The Library

“Books are a uniquely portable magic.”  Stephen King

If books are a uniquely portable magic, the same cannot be said for hundreds and hundreds if not thousands of books, but port them we did.  The first thing that my husband and I noticed about the house we ended up buying was the library—a room completely lined from top to bottom with built in bookcases.  I have lived in many places, and set up makeshift bookshelves from salvaged boards and cinder blocks, and later, the do it yourself–put them together to watch them fall apart IKEA models—but I have never had a library.  Say it with an affected British accent if you will—the “lye-brahr-ry”, or feign embarrassment and call it the “TV room”, this library has become the focal point of our home.

I consider myself fortunate—my family has always revered books.  I have two volumes from my mother’s childhood, Mary Poppins and Mary Poppins Comes Back, reprinted in August 1941.  You don’t remember Mary Poppins?  Let me jog your memory of a far more innocent time: “If you want to find Cherry-Tree Lane, all you have to do is ask the Policeman at the crossroads.”  At the end of the second chapter, the children Jane and Michael ask Mary where she’s been on her day off.  She replies, “In Fairyland.”  They are baffled when she tells them that she did not see Cinderella or Robinson Crusoe.  They proclaim that she could not have been in THEIR Fairyland.  Mary Poppins gives a superior sniff and replies, “Don’t you know, that everybody’s got a Fairyland of their own?”

My own Fairyland was created by Walter Farley, and Marguerite Henry and Albert Payson Terhune.  Farley wrote the famous Black Stallion and Island Stallion series of stories about Alec and The Black, an Arabian washed ashore with the young boy who tames him after a shipwreck, and Steve Duncan and Flame, the chestnut stallion he discovers on the mythical Caribbean island of Azul. Henry wrote Misty of Chincoteague, and Stormy, Misty’s Foal, inspiring little girls of my generation to long for their very own ponies.  Terhune wrote Lad, a Dog which I read when I was ten.  Twelve years later, while in medical school, the first puppy I ever bought on my own was a collie.  The dreams and myths inspired by a childhood of reading never really go away.

And so, when my children were young, I bought books upon books, and since I worked during the day, we read them together late into the night, before Harry Potter, which they were old enough to read on their own, and before video games, and computers and Facebook. The kids had their favorites—one was The Ox-Cart Man, describing the rhythmic seasons of life in colonial New England, by Donald Hall who later became poet laureate of the United States.  They also loved Wilfred Gordon McDonald Partridge, about a young boy who helps an elderly lady in a nursing home regain her memory by bringing her objects from the past, and of course The Giving Tree, by Shel Silverstein about selflessness and unconditional love.

When the kids grew up, and graduated to their own taste in reading material, I put away the children’s books—packed them lovingly into boxes and put them out in the shed by the barn.  And there they sat, quiet and safe, until the movers from Allied Van Lines retrieved them and brought them here, to the library.  As I unpacked all the boxes, the memories of childhood—my mother’s, my own, and my children’s came back full force as I indulged myself by opening and rereading nearly all of them, until I came to my own favorite, written and illustrated by Barbara Cooney in 1982, two years before my daughter was born.  It’s called Miss Rumphius, about a little girl named Alice who grows up and travels far and wide, but comes home to a city by the sea, where she plants lupines and becomes known as The Lupine Lady.  As a little old lady, she tells stories of her adventures to her great niece, also named Alice.  Little Alice says, “When I grow up, I too will go to faraway places and come home to live by the sea.”  The Lupine Lady says, “That is all very well little Alice, but there is a third thing you must do.”  “What is that?” asks little Alice.  Her great aunt replies, “You must do something to make the world more beautiful.”  “All right” says little Alice, who then reflects, “But I do not know yet what that can be.”

If books can inspire our children to make the world a more beautiful place, then they are indeed magic. I am so glad I kept all of ours.

