My Funny Valentine

I was watching Saturday Night Live tonight and Paul McCartney was singing.  For several years I have had to suppress a cringe when he comes on stage and sings live—there is something a little bit unseemly about a 70 year old man who’s had a face lift or two singing “Hey Jude.”  But there he was, singing “My Valentine”, a song most undoubtedly to his lost love Linda.  It goes “What if it rained?  We didn’t care.  She said that someday soon, the sun was gonna shine, and she was right, This love of mine, My Valentine.”  This song is beautiful.  It took me right back thirty years.

In 1980, I read Out of Africa, by Karen Blixen, who used the pen name Isak Dinesen.  The opening line was “I had a farm in Africa at the foot of the Ngong Hills.”  For me, it was the equivalent of “You had me at hello!” I was transported.  Karen Blixen, known affectionately as “Tania”, was a Danish woman who moved to Africa in 1913, married her second cousin Baron Bror von Blixen-Finecke, and started a coffee farm in the British colony of Kenya.  In her book, Dinesen details a story in which her deerhound Dusk plays a major role.  Coming home one night, Dusk stops his mistress with furious barking at a tree.  Thinking that there is a leopard lying in wait, Dinesen takes aim with her rifle. Just as she is about to kill the animal in the tree, she realizes with a start that it is her own house cat.  The cat is safely retrieved, but every evening walk after that is punctuated by Dusk stopping at the same tree, barking and then looking back at Dinesen while baring his teeth in what can only be described as a big deerhound grin. Dinesen commented that if ever there was a dog with a keen sense of humor, it was this deerhound.  I was enchanted.

Over thirty years later, I am still besotted by deerhound humor.  The females are the funniest—they are sly; they are bad girls, and they love to make fun of human beings.  Valentine, aka Ch. Gayleward’s Valentine, was one of the best.  Her particular joke was to lie on her bed, beseeching us, or our guests, to pet her.  Ear rubs were the greatest—she would moan and groan in the most embarrassing and yet self-reinforcing way.  But woe to the person who would pet her, and then stop.  Val’s head would pop up and she would give a hearty deep throated and very frightening bark, while “smiling”, with teeth bared and lips curled back.  To the uninitiated, it was terrifying.  The late, great Vicki Hearne wrote an essay about a deerhound called “A Distinct Impression of Diamonds.”  With Valentine, it was more of a distinct impression of a whoopee cushion.

Valentine passed away peacefully at nearly twelve years old in 2006.  Our current comedienne is Queen, otherwise known as Grand Champion Jaraluv Queen, or sometimes QueeQuee or Quigley.  Quee has  a peculiar way of showing her affection—she pokes her head between your legs, then comes out the other side.  I will never forget the first time I handed her off to a professional handler at a dog show.  She performed like the trooper that she is.  When the handler brought her back to me, Queen surprised us both.  Slipping her lead entirely, she dove between my legs, wheeled around and approached with another nose dive from behind. And then back again, from the front.  And again from the back, then coming up for air and placing her nose across from mine, she laughed and  clearly stated, “Am I not the funniest girl ever?”  We call this “going through.”  She now does it on command.

One day I will go to Kenya.   I will visit Karen, Dinesen’s house which has been preserved for posterity.  And I will thank Tania, forever young and hopeful and beautiful, for the inspiration which led to our own funny Valentine.

Road Tripping

ROAD TRIPPING

Road trippin’ with my two favorite allies
Fully loaded we got snacks and supplies
It’s time to leave this town
It’s time to steal away
Let’s go get lost
Anywhere in the U.S.A.
Let’s go get lost
Let’s go get lost
Blue you sit so pretty
West of the one
Sparkles light with yellow icing
Just a mirror for the sun
Just a mirror for the sun

 

It’s been awhile since I hit the road with my two current favorite allies, the Q’s—Queen and Quicksilver.  Now that I’ve figured out how to solve the carsickness problem which had me out of the driver’s seat, into the back of the van on my hands and knees with my Lysol, paper towels and those green plastic bags, usually within 20 minutes of starting out, I’m eager to go again. Two years of that and all it took was a little bit of Bonine—who knew?  My last big road trip with the girls was to Oregon eighteen months ago, for the Scottish Deerhound National Specialty.  Time was short, and we did not get to take the scenic route up the coast.

