On Friday June 25th, Violet the Wonderdog, my almost constant companion for more than 14 years, died peacefully in my arms following euthanasia. And although the temptation looms large to go on and on about her in an effort to vanquish the pain of loss more quickly, it seems more in keeping with who and what she was to share less weepy thoughts that occurred following her death. More specifically, those thoughts elicited by two quite different sources: the Summer 2004 edition of Dartmouth Medicinenewsletter and The Old American, a novel by Ernest Hebert (Hardscrabble Press).
Like many owners of aging well-loved pets, during my last month with Violet all the questions associated with euthanasia would creep into my thoughts no matter how hard I tried to banish them. In spite of the fact that I intellectually knew that the nature of the bond we shared guaranteed that, when the time came to let her go, I would know it and respond in the right way (not too early, not too late), I could never get rid of that last, nagging tinge of doubt no matter how hard I tried. That Friday morning when it was so obvious that the time had come based on the unspoken pact that she and I had made years ago, I nonetheless reverted to my scientific training. She’d eaten some that morning and that was good, even though I had to hand-feed her for the first time in her life and it seemed like she did it more for me than because she was hungry. Sure, she lost control of her bladder and was getting progressively weaker in the rear end, but a lot of things could cause that. Ditto for her increasingly frequent bouts of labored breathing. As I sat there, I clinically rattled off a list of all the tests I’d ask the veterinarians at the clinic to run when I took her in.
And then I looked at her as someone she trusted rather than as a fearful owner or science-blinded clinician. In that instant, I knew that this was not what I was going to ask them to do. This could be total projection on my part, but it seemed to me that I saw Vi heave a sigh of relief when I acknowledged this. For the first time in her life, rather than waiting for me to invite her to go somewhere with me, she went and laid quietly by the door. For the first time in her life, she told me it was time to go.
The article in Dartmouth Medicine was entitled “Striking variations revealed in end-of-life care at ‘best hospitals.'” By studying the records of the 77 hospitals listed in U.S. News and Business Report’s 2001 ‘America’s Best Hospitals’ issue, a team of researchers headed by Dr John Wennberg discovered “huge differences” in the care those with chronic illnesses received during the last six months of life. In spite of the fact that all of the hospitals studied were academic medical centers with excellent reputations for state-of-the-art care for geriatric patients as well as those suffering from heart and lung diseases and cancer, how individual patients were treated varied widely.
Aside from the fact that this study indicated that these bastions of medical science had no science-based standard when it came to end-of-life care, it corroborated the findings of previous studies which revealed that what services human patients received for how long was more a function of the number of physicians and beds available than the patients’ preferences or needs.
As I read this, I thought about Violet’s death and the rural Vermont veterinary clinic in which it occurred. The idea that her care and the manner and timing of her death would be determined by the number of empty cages or practitioners was ludicrous. Her death, like her life, reminded me once again of why I chose to be a veterinarian rather than a physician. Veterinary medicine is much more humane, I think. And although I know that some veterinarians aspire to be like the “real doctors,” I pray that their desire will never go so far that they deny well-bonded owners the right and privilege to let their suffering animals die quickly, quietly, and with peace and dignity, rather than slowly and possibly painfully fade away, separated from their loved ones just to fill a cage.
In The Old American, author Ernie Hebert’s main character, Caucus-Meteor, a native Connissadawaga American, says that the period of mourning following the death of a loved one is a function of any guilt and regret one had about the relationship with that other when he/she was alive. The more guilt and regrets, the longer the period of mourning, and the greater the reluctance to engage in another relationship.
People ask me, “Are you going to get another dog?”
Oh, yeah.
Definitely.
If you have any comments regarding subject matter, favorite links, or anything you’d like to see discussed on or added to this site, please let me know at mm@mmilani.com.
On Friday June 25th, Violet the Wonderdog, my almost constant companion for more than 14 years, died peacefully in my arms following euthanasia. And although the temptation looms large to go on and on about her in an effort to vanquish the pain of loss more quickly, it seems more in keeping with who and what she was to share less weepy thoughts that occurred following her death. More specifically, those thoughts elicited by two quite different sources: the Summer 2004 edition of Dartmouth Medicinenewsletter and The Old American, a novel by Ernest Hebert (Hardscrabble Press).
Like many owners of aging well-loved pets, during my last month with Violet all the questions associated with euthanasia would creep into my thoughts no matter how hard I tried to banish them. In spite of the fact that I intellectually knew that the nature of the bond we shared guaranteed that, when the time came to let her go, I would know it and respond in the right way (not too early, not too late), I could never get rid of that last, nagging tinge of doubt no matter how hard I tried. That Friday morning when it was so obvious that the time had come based on the unspoken pact that she and I had made years ago, I nonetheless reverted to my scientific training. She’d eaten some that morning and that was good, even though I had to hand-feed her for the first time in her life and it seemed like she did it more for me than because she was hungry. Sure, she lost control of her bladder and was getting progressively weaker in the rear end, but a lot of things could cause that. Ditto for her increasingly frequent bouts of labored breathing. As I sat there, I clinically rattled off a list of all the tests I’d ask the veterinarians at the clinic to run when I took her in.
And then I looked at her as someone she trusted rather than as a fearful owner or science-blinded clinician. In that instant, I knew that this was not what I was going to ask them to do. This could be total projection on my part, but it seemed to me that I saw Vi heave a sigh of relief when I acknowledged this. For the first time in her life, rather than waiting for me to invite her to go somewhere with me, she went and laid quietly by the door. For the first time in her life, she told me it was time to go.
The article in Dartmouth Medicine was entitled “Striking variations revealed in end-of-life care at ‘best hospitals.'” By studying the records of the 77 hospitals listed in U.S. News and Business Report’s 2001 ‘America’s Best Hospitals’ issue, a team of researchers headed by Dr John Wennberg discovered “huge differences” in the care those with chronic illnesses received during the last six months of life. In spite of the fact that all of the hospitals studied were academic medical centers with excellent reputations for state-of-the-art care for geriatric patients as well as those suffering from heart and lung diseases and cancer, how individual patients were treated varied widely.
Aside from the fact that this study indicated that these bastions of medical science had no science-based standard when it came to end-of-life care, it corroborated the findings of previous studies which revealed that what services human patients received for how long was more a function of the number of physicians and beds available than the patients’ preferences or needs.
As I read this, I thought about Violet’s death and the rural Vermont veterinary clinic in which it occurred. The idea that her care and the manner and timing of her death would be determined by the number of empty cages or practitioners was ludicrous. Her death, like her life, reminded me once again of why I chose to be a veterinarian rather than a physician. Veterinary medicine is much more humane, I think. And although I know that some veterinarians aspire to be like the “real doctors,” I pray that their desire will never go so far that they deny well-bonded owners the right and privilege to let their suffering animals die quickly, quietly, and with peace and dignity, rather than slowly and possibly painfully fade away, separated from their loved ones just to fill a cage.
In The Old American, author Ernie Hebert’s main character, Caucus-Meteor, a native Connissadawaga American, says that the period of mourning following the death of a loved one is a function of any guilt and regret one had about the relationship with that other when he/she was alive. The more guilt and regrets, the longer the period of mourning, and the greater the reluctance to engage in another relationship.
People ask me, “Are you going to get another dog?”
Oh, yeah.
Definitely.
If you have any comments regarding subject matter, favorite links, or anything you’d like to see discussed on or added to this site, please let me know at mm@mmilani.com.