It’s Been Awhile

Back in late September, my friends asked me if I was worried about the upcoming move to New Mexico.  I replied, no, it would be a piece of cake compared to my earlier cross country move from Boston to California.  After all, in 1993, I said goodbye to our babysitter of nine years and packed up three kids, a dog and a cat to move to a city where I did not know a single soul.  I will never forget walking into the principal’s office at our new elementary school, filling out the registration forms, and realizing that for the first time ever in my life, I had not a single name to fill in the blank space which said “Who to contact in case of an emergency.”  I was starting from scratch.

As it happens, I had seriously underestimated the effort required to detach from a home I lived in for seventeen years, from my accumulated belongings and from my youngest son and my elderly father, neither of whom desired to join me on my journey.  As sentimental as I am, it was impossible to merely throw things away—old photographs had to be examined and scanned, stuffed animals and dolls needed to be hugged one last time, old movie ticket stubs and playbills needed to reawaken memories before being tossed.  Each time I carried a large green trash bag out of the house, the closets, nooks and crannies seemed to refill themselves.  In the end, I ran out of time, and the movers packed what was left, which amounted to an entire moving van filled with our furniture, and over 300 boxes.  My culling was not very successful.

My biggest concern about the move itself was how my four dogs, especially elderly Magic in congestive heart failure, would handle the displacement, the two day 1,000 mile road trip and climb to 7000 feet in altitude, and the uncertainties of new territory.  As it turned out, the one that I worried about most surprised me with what appeared to be a new lease on life—clearly the cooler crisper mountain air seemed to rejuvenate him.  It was the little guy, Yoda, my tiny rescued Chihuahua-terrier mix that had some unexpected issues.

Yoda was picked up as a stray in Oakland, CA two years ago at Christmas time.  Starving and loaded with tapeworm, he jumped into the arms of a good Samaritan who stopped traffic on Fremont Avenue to pick him up. My veterinarian friend there made a search for an owner, but when none came forth she neutered him, wormed him and sent him down to me.  He quickly adjusted to life with the three jolly grey giants.  Playful and loving, he never met a soul he didn’t like and never caused us a moment of trouble–until the move.

For the first time ever, on arriving in New Mexico, Yoda suffered from severe separation anxiety.  When either my husband or I would leave the house, he would cry piteously and endlessly, despite the fact that the other of us was still there, along with his Scottish deerhound buddies. He was inconsolable. Amidst the doggy distress, fear and consternation, one thing became clear to me—at some point in his short life, he had been left behind.  And he did not want it to happen again.

Yoda has settled down now and he knows that if we leave the house we are coming back.  But his little trauma has left me with a New Year’s wish for us all:   Be brave!  Make a change.  Take a short trip, or a long journey, with your best friends and your family.  Yoda wants what we all want in our own way–to live, love and laugh—and never, ever to be left behind.   Happy New Year everyone!

A Not Quite Requiem for Big Red

Some of us think of the automobile as a means of transportation and nothing more.   Others, like me, see the car as something else entirely—an extension of ourselves, and an expression of identity.  Growing up I was influenced by my dear old Dad—our childhood was marked by a succession of American made muscle cars from the 1966 Ford Thunderbird convertible which met its sad end on the 610 freeway in the rain, to the Pontiac Firebird Formula 400 I drove out to Big Bend National Park, reaching its top speed of 160mph on a lonely stretch of interstate 10 before my new husband cried “Uncle!”  The first car I ever bought myself was a 1975 Chevy Camaro, V8 engine, bright red with white vinyl upholstery.  I was 21, and I was GOING PLACES.  I enjoyed that car for seven years until one too many spin-outs on Route 9 in the snow after I moved to Boston convinced me that it was time for something more practical.  The day I drove my brand new front wheel drive bronze Nissan Stanza out of the lot was the day I knew I had made a big mistake.  I was born for red cars with big engines.  I like people to see me coming.

