Love Is the Best Medicine (31 page)

How had I not known about this? It must have happened when I was away on summer vacation, and for some reason, Dr. Able had failed to pass on this update during my absence. Maybe he had wanted to spare me the bad news, knowing full well how it feels to return to work, cheerful and revitalized, only to be crushed by a dispassionate e-mail documenting the travails of one of your patients while you were relaxing in the sun.

I tried to imagine how much second-guessing played out between Eileen and her husband, Ben, during what must have been a long and difficult week in June. Their anguish at having agreed to poison their dog, for all the right reasons, but without the dog’s understanding or consent. Dr. Able would have explained all the risks of chemotherapy, the potential for complications, and reiterated that the odds of recalcitrant side effects were slim. Even so, and even though
Helen clearly pulled through and emerged on the other side, I could hear the remorse and distress in Eileen’s every word.

“It was so hard to visit her, to see her constantly licking her lips from the nausea, and even though the chemo had stopped, its damage was already done. Her white blood-cell count plummeted and I know the nurses did a wonderful job of caring for her and keeping her clean, but I can still see the discoloration of the fur on the feet of her back legs from where it had been stained by her endless bouts with diarrhea.”

The recollection caught Eileen in its net, and for a moment she was lost to me, swept away, dragged backwards through a painful quagmire of betrayal over her misguided enterprise. I couldn’t deny her this introspection. In fact I would encourage all owners to take this journey
before
they send their pet into battle against a determined and despicable enemy. Consider the darkest hours if things go wrong, what you might be asking your animal to endure, and be aware and accepting of this possibility and how you might feel if they get dealt an ugly hand. If, for you, the rewards still outweigh the risks, then sleep easy at night, because regardless of the outcome you have made the right decision. But if you hesitate, remain uncertain, or uncomfortable with the potential for predictable remorse and heartbreak, then be the friend brave enough to intervene, to ward off denial and assure gentle mercy.

Helen had proved herself to be, and clearly still was, a fighter, a tough dog who made her own luck, scavenging for food, avoiding coyotes, cars, and freezing to death during the throes of a New England winter. After all she had been through she wasn’t going to succumb to some chemically induced toxic conflict. She had surpassed her four months and so much more. Her summer had come and gone, and suddenly, though I realized I was ruining the chronology of Eileen’s account, I had an overwhelming desire to find out how a dream about a sick spaniel playing on a beach up in Prince Edward Island finally turned into a reality.

O
F
course it was nothing like I had imagined.

“To be honest,” I said, “I had this image of Didi bouncing around in the surf, goading Helen into taking her first dip in the ocean.”

Eileen laughed, because what transpired was far less predictable and, as a result, far more wonderful.

“Didi happens to be one of the few members of her breed who refuses to swim,” she said. “She might have the webbed feet and water-resistant coat, but she never goes in beyond her elbows and knees.”

“So what happened?” I asked.

“Oh, Helen never really swam in the ocean. I guess I’d describe it as more of a civilized saltwater foot massage, whenever she felt like it.”

Too funny, I thought. The only thing I had right was the only thing I could have guaranteed as soon as Helen crossed the Confederation Bridge from Nova Scotia to the island—the welling up of pride and wonder in Eileen and Ben at the accomplishment of a canine cancer survivor used to fighting for everything in her life. I didn’t have to ask. I could hear it in Eileen’s voice as she talked about their vacation. It didn’t negate all the fears and the perpetual uncertainty and I imagine it never felt like vindication for the tough choices Eileen had to make. I’m certain the reward came packaged in that moment, shared liberally between them, all-consuming, humbling, and unforgettable.

In truth, my Hallmark version of Helen’s happiness being so very wrong is one of the greatest pleasures I take in her achievement. How can any of us impose our version of happiness on others, let alone the animals in our lives? I asked Eileen if Helen had been happy playing on a beach for the first time, and as soon as the question got away from me, I realized it was futile. Can we take a reading from the canine wag-o-meter and determine a dog’s degree of
ecstasy? Do the volume and frequency of your cat’s purrs crank up to eleven when she is approaching feline nirvana? Thankfully our pet’s version of happiness exists in a one-of-a-kind language, something far more subtle than what we read about in books on animal communication, something explored, cultivated, and gradually understood by those who take the time to learn. All they have to do is observe and they just know. It might have been clear from a certain look from Helen’s upturned eyes, the intensity in her concentration during her hours of crab herding, the ferocity of her newfound appetite, or the ease with which she slept, utterly exhausted every night. However she managed to convey her message, it was obvious Eileen and Ben saw it, over and over again, as plain as if Helen herself had written “having a wonderful time” on a tacky tourist postcard.

I
COULD
try to make excuses for what came next, claim I got caught up in a moment of euphoria, the romantic in me shirking objectivity and scientific reason, but I felt compelled to share what I had kept to myself for all this time.

“I have a confession to make,” I said, rewarded with a predictable moment of silence signaling Eileen’s confusion or unease at being privy to some awkward, unanticipated declaration. “I need to tell you about a little miniature pinscher called Cleo and her owner, Sandi, and where they fit into my version of Helen’s success story.”

