Thoughts At Large

Passionate thoughts on random topics

Category: dog

Sharks and Cancer

quint

So, eleven hundred men went in the water, three hundred and sixteen men come out, the sharks took the rest…”  Quint, Jaws

It has been a very difficult year and a half. First, in November of 2014 my father died after a brief but excruciatingly painful fight with lung cancer which had spread to his bones. Almost one year later, last September, my wife died after a long fight with breast cancer which had spread to her lungs. And then only six months later, my dog died after a painful fight with a soft tissue cancer which had spread to his bones. One year, then only six months, part of me wonders what horror will befall us in three months. But I have to believe that the pain and suffering have ended now.  I can’t help but appropriate Quint’s quote to, “So, five of us went to Texas, three of us come home, cancer took the rest…”

Cancer has targeted my family for far too long now. I don’t want it to have any more power over us. My children have spent fully one-third of their lives living under the threat of cancer taking their mother and then their dog. Almost their entire teenage years, years difficult enough without cancer moving in to live with us, has been spent living under that dark cloud. They are 21 years old now and, in spite of these added pressures, will both graduate on-time from the University of Texas at Austin, each with over a 3.5 GPA. How they have been able to stay focused amazes me and is a testament to their strength of character.

I know people have had it harder than we have. I don’t claim to have a corner on suffering. And I am grateful for the seven years we were able to steal from cancer by moving to Texas and seeking treatment at the M.D. Anderson Cancer Center in Houston. I’ll never regret that decision. But if we could have a break from any additional pain for a short time, that would be great.

Each of us is dealing with these losses in our own individual manner. Certainly, grief counseling has helped, but we still face a world in which neither Lisa nor Delbow will walk with us any longer. We have had long discussions about faith, heaven, philosophy, and all of the accompanying topics. We disagree as much as we agree but the discussions are always lively and fascinating. I hope that we can each find some comfort in our positions.

Finally, there is the issue of moving forward. The house, already quiet from Lisa’s absence is now even quieter without Delbow’s rambling about. The kids are on spring break this week, so I have a respite before facing that still house alone. I now have six months of experience without Lisa and living alone. I hope this serves me well when the kids return to school. But before we know it, school will be over, graduations will have been concluded and we will be packing up for our trip back to Rhode Island. I hope it goes well and we can begin our new lives healthy. No sharks, no cancer.

Delbow

 

We lost Delbow Ploppers today. He has gone on to live with Lisa in heaven.

Throughout his life he endured a number of medical procedures, none of them easy. He tore the CCL ligament in both back legs and had to have them surgically repaired. He lost one eye to a detached retina and had to have emergency surgery in Chicago to save the other eye. He endured three different battles with cancer. And he lost most of the remaining eyesight to a cataract. Our little bionic dog saw it all. And he never showed anything but love to us.

And now he is gone. The house, already silent because of Lisa’s absence, is now doubly silent because Delbow is gone. The loneliness I felt after Lisa’s death was mitigated somewhat by Delbow always being there for me. And now he’s gone too.

Will Rogers famously said, “If there are no dogs in Heaven, then when I die I want to go where they went.” I couldn’t agree more.

The lone male in the litter of five Coton de Tulear puppies, we brought him home with us and he slept in Lisa’s elbow the entire ride home. We had just seen Kenneth Branagh’s Henry V with the kids and were reminded how the French princess, preparing in case her father’s army lost to the English, learned the new English language. Instead of saying “elbow,” she kept saying “d’elbow.” And that’s how Delbow got his name.

He lived to be twelve years old and encompassed most of the kid’s childhood. An era is gone. The kids are seniors in college now and will be off on their own soon. First it was my father in 2014, then it was my wife in 2015 and now cancer has taken my dog too. This continues a difficult time for us and closes another chapter in our lives. Cancer sucks.

Coming Around For Another Bite

Two Novembers ago it took my father. In September it took my wife. Now it wants my dog. I hate cancer. Why won’t it leave us alone? I am reminded of the quote from Christopher Hitchens who, when confronting his cancer diagnosis wrote, “To the dumb question “Why me?” the cosmos barely bothers to return the reply: why not?” So it is with my family. And so it goes.