Sometimes, however, we have to be practical.  By 1991 I had three children and a growing menagerie of pets.  I got my first Chevy Suburban, known then and probably now as the “National Car of Texas” on a company lease, and from then on I was hooked.  That car was indeed “like a rock.”  I drove it until the lease was up and then got another, this time the heavy duty three quarter ton with enough power to tow my house.  The menagerie had grown to include horses by then, and I wanted a car that I could both  live in and drive with three kids, 2 horses and an assortment of dogs.  There was nothing comparable to the trusty Suburban in the automotive world. A bemused trucker watched me struggle into a parking space at a truck stop and actually taught me how to park my behemoth.  By 2001 I realized that the horses were safer with professional drivers and big rigs, and I “traded down” to my current Suburban, affectionately known as “Big Red.”  That was in the spring of 2001, and I was in love—with a big red car.

I’ve had Big Red for nearly 14 years and 230,000 miles.  Shortly after the model year 2001, Chevrolet in its infinite wisdom decided to turn the historic first true sport utility vehicle into a soccer mom-grocery shopping car.  Gone was the bench middle seat, replaced by “captain’s chairs” for easier access to the third row.  Gone were the “barn doors” which opened from the middle out, one at a time, replaced by the hydraulically lifted single back window-door, which may have provided better grocery access, but was entirely impractical for those of us carrying three to four hundred pounds of dog, all wanting to exit the vehicle at the same time. Gone was the middle seat that folded entirely flat, allowing the entry of two 700 size dog crates, the only passenger vehicle to this day which had that much cargo space.  In my distress over the changes to my beloved Suburban, I spent an hour on the phone with a Chevy customer service representative from India, who duly noted my concerns, but had no idea what I was talking about.

Last week I covered a practice in El Centro, about 140 miles east of my home in Rancho Santa Fe.  I felt Big Red shudder and heave going over the Laguna Mountains.  For the first time ever, cars were passing me to the left as I struggled to maintain 55 mph. My good friends at Quality Chevrolet have been patching the air conditioning compressor together for years, but this was something entirely new.  Fearing the worst, I took the car back to the dealer today, with clear “Do Not Resuscitate” orders.  All day I waited, and finally around 4 pm I got a call from service.  Bill said, “Ma’am, I think your engine and transmission are okay.  We found a faulty oxygen sensor. We’ll replace it tomorrow.  You’ll be good to go.”

Good to go to New Mexico?  I sure hope so.  I don’t want a new car.  I love Big Red.  I am loyal and I persevere. The Chevy Suburban no longer comes in red.  My family thinks I’m nuts.

Lighting Out For The Territory

“But I reckon I better light out for the Territory ahead of the rest, because Aunt Sally she’s going to adopt me and sivilize me and I can’t stand it.  I been there before.”

Mark Twain, Huckleberry Finn

 

While I wasn’t looking, someone snuck up behind me and bought my house.  Well, not exactly “bought” yet, but all contingencies are removed and the closing date is set for October 3.  This wasn’t supposed to happen.  My realtor told me that our place is “special”, a euphemism for “old run down house with wonderful horse facilities.” She said it might take a year to sell, and that the right buyer would come along—someone who wasn’t too house proud, but who wanted to “live the dream,” as I did seventeen years ago.  Someone who had always wanted a horse of her own and had waited a very long time to get one—or two or three or maybe even four.  Someone, in short, just like me.  And let’s face it folks—how many people are out there who are just like me?  Apparently quite a few.  The house sold in ten weeks for close to the asking price. And there are back up buyers, who just didn’t get back to see it for a second showing in time.

For seventeen years, I put off having friends and family visit. I had no dinner parties because we were embarrassed.  The house was a mess.  The carpet was old, and pet worn and smelly, the roof leaked, the kitchen was hideous, the “powder room” was a disgrace with orange and brown tiles left over from the 1970’s. But my children, my dogs and my horses were blissfully happy with the place.  It was home. When my friend Catherine passed away in late 2012, she left me a little bit of money, which I used wisely for a new paint job, new carpet and curtains, a stunning garage renovation (after all, it belongs to my dogs!), a bathroom facelift and some nice hardware for the newly painted cabinets in the kitchen.  Friends began to visit.  They said, “We love your place.”  As I walked around the vacuumed soft carpet and outside among the newly trimmed hedges, pruned eucalyptus, reseeded pastures and freshly dragged arena, I said to myself, “They are right.  I love this place.”