I hadn’t confided in Eileen sooner because, well, to be honest, it felt ridiculous, even unprofessional, asserting that the spirit of a deceased dog somehow played a part in Helen’s extended survival. There had always been something appealing in Cleo’s role, if you could call it that, as a secret benefactor, working her magic from afar, generous and anonymous. But as I heard Eileen’s good news, part of me understood Cleo and Sandi deserved some of the credit for how well everything had turned out. Regardless of whether or not you
believe they had any influence on the course of Helen’s disease, one thing is for certain, they had a profound influence on me when I set about fighting it.

Eileen listened attentively, a kindred spirit, instantly bonding to a mother, a daughter, and a dog lost to tragedy. She got it, like I knew she would, because, like Sandi, Eileen has also been cursed and blessed by an affinity for stray animals, animals who need her help. Two women, two dogs, one life ending as another was allowed to begin. A painful symmetry between strangers whose lives unwittingly entwined to become a testament to the power of letting go and the possibility of a better future.

I
N
this new era of cancer treatment, we hesitate to use the word
cured
(perhaps for fear of jinxing ourselves). We are confused by the word
remission
because how can we be keeping cancer at bay if the disease appears to have gone away and we are no longer pursuing treatment? That leaves us with the concept of cancer as a chronic disease we need to manage over what time remains. This makes the “big C” sound more like bladder stones, eczema, or constipation. It is
time
that is the crucial variable here. In humans we used to think of five years in remission as a cure. In dogs and cats, especially teenage dogs and cats, five years might not be within their grasp even if they are perfectly healthy. I am not an oncology specialist, but sometimes when I discuss expected survival times for certain canine cancers with owners, I find it helpful to consider the future in
dog years
. Relative to their life expectancies, an extra dog year of quality living might equate to seven years cancer free for you or me. Of course this is hardly scientific, but, for some people, thinking in these terms can be helpful. Once upon a time the options for an animal succumbing to cancer were pretty much limited to a fatal overdose of a barbiturate. The owner had the comfort of knowing he or she had sought treatment, but veterinary medicine offered little
more than an alleviation of pain and suffering through humane euthanasia. In the twenty-first century, veterinarians have smacked the ball deep into the pet owner’s court, bombarding him or her with detailed medical information, a huge variety of therapeutic alternatives, and, not least, the fiscal challenge of how to pay for it. Maybe, when faced with the inevitable and tough decisions in your pet’s health care, the vagaries of survival, and what you and I may think of as relatively small packets of time, a consideration of longevity in terms of animal years might not seem so ridiculous. And bear in mind, with all our advances, fifteen is the new eleven for dogs and twenty-two is the new fifteen for cats!

Not long after my conversation with Eileen, I hit the hospital library, trying to get a handle on the magnitude of Helen’s achievement. The scientist in me had a flashback to high school statistics, could see a bell-shaped curve on a graph, the one in which the majority, the average, stand in the middle, leaving smaller numbers of individual stragglers on either side. How far was Helen hanging out to the right side of the curve? After all, cancer is an accomplished and perverse killer. Clearly Helen had dodged a quick, vicious attack, and based on Eileen’s description, she did not appear to be the victim of a slow torture, taking its time and savoring an inexorable demise. Helen was beating all the odds, but she was still vulnerable to what some consider a most disturbing and heartbreaking assailant—cancer as a faceless assassin who catches you off guard, with your defenses down, stepping out of the shadows when you least expect him.

Wading through textbooks and scientific journals, given the particulars of Helen’s case, I concluded that Dr. Able’s estimate of four months had been reasonable, doable, that eight months might be a stretch but not implausible, and that twelve months deserved a little more credit than merely remarkable and might even be working its way toward the loaded “M” word—
miracle
. By now, Helen had been alive for well over a year.

Scientific indoctrination makes most medical professionals reluctant to describe a clinical outcome as a miracle. It feels theatrical, affected, even conceited. As I perused my pile of data, I imagined it would be possible to decipher the minutiae and language of Helen’s pathology report, trace the line of the appropriate Kaplan-Meier survival curve, calculate her percentile in terms of disease-free interval, and manage to come up with a perfectly logical explanation for why she was still alive. And then I stepped back from the numbers and charts and dry, detached statistics and thought about a filthy, foul-smelling black spaniel greeting a stranger in a parking lot on a cold November night—a dog harboring a cancer, a stranger who would do whatever it took to give an innocent animal a shot at life. Following Helen’s journey from then to now, with everything in between, it is hard not to be staggered by her change in fortune and those who brought it to bear.

I closed the books and pushed the papers aside, smiling, the sentimental part of my brain telling me to lighten up, to live in the moment, demanding I surrender to the spirit of victory. Helen’s story may be as good a candidate as any for the term
miracle
. And besides, if I may bastardize the words of the legendary writer Cormac McCarthy, “If it ain’t, it will do until another one comes along.”

F
OR
better or for worse, thinking about Helen inevitably and appropriately led me straight back to Cleo, and given this unexpected and marvelous update, I was eager to share Eileen’s news with Sandi Rasmussen and her family.