Susan Sontag warns us of anthropomorphizing cancer, but it is so easy to do. Without a face, your foe it is that much harder to fight. What made Jaws so powerful was that the animatronic shark kept breaking forcing Steven Spielberg to come up with other ways to present the omnipresent danger through the use of camera movements and ominous music. The unseen monster is far worse than the seen. So we put a face on cancer and try to fight it from the outside while it destroys us from within.

So now we are awaiting the results of the biopsy which will tell us if the tumor is malignant. If it is, we will be faced with the difficult decision of what to do next. At twelve years of age, my wonderful dog has already battled cancer twice, had both back knees rebuilt, and had his eye repaired in Chicago. He’s been through it all. And yet his only concern in life is that he loves us. We will be faced with the difficult answer to the question: for whom are we going to submit him to more medical treatment? If it is for him, we will proceed, cost be damned. If it is for us, we will need to regroup and face the ultimate question of when is more surgery, radiation, and recovery too much for him leading to the inevitable decision whether to put him down. But I’m ahead of myself. We need the biopsy results first. We’ve been down this road before and will make the right decision when we have all of the facts and in spite of the perturbations it will cause.

We will be forced to answer the tough question: for whom are we going to submit him to more medical treatment? If it is for him, we will proceed, cost be damned. If it is for us, we will need to regroup and face the ultimate question of when is more surgery, radiation, and recovery too much for him leading to the inevitable decision whether to put him down. But I’m ahead of myself. We need the biopsy results first. We’ve been down this road before and will make the right decision when we have all of the facts and in spite of the perturbations it will cause.

I hate cancer. Leave us alone. Even sharks need time to digest their latest meal.

Summertime Thoughts

And now for a few thoughts:

I always wonder what my dog is thinking when he gets inside an elevator. We go into a small room, he looks out at the room we just left, watches the strange doors close and sees a completely different world when the strange doors open. What happened to the other world? What happened?

Is there anything better than a home grown tomato?

Nothing says summer better than hydrangeas in bloom.

In a perfect world, everything would smell like gardenias.

I love how time dissolves when I’m gardening.

Too bad I rarely get the chance.

Too bad it’s 150 degrees outside when I do get the chance.

Summer is going by too fast.

2013 is going by too fast.

My life is going by too fast. I still have a to-do list from when I was six that I can’t seem to get to.

I can’t think of anything so profound I would have to have it as a tattoo. And I can’t imagine any tattoo that isn’t an Oscar Wilde quote. Or George Orwell.

I love driving.

I hate other drivers.

I love to watch airplanes. I always wonder where they are going or from where they have come. What vacation stories are waiting to be discovered or retold. Take me with you.

I feel like my dog in an elevator when I fly. I go to the airport, sit in an aluminum tube for a few hours and exit into a totally different culture. Wonderful!

The older I get, the more I love my wife.

The older my children get, the more I love my wife.

The older my wife gets, the more I love life.

What’s next?

Shadows

I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.      – Abraham Maslow, The Psychology of Science: A Reconnaissance (1966)

A hungry stomach cannot hear.    – Jean de La Fontaine, Fables, IX, The Kite and the Nightingale (1678-1679)

The hungry are forgiven for thinking of nothing but food. Consider the cartoons of your childhood where the starving predator sees something (prey or any inanimate object) and it transforms, in his mind, into a sizzling pork chop or a talking fried chicken leg. So, too, the cancer patient can think of nothing but disease. Every cough, every twinge, every sniffle conjures up images of metastasizing evil reaching its suicidal fingers into new corners of their betraying body. However, unlike hunger, cancer has the ability to cloud the perception of those who love and care for the cancer patient.