But there was sadness here for me as well—the tack room with photos of children long grown and horses long passed lining the walls, the empty bedrooms, and the dogs dearly departing, one by one.  And the cost of maintenance in drought stricken energy gridlocked southern California was a daily reminder of the fact that in March of this year, I retired from my full time job so that I could experience a little more life, and a little less death.  It was a good decision, and one I don’t regret, but a reduction in cost of living was a necessary corollary.  So the house went on the market, and here we are.  I need to find a place to live and I don’t have much time.  My youngest son, and eighty nine year old father are still here in San Diego, but I yearn for the open spaces and big skies of the west.  New Mexico, with its spectacular sunsets and mix of cultures has indeed been the Land of Enchantment for me.

It’s not clear yet, but I may, like Huck, be soon lighting out for the territories.  I hope you will all come and visit.  Wish me good luck!

In Sickness and in Health: Seven Things to Know about Healthcare These Days

My 23 year old son says my blog posts are too long.  He says that his generation believes that if you can’t say what you mean in 350 words or less, you’re not worth reading. At the writer’s conference I attended last spring, I learned that books sell best if there are odd numbers in the titles (never mind the commercial success of “Ten Things I Hate About You”).   It has to be 5 or 7, because 6 and 8 just don’t cut it, and those of us old enough to remember know that Bo Derek is the only 10.  So here is my attempt at listing important things to know about how medicine works these days, in no particular order.

  1.  No news is NOT good news anymore.  The days of doctors calling you with your test results are, for the most part, over.  Do not assume that because you did not get a call, everything is fine.
  2. If we are treating you, please report your side effects so we can help you.  You don’t get brownie points for being a “good patient” by keeping quiet—you just get sicker.
  3. Please do not bring samples of bodily excretions in to the office on toilet paper in plastic bags.  You might make someone sick.  That someone might be the doctor. Brief quantitative and qualitative descriptions work well.
  4. If you need to get your doctor’s attention, one phone call may not be enough even though it should be. Go ahead, be a pain in the ass.  If the person up front gets tired enough of hearing from you, Facebook might be closed out and a message conveyed.
  5. Insurance companies are not your friends.  They will NOT call you back.  If you call and get a phone tree, press “zero” until a human being comes on, and then demand to speak to a supervisor. Your life and  bank account depend on it.
  6. Know the names of your medications and their doses, and if you can’t remember, write them down and put them in your wallet. Please don’t say, “A little yellow pill.”  UNDERSTAND what the pill does. Not knowing can kill you.
  7. Don’t say “I have the flu” when you have a cold or a little upset stomach.  Get your flu shot this fall or you will figure out what the real flu is when you really have it.

I could go on but I won’t.  As they say in obedience training, “Exercise finished!”

And Speaking of Plastic Surgery

I have a new favorite doctor show, “The Knick” on Cinemax, airing on Friday nights.   The show stars Clive Owen as the charismatic cocaine addicted Chief of Surgery Dr. John Thackery at a fictitious New York City hospital called The Kickerbocker at a time when surgery was one foot out of the barbershop.  The tagline is, as they say, priceless– “Modern medicine had to start somewhere.”  On the third episode, last Friday night, Dr. Thackery performs a pedicle skin graft from the upper arm to cover a gaping hole in a woman’s face where her nose used to be, before she got syphilis.   Back in those days, this was a marvelous feat.  Real progress in what we now know as reconstructive surgery didn’t come until the end of World War I, when Sir Harold Gillies, a New Zealand otolaryngologist later known as the “father of plastic surgery,” established the first hospital ward for the facially wounded in Queen Mary’s Hospital in Kent.