I’ve loved cars and driving for as long as I can remember.  Growing up in the flatlands of coastal Texas, having a car was an essential rather than a luxury.  During my early teenage years the driving age in Texas was 14, and I felt stunned and cheated when the legislature changed the legal driving age to 16, four months before my late December fourteenth birthday, and well after most of my classmates had earned their freedom.  My own liberation came soon enough, in the form of a 1963 white Chevy Impala, owned by my late grandfather, who literally only drove it to the corner grocery store and back. When I inherited that big engined beauty, with its turquoise Naugahide upholstery and plastic steering wheel with the little depressions for my fingers, the year was 1969 and the car had 7,000 miles on it.  I was in heaven.

By the time I graduated from medical school my love of the V8 surrounded by lots of “heavy metal” was fixed and for the last twenty years my vehicle of choice has been a Chevy Suburban, three in succession with the last one, Big Red, now 12 years old and about to roll over 200,000 miles.  I am somewhat pathologically attached to that car—I say that it’s because two years after I bought it in 2001, Chevy had the bad idea to turn it into a “soccer mom” car by pulling out the standard second bench seat and replacing it with two “captain’s chairs”, thus effectively removing 18 inches of rear cargo space, just enough to ensure that I could no longer get two 700 size giant breed airline crates in the back.  In the early years I spent hours on hold with Chevy’s customer service reps, likely somewhere in India, waiting to explain what a bad idea those captains seats were, not to mention the hydraulic lift that replaced the rear “barn” doors.  Imagine having 400 pounds of dog trying to exit the vehicle all at the same time.  But the real reason that I am hanging on to Big Red is the memories of many wonderful, and some not so wonderful road trips with kids and dogs.

The one my kids will likely never let me forget is the trip to Palm Springs when they were eleven, eight and five respectively and in a fit of sheer stubbornness (my husband was working in Rhode Island but there was no way THAT was going to stop me), I hauled the three of them along with three deerhounds to the dog show in January.  By the time we had come down the mountain into the valley, all six of them had thrown up. After the unloading at the hotel and the clean-up, we were back in the car where they commenced a fistfight over what kind of food and where we were going to eat for dinner.  I mistakenly turned down a blind alley and in one of the worst “Mommy moments” ever, briefly accelerated towards the adobe brick wall at the end.  Finally, there was silence in the car.

The ones I will always remember are the road trips taken separately with each child.  With my daughter, the ritual was always the same—peanut M and M’s, Cheetos, and Cokes for snacks, and turkey sandwiches with potato salad and dill pickles for dinner on the road.  With my older son, it was my turn for music education—he always made a CD of “his” music so he wouldn’t have to listen to mine. The content never failed to raise eyebrows the next time I would forget to turn off the player while ferrying a colleague around.  I took the longest trips with my youngest boy.  In 2007, when he was sixteen, we drove through southern Utah on our way to Colorado.  As he looked out the window, he exclaimed, “I never realized how beautiful this country was until we went on this trip.  Now I understand why people want to fight for it.”  Definitely worth every penny of the price of gas.

I’ve been feeling the wanderlust again lately—I dream of no agenda, no AAA prerouted trip, no reservations, no timetables, and no deadlines—just the open road, and of course, a couple of my favorite allies.  Want to come?

Dammit Janet

There is cancer.  And then there is CANCER.  The first refers to the ones we discover early, excise completely and move on—a tiny rent in the whole fabric of a life, easily mended or patched but never quite forgotten.  But the second, CANCER in capital letters—these are the ones that can never be discovered early enough, the ones that cause gaping holes in the hulls of unsinkable ships and the whole ocean falls in after the vessel goes under.  This kind kills, and kills so quickly that there are very few survivors left to mount the political assault necessary to raise millions for research and a cure.  These are the cancers that have no armies in pink T shirts walking or running for the Holy Grail.  Highest on my list of evil enemies these days is cancer of the pancreas.

In the early spring of 2011, my friend Janet Porter, President of the Scottish Deerhound Club of America, developed abdominal pain that she initially thought was gallstones or an upset stomach from food poisoning.  Her discomfort progressed rapidly and then, almost overnight she became jaundiced, with a yellow cast to the whites of her eyes, tea colored urine and light colored stools, because the blocked bile duct at the head of the pancreas cannot empty into the duodenum as usual, and the bile backs up into the blood stream and leaches into the skin.  She was diagnosed quickly, worked up well, and pronounced a good candidate for a Whipple procedure, one of the most difficult operations that a skilled surgeon can perform, involving removal of most of the pancreas, gall bladder and common bile duct with considerable rearrangement of the indoor plumbing. Janet was “lucky”.  Most patients diagnosed with cancer of the pancreas are inoperable and incurable from the minute they are diagnosed.  Janet was a smart cheerful optimistic person.  She underwent this difficult surgery, and then took months of chemotherapy and radiation, finishing late in 2011.  In the spring of 2012, she was able to attend the National Scottish Deerhound Specialty show which was held in Michigan. A week later she was told that the cancer had recurred in her liver and despite additional treatment she passed away on August 20.  She was 59 years old—we were born the same year. From the time she was diagnosed she lived every minute to the fullest—she saw her family, took care of her friends, and when it became clear that she was not going to survive she did what every good dog person does—she found homes for her beloved hounds.  I wrote something on the Deerhound List to try to describe her courage, and people liked what I wrote, but all I could think of, quite inappropriately, was title of that old song from The Rocky Horror Picture Show where Brad sings to Janet, in front of a cemetery—“Dammit Janet”.