Such was the case of our beloved dog Delbow. Stung by the appearance of a cancerous tumor in the muscle on the right side of his neck last year, an incomplete resection of the area was followed by cautious but deliberate irradiation of the area in 21 sessions over three weeks, concluding last spring. As with my wife, whose ongoing war with breast cancer leaves her with scars and nightmares, our dog, blissfully oblivious to the prognosis and baffled by the ongoing medical attention carries the painful reminders of his ordeal.  Suffering from increasing head tremors and restricted head mobility, coupled with teeth gnashing (a new manifestation), we sought answers from his veterinary oncologist.  Examinations were made and tests were run, all in our endless quest for information. Nothing was found to account for the changes.

We were referred to the neurologist, who suggested a myriad of horrible conditions which “may” be responsible for his symptoms. Again, tests were run, information was gathered but conclusions eluded us. Finally, the prospect of a temporomandibular joint condition was proposed and we were referred to the veterinary dentist. As my son and I waited (as my wife was too ill following another round of systemic poison being administered to her), the dentist informed us that it appeared the cancer had returned. In concert with the oncologist (with whom the dentist and neurologist are colleagues in a multi-specialty veterinary clinic), it was revealed that there were at least two, one half centimeter tumors on the back side of his neck. In addition, there was an inflammation in the area of his optic nerve within the orbit of his left eye and a huge mass pushing the lens out of position. The tumors on his neck were excised and sent for a biopsy and we returned home with a beloved family member lethargic from sedation and partially shaved with a four-inch, sutured incision on his neck.

The next few days saw his demeanor change, his energy decrease, confusion increase and us wondering if the end was nigh.  Cancer had again forced every other consideration of our lives to the very distant background. Sadness fought with anger for position as the overwhelming emotion we faced. Like walking out into an August day in Houston from the conditioned atmosphere of our home, the concept of life without Delbow hit us in the face within moments of awakening every morning. Sicknesses, such as cancer, have a way of forcing us to prioritize our lives, jettisoning the trivial matters eating up precious brain activity in favor of the immediate and irreversible concepts surrounding mortality. However, while this is true in the long-term (or even the mid-term) it is not true in the immediate aftermath of learning such news. Rather than prioritize the various weighted obligations we face, all other considerations (all other thought) drown in the dissonant din of this cancer-caused, immediate threat.

Weary from these considerations and exhausted from a lack of sleep caused by us each holding Delbow in shifts throughout the night because of his almost constant, semi-conscious leaps of pain (followed by a desire to stand alone in a corner with ears down, tail down and a sad, empty stare), our arms held him tight against us like living seatbelts, our voices soothing as we spoke tender deceits of everything being “ok.”  A week passed like this and we were finally scheduled to return to the oncologist to review the findings of the biopsy. Unable to convince Lisa to stay home, the four of us and our little, fluffy, white ball of radiating love made the trip together.

The first indication that this would not be just another doctor’s visit came to us upon entering the examination room. Rather than the exam table locked into place like a deployed, closet ironing board center, complete with rubber-backed bath mat for the patient’s comfort, there were simply five chairs in the room. It seemed that any pretense of medical art had been dispensed with and a consultative, group therapy session was about to ensue. What followed was unexpected, bordering on unfathomable.

The biopsy of the tumors from his neck came back as benign, dermatopath lesions, non-cancerous. However, the inability to conduct a biopsy of the optic nerve enlargement left the physicians dubious of its construction or intent. That, coupled with what was originally thought to be a massive, mature cataract on the CT scan was now believed to be a suspected soft tissue ciliary body tumor. One step forward, two steps back. Because of Delbow’s extensive medical history (exclusive of his cancer and treatment), including two TPLO surgeries, one on each back leg, and an emergency retinal reattachment surgery four years ago, it was thought that his ophthalmologist might be able to provide some (if you’ll forgive me the word) “insight” into Delbow’s visual condition. This was at 11:30AM. A quick, frantic call to his ophthalmologist, where I simply needed to drop Delbow’s name (as everyone who knows him finds him beautiful, adorable and memorable), and we were scheduled to meet with the ophthalmologist at 1:00, thanks to a double booking trick of the office staff.