For over fifty years, I have been a bystander to the evolution of plastic surgery.  As a teenager I remember the heady early days of microvascular surgery—my father, Dr. Melvin Spira reattaching the scalp of a man whose hair got caught in machinery, then the tales of sewing back severed fingers and ultimately entire limbs with gradually improving functional results.  In the 1970’s the great French surgeon Dr. Paul Tessier, pioneer in techniques for cranio-facial surgery to correct birth defects came to the United States to teach, and I remember a Saturday morning clinic at my father’s office, where mothers whose children’s facial deformities were so severe that these kids had, literally, never seen the light of day waited in line to be seen by the great surgeon who could give them back a normal appearance, and thus a life.

Plastic surgery, like my own specialty of Radiation Oncology, has become one of the “lifestyle” specialties to which medical students aspire, particularly those with an artistic bent and good hands, and for good reason.  Cosmetic procedures are highly reimbursed, and are done during “regular” working hours. Walking around here in San Diego and Los Angeles, surely two of the plastic surgery capitals of the world, it’s easy to spot who has had “a little work” done.  Having one face lift might be a good thing (I wouldn’t know because, as I’ve covered in previous blog pieces, my imagination runs wild with the possibilities of complications and I am far too chicken for elective surgery), but have three and you become one of “Our Ladies of Perpetual Surprise”, eyebrows at the hairline.  Same goes for breasts—it is not normal for the “girls” to be rigidly immobile as their owner pounds away at the Stairmaster.

Last year I mentored a medical student who had started his medical education thinking that he wanted to become a plastic surgeon.  After a beloved aunt developed breast cancer and needed radiation, he started to think that perhaps he would rather become a radiation oncologist because he enjoyed dealing with cancer patients.  He was an outstanding student, and I was quite sure that he would be accepted, and do well in either specialty.  I assured him that with his gifts, and his compassion, he could combine his interest in helping cancer patients with his interest in reconstructive and restorative surgery. Residency interviewers for plastic surgery residencies have a difficult job these days: all of the applicants SAY they want to do reconstructive surgery, but most end up doing cosmetic work.  Apparently my student was convincing when he said he wanted to do plastic surgery to help cancer patients.  He started his plastic surgery residency at Stanford last month.  Dr. John Thackery of “The Knick” may be fictional, but I hope that my student leads the way in new innovations in reconstructive surgery.  My cancer patients may depend on it.

You Can’t Keep A Good Man Down

It’s been awhile since I got my readers up to speed on the adventures of Dad.  For those of you who are new to this blog, my father is a plastic surgeon who retired from full time practice about 15 years ago after a very successful academic career.  He turned 89 years old in July and the last couple of years have not been kind to him:  my mother passed away in January of 2013, and shortly after that Dad had an aortic valve replacement followed eight months later by a hip replacement.  These surgeries were in addition to coronary bypass surgery ten years ago, a splenectomy a few years later necessitated by his penchant for running red lights, and a badly fractured collarbone after taking an expert ski run a little too fast at age 85.  Despite all of this, I was not surprised when he told me a few months ago that he planned to go to Guatemala last week with Surgicorps International, a group that performs plastic and reconstructive surgery in developing countries.  What DID surprise me however was his announcement that he was taking his 84 year old girlfriend Evelyne with him.  He was positively gleeful—he proclaimed over dinner that he was going to teach her to clean instruments and prepare the OR between cases. I did not think this was a good idea, and my opinion was backed up by my sister who has never been a big fan of medicine in general, blood and guts in particular.

