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Authors: Dr. Nick Trout

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BOOK: Love Is the Best Medicine
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Eileen knew what Dr. J. meant, but the word
investment
sounded wrong, like Eileen was looking for a return on her money. Then again, in a sense, maybe she was.

“I can’t stand this waiting for the surgery,” said Eileen. “They’re telling me the larger it gets the worse the prognosis, so wouldn’t they want to take it out as soon as possible?”

“Who’s Dr. Able trying to get to be Helen’s surgeon?”

“No idea,” said Eileen. “To be honest I’ll take whoever’s available first.”

Dr. J. waited a beat and then said, “What about asking Dr. Trout?”

For Eileen, the name breezed in from the past.

“That was the doctor who operated on Didi’s knee. I thought he only did orthopedics?”

“Don’t know. A lot of surgeons do both orthopedics and soft tissue
surgery. He knows you, you know him, and I’ll bet he remembers Didi. Worth a try?”

Eileen hung up and placed a second call to Dr. Able, giving serious consideration to putting his number into her speed dial. An operator bounced the call into a paging system and after few minutes he picked up.

“I’m not really stalking you, I promise,” said Eileen.

“That’s okay,” said Dr. Able, but without humor. “What’s up?”

Eileen hesitated. The poor guy must get this all day long, pushy clients acting like big insistent moths, hovering, swooping, determined to cross his path. Uneasily, she pressed on.

“I wanted to tell you
why
I decided to go ahead with Helen’s surgery. I know that probably doesn’t make much sense, but I think it might help you convince a certain surgeon to take her on.”

Any reticence she might have detected in Dr. Able’s tone was now replaced with sly curiosity.

“You sound like you have someone in mind,” he said.

Eileen smiled.

“I do.”

P
ASTED
to the door of the radiology reading room is a photograph of a suburban street sign warning “Unnecessary Noise Prohibited,” and like a combative librarian enforcing silence it sets the tone for all who enter. It may be black-and-white pictures and not words, but the reading of X-ray images is best achieved with privacy, mood lighting, and silence.

I sat alone in the physical and emotional gloom created by the three films hanging on the viewing box in front of me. In my hand I held an index card embossed with a patient sticker, a gift from Dr. Able, delivered with more of a romantic story than a clinical synopsis. Baiting a surgeon with a procedure guaranteed to crank up the adrenaline is a perfectly acceptable recruitment ploy, but in this particular case, instantly hooked by his compelling narrative, I felt the allure of something far more important than a surgical challenge. Even before I tracked down the chest X-rays, I had the sense that there was something special about this case, this dog named Helen.

No one wants to hear a surgeon say he or she is daunted by the size of a tumor or the challenge that befalls the clinician willing to take it on, but my sharp and involuntary intake of breath seemed
appropriate. I checked the written radiology report on the X-rays and found an unnerving verification. The report ended:

Diagnostic Impression: Solitary mass left caudal lung lobe. Primary lung tumor suspected. Proximity to the bronchial origin would make successful surgical resection questionable
.

I held on to the last four words of the report, “successful surgical resection questionable,” and stared into the tumor, replaying Dr. Able’s impartial, abbreviated account of a nomadic dog. I found the name Helen unusual and endearing (far preferable, in my opinion, to the easy Lucky or Chance) for a stray dog who had been welcomed into a family prepared to foot enormous medical expenses to give this virtual canine stranger a chance of experiencing something as ephemeral as a walk on a beach. I remembered this owner, Eileen, having performed surgery on her other dog, a huge Newfoundland called Didi, cursed with bad knees. Eileen had been wonderful to work with but our interaction had been brief. I had failed to appreciate how her love of animals went far beyond the role of attentive and responsible pet owner. How many of us would rescue a geriatric dog and welcome her so quickly and so deeply into our hearts that we would do whatever it took to give her a glimpse of canine bliss? It doesn’t necessitate a remarkable dog. It necessitates a remarkable person to see a remarkable dog.