The benefit of having a background in the health insurance field is that no generational or geographical biases prevent us from seeking out the best practitioners (we moved from Rhode Island to Texas to obtain treatment at M.D. Anderson and took Delbow to Chicago to have eye surgery). The “benefit” of having a two inch thick file on Delbow at the ophthalmologists (I put benefit in quotes because to amass such a file necessitates ongoing physical conditions requiring medical treatment) is that this history provides benchmarks against which current issues can be gauged.

It turns out that the enlarged shadow the oncologist saw on the CT scan near Delbow’s optic nerve has always been there (or in the words of the ophthalmologist, “he most likely came that way from the factory”). As for the huge, globular mass distorting the normal position of his lens, it is simply the silicone oil injected into his eye four years ago as part of the retinal reattachment surgery he had in Chicago. It appears as a mass because the silicone oil is now sharing the area inside the eyeball with accumulated tears, and, as we know, oil and water don’t mix.

So, it turns out that sometimes a shadow on a CT scan is just a shadow and not an exposed, nefarious shade. A good lesson and a difficult one to learn outside the painful necessity of experiencing it, the thumping warning signals, the paranoid expectations of the other shoe dropping are not fleeting.  No, but while we’re not out of the woods yet (we still don’t have any plausible explanation for his ongoing pain and behavior changes) we no longer see the forest before us as raw lumber in search of a nail in search of a hammer.

Road Rage

I must admit to a certain bias.  Not to open the age old rift, but I fancy dogs more than cats. While I can accept the anthropomorphic attributes of wisdom, solitude and supremacy that we impose on cats in an effort to embrace them as something other than the self-centered, personality restricted, hangers-on that they truly are, I rather prefer the capricious, attention seeking, connection of a dog. The dog yearns to become part of a family, to participate in activities, offers affection and seeks attention.  Is this any different than me?  And while I anthropomorphize them and admit to attributing human emotion to their actions and reactions, I will not apologize.

I confess that I was fortunate enough to have been raised with dogs, and while their names (Bozo, Booker and Pandora) mean nothing to you, they engender warmth and familiarity on par with that of siblings to me.  Their deaths were no less painful than those of my grandparents, having occurred during the same era of my life. Now, as a father, the addition of our dog Delbow to our family offered no less enchantment.  When we welcomed him into our hearts, he was only eight weeks old and my twins were only nine years old.  Missing only the white picket fence, our future was a pastoral Rockwell painting.

Unfortunately, the past nine years has seen us leave our wonderful home, family and friends in Rhode Island and move to Texas to fight my wife’s aggressive, single-minded (though unfathomably suicidal) breast cancer, forced my children to uproot their lives and face parental mortality sooner than should be required and witnessed the various medical afflictions with which our beloved dog has had to endure (from blindness in one eye due to a retinal detachment, to emergency surgery to save the other, to two tibial plateau leveling osteotomies following two ruptured cranial cruciate ligaments, to surgery and radiation for a cancerous tumor in his neck).  In short, the life we had planned vaporized with the unwelcomed arrival of that insidious cancer and we have done our best to remain a family, drawing strength from each in our times of weakness under some unnecessarily painful and harrowing conditions. My wife fights on, my children pursue their lives and Delbow continues to offer his boundless affection.

It is against this backdrop that I share with you now my vexations at the way in which dogs are treated here in Texas (or at least in the area I travel daily to and from work). Not a week seems to elapse without my seeing the body of a dog lying by the side of the road. My anger comes in waves, my heart breaking.  Unanswerable questions flood my mind.  What home did this dog belong to? What must the family be thinking? Do they know their dog is missing? Do they know he is dead? Are there children in the home, facing the loss of their beloved boon companion? How could they not have secured their dog? Did he escape by accident? Did someone leave the door or gate open and now must endure the timeless misery of guilt?  Why does he lie there, day after day? Does no one care to retrieve him?