A week after the big “reveal”, I took Dad aside and told him that while I had no objections to Evelyne accompanying him on the trip, I thought it was a TERRIBLE idea for him to consider taking her into the operating room.  I said, “Dad, Evelyne was a piano teacher, not a nurse!  And don’t you remember what happened the first time you took ME into your operating room?”  He remembered.  I was seventeen years old, a high school student mildly interested in medicine, at least to the degree that I was volunteering at a local hospital as a candy striper (do they even have those anymore?). He invited me to watch a face lift, being performed under local anesthesia.  I was fine for the first 30 minutes or so—the slice of the scalpel, the smell of the Bovie, the careful undermining of tissue between the skin and the soft tissues of the face.  But when he then peeled back the loose skin to reveal those sinewy muscles below—well, the last thing I remember hearing was—“QUICK!!  Somebody catch her!”  I fainted dead away.  I could only imagine poor Evelyne doing the same, and cracking her head on the instrument cart.  Dad smiled and nodded.  A week later he announced that they had driven to San Marcos so that she could pick out scrubs.

Dad and Evelyne returned home from Guatemala on Saturday night.  On Sunday afternoon, I went over to their senior community to return their cat, whom I had been keeping during their trip.  Well, actually it’s my daughter’s cat, but that’s another story.  I loaded kitty into his carrier, and the litter box, the unused kitty litter, the big bag of food, the two stainless steel bowls, and numerous cat toys into the back of my car.  I called and gave Dad the 15 minute warning:  “Meet me downstairs because there is too much for me to carry.”  He dutifully met me in the parking lot, but there was still too much paraphernalia.  I said, “I’ll just run the cat up to Evelyne’s place.”  So I did.  I knocked on the door, cat in hand.  No answer.  I rang the doorbell.  No answer.  I knocked again, louder.  Still, no answer.  I dropped the cat carrier and ran back downstairs.  I said, fearing the worst, “Dad, when was the last time you SAW Evelyne??”  He said, “Last night—why?”  I said, “She’s not answering the door.”  He said, “Well, I think she’s been on the phone for a long time.  I keep calling her but the line is busy.”  At this point, I am completely unhinged.  I said, “DAD—SOMETHING COULD HAVE HAPPENED TO HER!!!!  WHAT IF SHE IS UNCONCIOUS AND DROPPED THE PHONE??”   At this point, even he is looking a little scared.

I ran back upstairs.  The cat is meowing in his carrier.  I knock, no, I BANG on the door shouting, “Evelyne, it’s me, come to the door!”  I ring the bell again and again.  And finally, I hear stirring and a small voice inside the apartment.  Evelyne appears at the door, a little bewildered that I have made such a fuss.  She says, “I’m sorry.  I didn’t hear the door.  I’ve been on the phone all day, telling EVERYONE about my adventure!”  As I sighed with relief, I said, “Oh, you enjoyed yourself?”  She said, “It was the greatest experience of my whole life.  I even got to see a gall bladder being removed.  And when they cut open the gall bladder, I got to see REAL gallstones!  I had to call everyone I know and tell them ALL about it.”  She looked exhausted, and utterly triumphant.

Needless to say, they are already planning to go with Surgicorps to Viet Nam in October.  At age 89, he has found a soul mate.  And at 84, she has found a new calling in life.  There’s hope for the rest of us, for sure.  We’re planning one heckuva ninetieth birthday party for him in July.  That is, if his schedule permits.

In Pursuit of Perfection

“Upon what instrument are we two spanned, and what musician holds us in his hands?”

Rainer Maria Rilke

This past week was a very busy yet very interesting time for me.  Early in the week, I had a visit from an old medical school classmate who is now one of our nation’s leading researchers in diabetes and other endocrine diseases.  Although most of his time is spent in the lab, he still prides himself on being an outstanding clinician, and I can attest to that.  I would choose him for my own personal physician any day, were he not based at Duke in Durham, NC.  He told me the following story:  a few months ago he was the attending physician on the endocrine consultation service.  The fellow on duty was called for a consult on a middle aged man who needed an amputation for vascular complications related to his diabetes, and the surgeon needed to make sure his blood sugars were under control before taking him for surgery.  The endocrinology fellow assessed the patient’s insulin requirements, and also mentioned that the man was complaining of some mild upper back pain, which seemed insignificant at the time. The case was presented to my friend, was assessed to be routine, and the patient went to surgery.  Shortly after the operation, the man suffered a cardiac arrest due to a myocardial infarction in the posterior circulation.  He did not survive.  My friend, whose job was NOT to assess the patient’s cardiac status, but rather his diabetic control, is still beating himself up about the patient’s death, many months later.  He insists that he should have asked the surgeon for a cardiac work up prior to the surgery.