Today in clinic I saw another patient with pancreatic cancer—this time a lovely woman who is 87 years old.  One of the best surgeons in the country had deemed her operable when she was diagnosed in May, but she hesitated, knowing that complications from such radical surgery could abruptly end her life, or at the least, affect the quality of her remaining days.  She was started on chemotherapy and did well initially, at least well enough to be considered for definitive radiation therapy, which is used when surgery is not desired or possible. Last week, a scan done for treatment planning showed that, like my friend Janet, the cancer had already spread to her liver.  Today I explained to her and five of her visibly distraught middle aged children that there would be no point to pursuing radiation therapy to the pancreas.  I said it would be like closing the barn door after the horse had gone.

Is an 87 year old dying of cancer less sad than a 59 year old?  How do you compare the life well lived for all those years which should have ended quietly, rewarded with a peaceful passing with the life that ended early, devastating friends and family?  Sitting in my exam room with that family today, I certainly could not say.  But tonight I am still thinking, damn it.  Janet.

Hunger Strike

The Q’s will not eat.  My two female deerhound sisters, Queen and Quicksilver, aka Quibbets and Little Grey, are coming four years old in January.  They are both AKC Grand Champions and as such, I have not spayed them yet, thinking that perhaps I will breed a litter, my first since my only prior litter in 1997.  At that time, I discovered that it is much easier to BUY a nice deerhound than it is to raise a passle of poopy giant puppies. In some respects, I am a quick learner.  Anyway, when the Q’s come in season and go out without being bred, a month later they stop eating.  The veterinarians call this a false pregnancy.  I call it a hunger strike. Today I have cooked fresh ground beef, chicken, brown rice, green beans, and have shared some expensive Sargento shredded cheddar cheese. The fruits of my efforts have gone untouched.  Queen is now ensconced on the family room couch.  She is glaring at me.  Later, I will cook bacon and pretend it is for her.

I don’t know why I seem to spend an inordinate amount of time trying to get others to eat.  Although my children were never picky eaters, my youngest went through a period where he would ONLY eat jelly sandwiches for lunch.  Forget the peanut butter, forget protein, forget the healthy apple and the mozzarella string cheese.  It was gooey jelly sandwiches, or NOTHING.  Years later, he said to me, “Do you KNOW how unhealthy that was, what you fed me for lunch?”  I said, in my best Jewish mother voice, “Really?  I was supposed to let you starve?  Over my dead body would you go hungry at school!”  As a girl, I cleaned my plate, always, because of the starving children in Africa.  Still do.  I have a theory that if every time I reached for a bowl of ice cream, a touch screen in my freezer would give me a choice—eat the ice cream myself OR see the calories get deposited DIRECTLY into the mouth of an emaciated child—I and millions of Americans just like me would hit the “kid” button, walk away from the ice cream and make the world a better place.

Now the intended objects of my need to feed are my patients.  I plead with them, I entreat their spouses, I offer prescriptions for Ensure, Boost and Jevity.  In some cases, I recommend feeding tubes.   I tell them that they MUST not lose weight, because unintentional weight loss in many types of cancer can be a very poor prognostic sign.  I tell them to forget their cholesterol and focus on their cancer—eat protein, eat fat, eat sugar (yes, even sugar!), but please just eat.  I tell them that my job is to cure their cancer.  And then I tell them in no uncertain terms, that THEIR job is to EAT.  Even if it doesn’t taste good.  Even if they aren’t hungry.  Even if they used to be fat.  If my lung cancer and bowel cancer and head and neck cancer patients will just eat, their bodies and their spirits will get ahead of that thing that is eating THEM alive. And since most of my patients want to be good, to be cooperative and above all to live, they try.