Despite the fact that Helen’s problem lay at the limits of my and any other surgeon’s capabilities, everything about this case, this hapless drifter of a dog, began to fall into place for me. I thought about Cleo, loving the fact that these two dogs could not have been more different. Helen was a sporting breed, Cleo a toy. Helen was in her dotage; Cleo had been little more than a pup. Helen would be cursed with the weighty, odiferous ears of her lineage, Cleo blessed with the attentive, pricked ears of hers. Based on the X-rays and the depth of back fat overlying her spine, Helen obviously liked to eat,
whereas Cleo had been a lean and muscular machine. As far as I was concerned there was absolutely no overlap between the two of them, but I found myself becoming convinced that Helen might be exactly the kind of underdog that, according to Sandi, Cleo would have been rooting for. This dog had found her way to me. This wasn’t a random pickup through emergency. I didn’t happen upon Helen’s story after the fact. I didn’t seek her out because I was keeping track of heart-wrenching cases in need of surgery. There was nothing contrived about our encounter.
Helen
collided with
me
, for whatever reason, and all I can tell you is that as soon as she did, it became apparent that this was how I would fulfill my promise to Sandi Rasmussen.

L
ULLED
by the peaceful darkness of the reading room I thought about what Sandi had said.

Take Cleo’s spirit on a journey … realize all the wonderful qualities she embodied … pour all the skill, effort, and talent you had intended for Cleo into the lives and health of other unfortunate animals
.

This promise, hastily but sincerely made in a flitting moment of supreme emotional susceptibility, suggested that I somehow knew how to take the spirit of a deceased dog on a sterile expedition into an operating room. Of course, I didn’t. This scenario didn’t come with a set of instructions as to how to proceed. To make this happen my scientific rigor would have to embrace intuition. To my way of thinking, Sandi wanted me to think of Cleo as a clinical touchstone, there if I, or some other animal, needed her. And it was clear if any dog did, it was Helen. I was facing a very tricky surgery trying to rid Helen of a cancer that had snuggled up to her heart, a location many of us consider to be the emotional and physical core of our being. Everything about this scenario required that I make an enormous leap of faith. So why not jump? These animals seemed like
kindred souls. If anyone could guide me on this endeavor it would be Cleo.

Many clinicians (far wiser clinicians than I) might prefer to ignore, refute, or circumvent the concept of an animal possessing a soul. For the most part I had fallen into the latter category, but for my promise to be more than convenient lip service, I forced myself to dig deep, to consider some tough questions, to wander down ignored, forgotten, or neglected pathways and try to justify why this commitment seemed reasonable.

Much to my parents’ chagrin, as a pimply teenage boy I rejected Church of England Sunday school and its ecclesiastical arguments for life after death, and that left the scientist in me succumbing to the sway of cynicism. Okay, so the law of thermodynamics, the one claiming energy can change from one state to another although the total amount of energy remains the same, gave me pause, but I found it a stretch to believe that some nineteenth-century German physicist had actually intended to engineer a scientific proof of a metaphysical afterlife. In fact, I would go so far as to say it wasn’t until I became a father, with children of my own, that I came to realize there was so much more to life than could be grasped by mere mortals.

When my youngest daughter, Emily, was three years old she claimed to see dead people. One day we were in the car and she was strapped into her car seat, watching the road, singing along to another stirring riff by a purple dinosaur, when we were overtaken by an eighteen-wheeler and from nowhere she announced, “I remember when one of those took my skin off.”

I glanced in the rearview mirror looking for Bruce Willis, waiting for the green vomit and a Linda Blair cranium spin, but Emily sat there smiling back at Daddy, totally unfazed.

“What do you mean?” I asked.

“My doll was in the road,” she said. “I ran out to get it and it hit me.”

This sixth sense reappeared some days later when I was tucking her into bed. Instead of sleeping in the middle of her twin bed, she made a point of setting up her pillows, stuffed toys, and blanket off to one side.

“Aren’t you worried about falling out of bed?” I asked.

Again, with a weary look that she would later perfect as a teenager, she said, “This is where Grandma Ann sleeps.”

I’m certain the hairs on the back of my neck plumped up like gooseflesh.

“But you’ve never met Grandma Ann,” I said.

My wife’s mother died four years before my youngest daughter was born.

“Yes I have,” she said. “We met in heaven.”

Coming from an older child, I might have blamed this on a vivid imagination, attention seeking, inappropriate channel surfing on the TV, or the rehearsed lines of a practical joke. But Emily was so young and she seemed so innocent, so sincere.

