Daze Of My Life/Two Much Together
by Ken Lourie
Recently I was presented with the same “What if ... ?” question, not once but twice, almost simultaneously, in fact. The first time was about my cat, Smokey; the second time was about my father, Barry. In each instance the “What if?” had to do with the patient’s health, and the “What if?” to which I refer is the Big “What if?” as in, if this procedure or pain medication doesn’t offer any relief, then is there a quality-of-life issue to consider? With both patients, even though one was human and the other feline, my thought process was nearly identical: Do I let them suffer (for selfish needs, I still want them in my life) or do I consider their self-respect, their discomfort, etc., and allow/arrange for their transition?
One night, at approximately 10:30 p.m., I was quite unexpectedly cat-in-box at the Pet Emergency Medical Care Center in Rockville, Md. Smokey had come in the house earlier that evening screaming, with his left rear paw bent in the air, unable to bear any weight. After checking him for any external signs of damage or distress - cuts, bites, broken bones, ripped pads, blood, etc.; I decided, after watching his continued struggles to move around and listening to his obviously-in-pain vocalizations, that I had to box him up and drive over to Nebel Street in Rockville and see the late-night veterinarian (and to bring my credit card).
Two hours later, we received a preliminary diagnosis. X-rays taken that night indicated that Smokey had a mass, possibly a malignant tumor, maybe even one that had metastasized, growing into or around his left rear hip joint. If true, and a follow-up appointment with our regular veterinarian to confirm was strongly suggested, the prognosis was hardly encouraging (cancer, amputation, chemotherapy, etc.) possibly leading to the inevitable question as to whether any of the procedures to be considered would be beneficial to the cat, affordable to the owner or even recommended by the doctor.
As for my father, the “What if?” decision was also quite surprising. Though he is nearly 85, and four months plus into recovering from a stroke, his progress was measurable and proceeding on pace until he had a middle-of-the-night fall and compression-fractured a vertebra, L4, in his lower back. As best we can figure (since he can’t really remember) he was trying to find the bathroom, at night, in the dark, with cataracts impairing his vision. He fell and my mother found him lying in the foyer. A call to 911 followed, and the rest is the balance of this column.
After five days in the hospital being treated for a urinary tract infection, which led to the dehydration that might have caused his late-night walk and subsequent fall, he was finally released, and he’s had round-the-clock caregiver assistance ever since. It hasn’t been pretty. He’s been in excruciating pain 24/7, so now he’s on heavy doses of narcotic pain medication. Needless to say, he’s not himself, and his quality of life is lousy. He’s unable to perform any of the tasks of daily living and if the scheduled back surgery doesn’t solve the underlying problem, then we may no longer have a “What if?” question.
We may have a “What now?” question. And as with Smokey, it becomes extremely difficult to watch your loved ones suffer.
So, on consecutive days I had the same serious conversation about life and death. On one day I had that discussion with my brother, Richard, about my father and on another day I had that exact same conversation with my wife, Dina, about my cat. The issues were the same, but the patients were not. It was weird.
And though I was experiencing identical feelings about both, the facts that mattered were quite different. In one instance the patient shares in the decision-making, whereas the other, the responsibility is up to the caregivers. We’re still working through the details: the doctor’s appointments, the specialists, the follow-up appointments, aftercare arrangements, etc., as best we can, so the future remains a bit unclear, but the present is certainly not. Pain and suffering are not confined only to the patient.
Lourie is a regionally syndicated columnist who resides in Burtonsville, MD.