I took care of a lady last night whose gastric band had slipped, causing her tremendous amounts of pain and a surgical emergency. She lived somewhere 2 hours inland from San Diego, and the hometown hospital where she was treated for 18 hours was clueless as to how to manage her. Her husband, a church pastor where she is the pianist, got scared because he saw the medical team treating the symptoms troubling her, but not the source. He had an intuition (divine providence as Glenn Beck would put it) that his wife's problems were grave, and that they were related to the gastric band. The man finally called her surgeon's office, which the hospital treating her refused to do, and the surgeon's on-call covering physician arranged an ambulance transport and emergency surgery after the two-plus-hour ride. I saw her briefly after the surgery was completed before I was off my shift and she looked good. It seems that she will live, and I am glad for her and her family.
I was more concerned, however, with the mechanics of my job than the substance of her unfortunate circumstances while I was managing her care as her nurse. The computer system was down for a scheduled tune-up, which to me is actually kind of fun because generally I am bored to death by the lack of action on the new floor where I am working. My only real engagement comes from the anxiety of being somewhere new and trying not to fuck up. The time passed quickly and the process of keeping this patient safe while having to simultaneously transcribe orders, override medications out of the dispensary machine, navigate new logistics that rely on a vacuum-tube system and carbon copies, get her admitted and then prepped physically and mentally for emergency surgery...it was a trip and oddly enjoyable when compared to my recent weeks of up all night with twitter and solitaire phone aps. (A Type-A sort of person would have used the time more constructively to at least clean the house, but alas, I am more akin to Type-F.)
I came home for the first time in a long time a little bit jazzed-up after work, so when I walked in the door and was greeted by Mae I decided to take her to the beach to play. I glanced out the sliding patio doors to check for sea gales, sharks and/or an oncoming tsunamis that frequently hamper my beaching in San Diego (ahem), and saw Roscoe and his Owner sitting close together at the top of the steps down to the beach. Now as a dog-lover and dog-coveter I knew that this was the sign of something being off. A dog doesn't stop at the top of the stairs to go down to the beach. A
lab, as this dog is, has to be
restrained from going down the stairs to the beach. That is unless the dog knows that the trouble going back up the stairs is too difficult a task. And a middle-aged woman does not sit on the ground with her dog unless she is seizing the moment with this dog as it is apparent that these are some of the last ones. I know this situation well. So I told Mae, "Let's go to the beach."
We approached Roscoe and Owner, and she said to me, "He's not doing well today." Without being prompted she worked herself up to tears telling me that he hadn't pooped in two days and he won't go down to the beach for the first time ever. She said he hadn't wagged his tail, and wouldn't budge from that spot. Almost thinking aloud she looked at me and declared, "I'm going to go get the car and pick him up and take him to the vet." I offered to wait with him and she obliged the offer. She took off up the hill and Roscoe decided that was enough motivation to get his ass in gear, and he started to follow her up a steep pitch. Mae and I coaxed him and told him it was okay to stay, but he wanted to be with his mom, and he started huffing and puffing, swaying almost, to follow her. Luckily Owner was only parked at the top of the street, if this tells you anything about her dedication to Roscoe, and Ros didn't have to go far to meet her again. She then picked up the dog's front and back ends to get him into her jeep. Her parting comment was, "Luckily the vet is a personal friend and I'm just going to go to his house." I wished her well and walked back toward the water.
Roscoe's day may be at hand, this was obvious. I hope it isn't, but I recognized in him a dog that isn't sure it's all worth it any more. I thought how lucky Roscoe is in a sense that someone can end his suffering so readily, and I wondered how Owner was wrestling with her role as his decision-maker. And then I questioned my judgement of the situation. I could be wrong about the prognosis. Roscoe could maybe be propped up with some steroids and antibiotics, just like what just happened in the last two weeks to my grandfather.
My grandfather was sent home from the hospital for his third pneumonia in a year on steroids and antibiotics...and on hospice care. He has end-stage emphysema that has stolen his quality of life for a long time now. Over the course of two or three years, he has shrunk down to a 115-pound 6'0" tall 86-yr-old man who can't hear unless someone is shouting at him, who lives 22 hours of each day in a lazy-boy recliner in front of soap operas and baseball games in closed-captions, who has fallen multiple times and who has developed pressure ulcers on his butt from so little physical activity and such poor nutrition. And now he has lung cancer. But, the decision was finally made: no more. To my utter dismay, this decision has caused terrible strife between my grandfather, my grandmother, and their children. They all love each other, but they all doubt each others motives and sincerity, and no one wants to be the one to wave the white flag. I suggested it two crises ago, but was met with silence. It was finally the physician at the hospital who sat the family down and said, it's time. No more. Even my mom, who I have been talking about the inevitability of my grandfather's situation (in fact the inevitability of all of our situations) for years, had difficulty with discontinuing medical treatment.
Now I realize that I have a unique perspective on death and dying. I've seen what it looks like and I know that the process of it sucks. It's painful and anxiety-provoking. But I also know that once someone dies, they no longer suffer, and they get other bonuses such as not having to work or pay bills or exercise. No matter what happens to their consciousness (in my opinion, nothing) I can say with all certainty that the dead person doesn't give one shit about any of it. They are relieved from the bullshit that this life has engineered for us. They don't have to contemplate going down the stairs to the beach.
And so this lesson repeats itself over and over in nature. In flora and fauna, there is no avoiding death if something has the experience of being alive. This is an undeniable truth of existence, and therefore nature should command our respect. Nature, the natural course of events, should not try so violently to be avoided. I learned this lesson today. I didn't learn it from the piano-playing church pastor's wife who was almost killed in her effort to undo a lifetime of unconsciousness that led to 250 pounds of lard ass. And I can't teach it to a bunch of grown-ups who won't acknowledge the inevitable. Today I was able to experience a universal truth with a dog who loved his Owner and decided that he wasn't going down the steps.