On Thursday, I flew to Kalispell, MT to attend my nephew’s graduation from Montana Academy, a boarding school dedicated both to academic excellence, and the therapeutic mission of helping teenagers with problems learn to cope in positive ways. At the graduation ceremony, I was moved to tears several times, first by the headmaster’s recounting of the tale of Odysseus and the Cyclops as an analogy for the importance of finding and declaring one’s true identity, and later by the speeches of some of the parents whose children had benefited from this school, set in the green pastures and foothills of Montana. Finally, and even more importantly, some of the students themselves spoke, hesitating at first and stumbling over their words, but gaining strength from the support of the gathered crowd as well as their teachers, counselors and the founders of the school sitting behind them.  The students spoke of the failures which led them to the academy, each small but increasingly significant success they met there, and their hopes and dreams for the future.  These students were articulate and impressively intelligent. The last student who spoke was particularly moving, when she said, “Here I discovered that I am worthy of love, and that I DESERVE to love and be loved in return.”

We all strive for perfection, and yet for most of us it is our failures which teach us the meaning of life and of being human.  Some of us are lucky enough to learn this at eighteen, but many of us are still learning these lessons at sixty.  Last night, as I prepared for bed a row of necklaces I have hanging from pegs in the bathroom caught my eye—fossil mammoth ivory turned blue from arctic hoarfrost, and set with a fire opal, lapis prayer beads from Bhutan, ancient carnelian beads from the mountains of Nepal, and an old Chinese quartz crystal set in silver with enameled symbols of yin and yang.  I wondered, for myself, for my nephew and for my old friend, what talismans are these which can keep us safe, which can protect us from our own demons?  And what great musician holds us in his hands?  We can only continue to do the very best we can.

Do Dogs Know They are Dying?

Labor Day, 2006, is a day I will never forget.  It was a gorgeous day here in San Diego—bright, sunny and nearly 90 degrees.  I decided it was a perfect day to give the dogs an outdoor bath.  At the time, we had Valentine, the matriarch at nearly twelve years old, Izzy who was four, and the two young  ones Magic and Angelina who were two years old.  We started with Valentine—at her age she’d had a little problem with urinary incontinence, and she needed her bath the most.  We knew that the coiled up hose sitting in the sun on that hot afternoon had enough warm water to bathe her in, so my daughter and I mixed shampoo in a bucket of hot water from the kitchen sink, and just outside the garage, we soaped her up.  She seemed to be enjoying herself, a nice soapy massage on a beautiful day, and then a quick rinse.  As I turned to get the towel to dry her, I heard my daughter say loudly and in a panic, “VAL, DON’T FALL DOWN!”  I turned back around and she was gone, down on the wet pavement, eyes blank.  She never felt a thing.   I spent the rest of the afternoon sitting on the driveway with my dead dog, brushing her hair until it dried and the crematorium people came to take her away.  Needless to say, no one else got a bath that day.

I once read an essay by an oncologist who said that she hoped that she would die of cancer.   I was baffled by this, because my personal preference would be to go suddenly, of a heart attack or a massive stroke, preferably while doing something I enjoy.  But her reasoning was quite clear:  she said that with cancer, when you know that your days on earth are numbered, you still have time—time to do the things you always wanted to do, time to say good bye, time to make amends.  This has actually been true for most of my patients—when they know that they are diagnosed with a life threatening illness, their priorities change.  If they have the means, they live the lives they always wanted to live, for as long as they are able.  They remember, they forgive and they forget.  The trivialities of daily life become unimportant, except insofar as they struggle to get through them.   Many become the person they always wanted to be, and I hope that if this is my fate, I have the grace to do the same.