Only when a dog trainer came to the house to teach our Jack Russell terrier, Sophie, some tricks (or was it the other way round?) did we have an explanation (of sorts) for this unsettling phenomenon. I remember the guy clearly—late forties, transparent skin, baby-bird features, wispy hair of the postchemotherapy patient. Despite his frailty he was upbeat about his remission from leukemia. He worked with Sophie for about an hour, happy to have my daughter join him in the session. As he was leaving he told me he was a practicing Buddhist, but as I braced for the literature and awkward invitation to join him and his friends for coffee, he said, “Emily’s a messenger. You need to listen to her.”

Sadly, my understanding of Buddhism was restricted to shaved heads, orange monk suits, a reluctance to kill creepy crawlies, and the concept of reincarnation. I asked for clarification.

“Sometimes children get caught between two lives. They can remember their past. They may or may not be able to verbalize what
they remember but for most of them that do, this window into their past closes by the time they are about four years old.”

We never saw the cancer-survivor dog trainer again. I don’t remember why exactly, because all of us liked him very much. Perhaps it was Sophie’s fault for being too smart, too easy to train. Not that it mattered. What he said was absolutely true. Well, at least the closing window part. From time to time Emily would regale us with snippets of information that seemed as disturbing as they were impossible to contrive, and shortly after she blew out four candles on a birthday cake, her echoes from a past life faded away and were gone, forever.

I know what you’re thinking—not exactly proof of a great hereafter—but please, bear with me. Leaning back in a comfy chair, hypnotized by Helen’s X-rays, I realized this trip down memory lane was not a quest for definitive answers. I was just hoping to unearth some kind of vindication for my pact with Sandi. And again, I found a connection through my daughter.

Although Emily entered our world as a beautiful blue-eyed blond, her outward perfection was belied by her DNA. In an unwitting roll of the hereditary dice, my wife and I had beaten the one-in-four odds of a crafty Austrian monk by the name of Mendel, and passed on a defective pair of recessive genes. Our invisible, enduring gift to our daughter would be the number-one genetic killer of children and young adults, a disease called cystic fibrosis, or CF.

I won’t go into the details of bringing up a child with a chronic disease for which there is no cure, apart from saying that such an experience has a funny way of changing your outlook on both life and death. As I stated earlier, in my opinion none of us are spared suffering of some description. Perhaps suffering is simply part of the plan. We might flail and thrash, cry out for help, make a lot of noise and smother anyone who comes to our rescue, but ultimately our choice to survive our personal form of suffering must come from within. Briefly, during my own battle, I considered quitting
veterinary medicine. How could I justify working on pets when my own child needed me to find a cure? I should go back to school, become an MD, a researcher, and make a real difference in her life. Though the chaos and fear never subsides entirely, eventually I had a breakthrough. They call it
acceptance
, and with it came an appreciation of how lucky I was, how blessed simply to have this child in my life.

There’s something to be said for the certainty of death and our absolute incapacity to control when our number will come up. Despite the prospect of a bony grim reaper finger tap-tapping on your shoulder at any time, it seems as though we only appreciate the dogma of living every day as though it were our last when our doctor drops his eyes and shakes his head. It doesn’t have to be this way. For me, it took a sick child to make me recognize the fragility of life and the need to enjoy the moment and to live in it, until the desire to squeeze all the joy out of it becomes overwhelming and, with a lot of effort, even possible. I believe Sandi Rasmussen found this kind of joy in Cleo. Of course it’s simply not possible or healthy to live every day as though it were your last. We’d go out of our minds, permanently tortured in some sort of hellish wonderland at the bottom of a rabbit hole, striving toward a goal guaranteed for failure. But Sandi found a compromise, able to relish and bask in every wonderful memory of her little dog, and in doing so, even given the relatively short amount of time they had together, she realized how lucky she was. Somehow Cleo cast her spell and also managed to squeeze in a little wisdom and a whole lot of loyalty. Regardless of when or how we lose them, our pets are with us for such a short period of time. Through my daughter, I came to find a renewed empathy for my clients, the “pet parents” whose fear of losing a loved one is no less heartfelt than mine. Sometimes I think this lesson helps me connect with people in ways that would have been unattainable before Emily.

BOOK: Love Is the Best Medicine
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