As for me, age, arthritis and a very busy clinical schedule have not been conducive to keeping off the excess pounds.  My kids will know that indeed I am dying, if I ever miss a meal.  Especially if that meal is paired with a nice glass of wine and has a dessert course which includes chocolate.  But right now, I have to go.  There’s bacon to be cooked!

I am a Dog Person

If it’s true that in this world there are cat people and dog people, I am most definitely a dog person.  I cannot remember a time when I have had fewer than four dogs.  Most of my like-minded friends think that this is normal.  My chosen breed is the Scottish Deerhound.  This is a very old breed, used in Scotland to hunt the red deer even before the advent of firearms.  These powerful hounds were able to keep pace with the fleetest of foot, and are pictured in old etchings going for the neck and throat, or for the hamstrings of the unfortunate deer. It has been said that the deerhound is the “Royal Dog of Scotland”, that no one ranked lower than an earl could own them, and that a “leash” of deerhounds was the price whereby a convicted murderer could buy back his life.  My friend Richard, historian of the breed, says that these stories are likely apocryphal, but they please me nonetheless.  Lately, my husband has taken to calling himself “The Laird”, while three or four of them lounge about his feet as he watches Monday night football on the giant screen tv.  Sir Walter Scott’s monument sits in the heart of Edinburgh, his deerhound Maida at his side, whom he called “the most perfect creature of heaven.”  I couldn’t agree more.

And so it was only natural, that when the veterinary specialty clinic in our area was looking to partner with human radiation oncologists for the purpose of delivering stereotactic radiosurgery to dogs with brain tumors, I was chosen to forge ahead with the alliance.  As part of the bonding process, I was invited to tour the veterinary cancer center with my staff.  The facility was clean, bright and airy, the staff cheerful and obviously skilled, and the linear accelerator used to treat the animals was state of the art. Stationed outside the linac was a white board schedule with the names and treatment times of the dogs under treatment. I was surprised to see that the schedule was full, morning to evening. Both the medical oncologist and the radiation oncologist greeted us, and we discussed ways in which we could collaborate to improve the lives of both dogs and humans affected by cancer.   As we were leaving, a sad eyed basset hound, held tightly in the arms of a vet tech, gave a low whimper as his IV was started for his chemotherapy.  To my amazement, my office manager, who has seen EVERYTHING in the human spectrum of suffering over a 15 year career working in cancer centers, burst into tears and exclaimed, “It’s just so SAD!”.  And she is not a dog person.

What is it that drives human beings to spend thousands of dollars treating their pets for cancer?  People who swear that they would never under ANY circumstances themselves undergo chemotherapy or radiation change their minds abruptly when it comes to their beloved pet.  People who become apoplectic when faced with 20% co-pays on their own insurance will cheerfully re-mortage their homes to give their 11 year old dog a chance of cure.  What is it about the human-animal bond that compels us to never give up, to fight the good fight for our cat with lymphoma?  Especially since that animal cannot tell us that yes, they want that amputation and they want that chemotherapy and radiation.  Scottish deerhounds are particularly susceptible to osteosarcoma, a nearly always fatal bone cancer very common in large to giant breed dogs.  I asked the veterinary oncologist, who has since become a good friend, “Why do people amputate the leg of a giant running hound, and give intense chemotherapy, when on average the dog lives only a year?”  I tried not to sound judgmental but he knew what I meant.  He said, “Miranda, you must stop thinking of the dog as a human being.  The dog doesn’t look in the mirror and say, where did my leg go?  Look at how deformed I am!  The dog says, I am so grateful that the horrible pain is gone.”

I have been very fortunate.  I have never had to make the decision to amputate the leg of a dog who lives to run.  But I have corresponded for years with a British couple, Marc and Bev Doyle, who made that decision for their deerhound Darcy, who lived happily as a “tripod” for four more years before dying of other causes.  Marc and Bev have used Darcy’s example to raise a huge amount of money for osteosarcoma research and have likely benefited countless other Darcys in the process.  Marc is a photographer, and one of my favorite images of his was taken out on the moors, when Darcy ventured out for a walk for the very first time after her amputation.  It is a purposely grainy black and white photograph, taken from behind as the day is waning.  Darcy has become tired on her walk and pauses for a few minutes to lean on her deerhound brother Duffy, who stands very still to support her while she rests.  There is a gentle breeze reflected in the dogs coats. They are both looking ahead to the horizon.  I call this picture “Lean on Me”.   Marc calls it simply, “Hero.”

The odds are that one day, perhaps soon, my luck will run out and I too will face the decision of whether to pursue aggressive cancer care for one of my dogs. When that time comes, I don’t know what I will do.   Do you?