Today we took old Magic to the veterinary cardiologist.  Magic is my eldest deerhound—a big male at 120 pounds, and nearly ten years old.  The last two weeks have been hard for him—we’ve had thunderstorms and he has always been afraid of thunder.  In desperation over his anxiety last week I called his vet for a prescription for a tranquilizer.  It worked temporarily, but on Tuesday we had strangers in the house and he was panting, salivating, and his heart was beating far too rapidly.  I laid a hand on his chest and I knew instantly that his big old heart was failing.  Today the diagnostic echocardiogram confirmed what I already knew—that my big guy has dilated cardiomyopathy, and that he is in congestive heart failure.  We started medication immediately, and I am hoping for a few more weeks, or a few more months with this grand old man who is, as my husband says, “the dog who never did anything wrong.”

Do dogs, like humans, know when they are dying?  I don’t think so.  And in fact, for their sake, I hope not.  Unlike us, they have nothing to apologize for, and perhaps their next meal, or a walk in the park, or in a dream a wild chase after a highland stag, followed by a soft bed and the touch of a human hand is all that they hope for and dream about.  As Magic slowly made his way out of the van today onto solid ground, he was greeted warmly by Queen, Quicksilver and little Yoda.  I can no longer promise him a life beyond his years, but I promised him today that every day from now on will be the best day I can give him—lots of treats, a comfortable place to rest, and with all certainty, no more baths.

Learning to Fly Without Wings

For Morgan

Two days ago, one of my daughter’s best friends from childhood lost her beloved horse Rumba.  This young woman is now a yoga instructor and for the past year she has been traveling and working in Australia.  The strange thing about this story is best said in her own words:

“I never sign up to go on trail rides when I travel because I know I will be disappointed when all we do is walk. But something drew me to this ride, it was for “advanced riders” with promises of cantering. I wanted to go a few days ago but it wasn’t available so I had to settle for yesterday morning. They gave me a horse named Big, I felt that was appropriate since I am used to riding my big mare. We rode for 3 hours through the streams, by the blue lake water and galloped across a field. Towards the end of the ride the horse started prancing back towards home exactly as Rumba would have done on a trail. In that moment I thought I was riding her and maybe I was. Maybe that was the moment she passed away. She was with me and I was with her.

I may not have wanted to buy her but we did anyways. I may not have liked her in the beginning but I rode her anyways. She taught me how to be strong and courageous. It seemed at times we had the same bitchy personality and in the end we knew each other better than anyone else.
I spent this last day with myself. Sometimes crying, meditating and just existing. I treated myself to some spa time, cupcakes and most importantly yoga. I’ve read all the loving comments and messages from near and far. And I am finally starting to feel better. Thank you all for the love and support. It literally means the world to me.”

With these words on Facebook she published several photos of herself riding her old horse.  In one of the photographs, they are mid-jump over a high double oxer– a difficult jump—together as one.  I can only imagine how she must have felt, airborne, in the split second it took the large bay mare to clear that jump.  It must have felt like she was flying.

I think that we all imagine ourselves flying as children. We dream about it and we try to live it.  From the first viewing of Peter Pan, to the teenage pursuits of riding racing bicycles, or motorcycles, or horses, or learning to sail or ski, we all grow our imaginary wings, and for the times that we are doing what we do, we feel pure joy:  we are limitless, unbound by gravity or sadness or sorrow.  We have wings.

For most of us, growing up is learning to fly without wings—to find satisfaction in our friends, our families, our pets, our careers, and our hobbies.  If we are lucky, we find solace in the daily small pleasures that surround us—the scent of a blooming rose, the wag of a tail, the taste of good food or fine wine.  My daughter’s friend is learning this now, traveling alone in a strange land far from the familiar neighborhood she grew up in.  The day after her horse died, she put another picture on Facebook, of a beautiful rainbow arching over the New Zealand road she was driving on.  I’ll never know for sure, but I think it was Rumba, telling her everything is going to be okay.