in a plastic dinosaur (he was about 5) and explained to me some
medical problem it had and his treatment plan for it. I don't usually enjoy kids…..THIS is a kid I LIKE. I could hang out with him and have
Ivan and Ike are like all dogs with the best families-
medical disasters! I don’t think there is a problem common to labs that
at least ONE of them hasn’t had in the last 10 years. They’ve both
been to see specialists multiple times. Ivan has had both knees
re-built. Ike once ate an ENTIRE tin of popcorn on Christmas Eve
morning (you know, those HUGE tins with the Christmas scenes on the
outside and three flavors of popcorn inside?) I usually see
appointments until noon on December 24th, but somehow I’d gotten REALLY
lucky and nobody needed to come in. I was planning to stay home, but I
got a call from the office- Rita had called in a panic, thinking Ike
would rupture his gut from the popcorn! I went in to examine him, he
was stable, happy, tail wagging, face grinning, belly HUGE! He belched
NOT so softly as I palpated his belly…..he felt like a plastic trash bag
STUFFED full of popcorn! Rita felt so bad about calling me in on
Christmas Eve she brought coffee AND Starbuck’s gift cards.
Ivan and Ike survived the popcorn and various similar disasters over the past
decade…and there was NEVER any question from Joe & Rita that they
were going to choose the best recommended tests and treatment every
time. But they are also 10 year old BIG dogs. They’ve really started
to show their age the past couple of years.
Ivan has always had
some lameness issues from his bad knees, but then Ike started having
trouble with arthritis in one of his shoulders. We’ve tried a number of
therapies, all of which are either ineffective or they make him ill.
He can barely get up and down the stairs now, and the loss of the muscle
tone of that leg is obvious from yards away. He simply can’t use the
leg any more.
Then about a week and a half ago Ivan was on my
appointment schedule. He wasn’t eating, seemed really lethargic. Rita brought in Ivan (Ike waiting in the truck this time) and Joey. As I bent
over to say hello to Ivan my heart sank. I stroked him under the chin,
only to find the lymph nodes there were the size of large eggs. Moving
down along his neck I found more enlarged lymph nodes in front of his shoulderblades, and again in his calf muscles in his rear legs. “Rita,” I
said…”You guys fish a lot, right? Could he have possibly eaten any raw
salmon or trout?” (I knew the answer was no…Joe and Rita have learned
over the years NOT to let the dogs have anything out of the ordinary
because Ike has a particularly sensitive stomach). She confirmed that,
though they’d been fishing, there was no way the dogs had eaten any
fish… Damn. Not salmon poisoning.
I looked up at her, "All his
lymph nodes are enlarged. This worries me. I am NOT happy to find
this.” I could see her start to mist. She’d known. She sent Joey
out of the room to sit in the lobby. He protested- he’s always well-behaved
and has NEVER had to leave the room before. But she asked him again
quietly, and he nodded, and left the room. I think he knew, too…even at
8. I told her my fear was that this was lymphoma. I needed to take
some samples to send to the lab to confirm it…then we talked about
cancer. If I HAD to pick a kind of cancer for my dog, it would probably
be lymphoma- chemotherapy protocols these days can do amazing
things…remission is common and many times you can get good quality of
life for years. Then she dropped the bombshell. She asked if it would
be wrong, and could I do it if she asked, to put the boys to sleep
together. Ike hasn’t been doing well, and now Ivan is really
uncomfortable and not eating. They’ve NEVER been apart. There was
crying. And talking. Lots of talking. We decided to wait for lab
results, then we’d take it from there.
Unfortunately (as I’m sure
all the DVM readers have already guessed) the lab confirmed small cell
lymphosarcoma. Ivan did ok during the weekend while we awaited the
results, but his appetite was down again Monday. I spoke with Joe and Rita probably four or five times on the phone last week…deciding
whether to go see the internist for a consultation, then deciding
whether to give prednisone a try, then deciding when it’s time….
time. Today. This afternoon. Ivan is not doing well- won’t eat,
won’t play. Ike is plugging along but in constant pain from his
shoulder. I imagine the whole family will be there. There will be
tears. There will be hugs. They want the boys cremated together, their
ashes mingled in a single container. It will be hard. But I will do
it, because I love them and they are my friends and I have the privilege
of sparing them from a horrible end. So is the life of a family Vet.
a poem called “The Rainbow Bridge” we send to clients at the loss of a
pet. It’s quite lovely, a nice sentiment….Heaven for animals,
essentially. I’m glad it gives people solace. At times I wish I could
believe in those things. But I am a naturalist, realist, scientist,
atheist. I believe that the end is, well…the end. Now, before you go
feeling all sorry for me, or disappointed, take a moment to think about
what that can mean:
We have this life, and ONLY this life. Enjoy
it. Make the world better for yourself and the others around you.
Heaven is not some mystical reward to be given to you in the afterlife.
It’s an ideal, a dream, a goal. It’s something we all need to work
together to MAKE for OURSELVES. Love well, love deeply, love many.
Find humor. Find beauty. Find joy. SHARE it. Share your defeats and
tragedies as well, for without sorrow there is no joy, and pain shared
is pain halved. Smile, laugh, cry, dance. Live.