Sometimes the dog looks like he simply put his head down on the side of the road and slipped into a peaceful eternal slumber.  Other times, the carnage left by the accident leaves me hoping that pain was inhibited at the moment of impact. Either way, there is no excuse for these creatures to remain in their final repose for weeks on end. Soon bloated and fetid, and eventually transforming into a fur bag holding only bones, accumulating the dust and road grime wafting ever over them each day, they seem to linger there, pleading for exemption, crying in silent strains for finality as I hurry on my way, unable to avoid the scene, unable to look away.  Like some highway of death, this well-traveled road tears anew the gash in my heart every time I see the next victim.  Left there to die, and just left there.  Will I become accustomed to this over time?  Will I no longer see death’s hand by the side of the road?  Will I no longer have all of these questions surge through my mind?  I hope not. To have your heart broken requires a heart to begin with and and while mine tears anew, I defend against the nerve dulling scars and callouses that repetition imparts.  I am grateful for my Delbow and yearn to get home to give back to him that which he freely offers.

In Praise of a Dog

Delbow Ploppers

The soul, that ephemeral wellspring of morality and ledger upon which eternal judgment is based, or so it is believed in Christianity, is, according to the Bible, a wholly human characteristic. “Dominion over the animals is the right of man.” Might we not take this with a grain of salt if we step back and acknowledge that we read this from a text written by, whom else, humans? What else would we write? And it is not limited to Christianity. Islam believes dogs to be unclean, and few Sunni or Shi’a own dogs, but are taught in the Quran to treat dogs well. Hindus believe that dogs guard the gates to both Heaven and Hell, not unlike Cerberus, the three headed dog employed by Hades to guard the underworld in Greek mythology. But do dogs have souls?

Theologians argue that animals have no souls and therefore are not candidates for the eternal paradise of Heaven. However, this is not a universally accepted position. Abraham Lincoln said, “I care not for a man’s religion whose dog and cat are not the better for it.” Not surprisingly, Will Rogers said it more plainly, “If there are no dogs in Heaven, then when I die I want to go where they went.” Lord Byron in his poem Epitaph to a Dog, written in 1808 as a eulogy to his Newfoundland dog Boatswain writes, in part:

But the poor dog, in life the firmest friend,

The first to welcome, foremost to defend,

Whose honest heart is still his master’s own,

Who labors, fights, lives, breathes for him alone,

Unhonored falls, unnoticed all his worth,

Denied in heaven the soul he held on earth –

While man, vain insect! hopes to be forgiven,

And claims himself a sole exclusive heaven

James Thurber said, “If I have any beliefs about immortality, it is that certain dogs I have known will go to heaven, and very, very few persons.”  I would go a step further and suggest that, if Heaven exists and is the paradise promised by the prophets, perhaps man’s care of pets constitutes one of the thresholds for admission.  Perhaps we meet Saint Rocco and our pets at the gates of Heaven, not Saint Peter, our pets providing an incontrovertible assessment of our character.  If this is true, then all dogs do indeed go to Heaven, patiently awaiting our arrival, ball in mouth, ready to play.

“A dog is a man’s best friend.” We have all heard this phrase, but as is the case with so many other colloquialisms, we retrieve it from the card catalog of quips we hold in our heads whenever we deem it appropriate, but few of us know its origin. In fact, the phrase comes from a trial in Warrensburg, Missouri that took place in 1870. George Graham Vest, a lawyer and future senator for the United States (as well as in the Confederate States) represented a man whom had sued his neighbor for shooting his dog, Old Drum. The statutory limitation on damages was limited to $50. In his closing argument, Vest said:

Gentlemen of the jury: The best friend a man has in this world may turn against him and become his enemy. His son or daughter that he has reared with loving care may prove ungrateful. Those who are nearest and dearest to us, those whom we trust with our happiness and our good name, may become traitors to their faith. The money that a man has, he may lose. It flies away from him, perhaps when he needs it the most. A man’s reputation may be sacrificed in a moment of ill-considered action. The people who are prone to fall on their knees to do us honor when success is with us may be the first to throw the stone of malice when failure settles its cloud upon our heads. The one absolutely unselfish friend that a man can have in this selfish world, the one that never deserts him and the one that never proves ungrateful or treacherous is his dog.

Gentlemen of the jury: A man’s dog stands by him in prosperity and in poverty, in health and in sickness. He will sleep on the cold ground, where the wintry winds blow and the snow drives fiercely, if only he may be near his master’s side. He will kiss the hand that has no food to offer, he will lick the wounds and sores that come in encounters with the roughness of the world. He guards the sleep of his pauper master as if he were a prince. When all other friends desert, he remains. When riches take wings and reputation falls to pieces, he is as constant in his love as the sun in its journey through the heavens.

If fortune drives the master forth an outcast in the world, friendless and homeless, the faithful dog asks no higher privilege than that of accompanying him to guard against danger, to fight against his enemies, and when the last scene of all comes, and death takes the master in its embrace and his body is laid away in the cold ground, no matter if all other friends pursue their way, there by his graveside will the noble dog be found, his head between his paws, his eyes sad but open in alert watchfulness, faithful and true even to death.

Not only did Vest win the case, his client was awarded an unheard of $500!  Why is man “blessed” with the promise of eternal salvation, even on his death bed following a lifetime of moral depravity, if he opens his heart to God? Why do we posit an omnipotent overlord capable of superhuman forgiveness of evil, crime and sin while at the same time turning His back on the dog? Is it because humans have the gift of verbal expression and emotion? I would offer as a counterargument that my dog, with his expressive eyes, ears and tail combines these three attributes into more expressions than the English language has words to express emotion. “Man himself cannot express love and humility by external signs, so plainly as does a dog, when with drooping ears, hanging lips, flexuous body, and wagging tail, he meets his beloved master,” wrote Charles Darwin.

Is it because man reasons, where dogs do not? Consider this quote from Stanley Coren, “The greatest fear dogs know is the fear that you will not come back when you go out the door without them.” Or consider this passage from Mark Twain’s Letters from the Earth: Uncensored Writings:

Man is the Reasoning Animal. Such is the claim. I think it is open to dispute. Indeed, my experiments have proven to me that he is the Unreasoning Animal… In truth, man is incurably foolish. Simple things which other animals easily learn, he is incapable of learning. Among my experiments was this. In an hour I taught a cat and a dog to be friends. I put them in a cage. In another hour I taught them to be friends with a rabbit. In the course of two days I was able to add a fox, a goose, a squirrel and some doves. Finally a monkey. They lived together in peace; even affectionately.

Next, in another cage I confined an Irish Catholic from Tipperary, and as soon as he seemed tame I added a Scotch Presbyterian from Aberdeen. Next a Turk from Constantinople; a Greek Christian from Crete; an Armenian; a Methodist from the wilds of Arkansas; a Buddhist from China; a Brahman from Benares. Finally, a Salvation Army Colonel from Wapping. Then I stayed away for two whole days. When I came back to note results, the cage of Higher Animals was all right, but in the other there was but a chaos of gory odds and ends of turbans and fezzes and plaids and bones and flesh–not a specimen left alive. These Reasoning Animals had disagreed on a theological detail and carried the matter to a Higher Court.

I offer these thoughts as I sit in the waiting room craning my neck in hopes of seeing my dog’s surgeon approach. I take umbrage with the term dog “owner.” I do not “own” my dog as much as share a portion of our short lives together. My small dog, the youngest member of what must seem to him like a Brobdingnagian family, is worthy of every consideration I would offer to my children. Having survived cancer in his neck earlier this year and emergency eye surgery three years ago, this is the second surgery he has had on his back legs. He tore the cranial cruciate ligament in his left leg in 2009 and tore the same ligament in the other leg this past week. In spite of this, he, our little bionic dog, never complains and seeks only to love us and have us play with him. Mordecai Siegal summed it up well when he said, “Acquiring a dog may be the only opportunity a human ever has to choose a relative.” My position may differ slightly in that I consider it more likely that our dog chose us. And how fortunate we are to have in our lives this gentle soul.