I was at Cobs’ Bread this past Friday watching a middle-aged guy berate the pimply kid behind the counter. It wasn’t because the guy had discovered hair in his bread, or because he’d had a $20 stolen from his wallet, or anything else — it was because the particular Cobs in which we were standing didn’t make the olive Pane Di Casa bread on Fridays. The guy was going on a righteous rant about how screwed up Cobs was — because, you know, these kids definitely have the power to set the baking schedule, and the guy clearly knows more than they do about what sells and what doesn’t — and I wasn’t going to say anything until the guy roped the other pimply kid, the kid who’d been helping me, into his rage fest. This kid was clearly overwhelmed, and so being the person I am, I offered to the middle-aged guy that maybe he’d like to try another Cobs, since they all have different baking schedules.
“No!” he more or less screamed. “I’m not running around all over town to fix their mistake!” Fair enough. The kid meekly offered a suggestion that perhaps he try a different kind of bread; the guy indignantly told him he couldn’t eat white bread, and huffed out of the shop after complaining that Cobs had ruined his dinner (it was 10 in the morning — I’m pretty sure I could have made bread in time to get it out with dinner). I left with my garlic and herb loaf, thinking warm thoughts about what I could do with its chewy texture and appealing taste (thought number one: take the freshest tomatoes from the back yard, mix with brunoised red onion and garlic, coat with good olive oil, and toast — yum). Ordinarily I’d get kind of worked up about this sort of guy, and maybe I am, but I just couldn’t see the value in getting mad about him. He was, after all, getting mad about something entirely inconsequential.
This past week has been a lesson in perspective. The main floor of my house has been turned into what is effectively a hospital room. The patient is Goblin, my 13.7 year-old English Shepherd, and Thursday night I brought him home from the hospital — for better or worse.
Goblin was my wife’s dog before he was my dog (and before she was my wife, for that matter). He’s the first dog I’ve had that I could really call my own — I’ve had other dogs before, but they’ve been other people’s dogs first, and mine only as a second or third choice. With Goblin, though, he was my buddy almost from the day we met, and even K. says that he’s my dog more than hers. Goblin wasn’t even her dog to begin with; he was a rescue, a very loved rescue, who grew up in Canmore and whose human parent sadly developed a brain tumor, and couldn’t look after him anymore. So he came west, to the coast, and spent six months with K. before I came along, and from that point forward he was happy. I’ve been very happy, too: I’m quite certain that, at the end of my life, I’m going to look back and think that Goblin was the best dog I’ve ever had, by a huge margin.
English Shepherds are a rare breed. Most people don’t know what they are. They’re sort of like Border Collies, but they’re bigger, and dumber, and less psychotic, and if Goblin is all of these things — and he is — he’s also the most rule-following dog I’ve ever known. His yard is protected by an accordion bamboo fence, so we can get the cars in and out, and occasionally it doesn’t anchor properly and falls over. Most dogs would take advantage of this situation to effect an escape, but not him. I find him sitting quietly in the yard, looking at the gate, knowing he’s not supposed to go across. The one time he did make an escape attempt, I found him down the block (not across the street), playing with a neighbor’s five year-old. It was a heartwarming scene.
I was in Vancouver last week on a training course, and Goblin had spent the weekend at my mother-in-law’s. When he came home, when I came home, he was lethargic and quiet, and I had attributed it to his playing with the (real) Border Collie and the small Horrible Little Dog (which is really a Brussels Griffon) over there. He’d had a bit of diarrhea on Sunday night, which happens when he gets unfamiliar food or different treats, but I wasn’t worried. Monday morning he wasn’t very interested in his breakfast — unusual for a dog who once tried to bite my boot because I got too close to his meal bowl (it’s his one fault). We made a bed for him in our foyer, a tiled space that would be easy to clean up, and went to work.
I snuck home mid-afternoon, arriving to discover that a multicolored shit and puke bomb had detonated in my front hallway. I also found a very tired, very sad looking dog trying gamely to be brave. I took the rest of the day off and drove him over to the animal hospital, where the vet on duty diagnosed him with a gastroenteritis, made a couple of diet suggestions, and sent us home with some metronidazole to try and settle his gut down.
Goblin came home and immediately set about flopping all over the yard. He’d get up, walk five feet to a new place, and then lie down. Three minutes later, he’d repeat the whole process over again. I saw him vomit a couple of times, and he had an awful, multi-stage diarrheal attack across half the yard. I couldn’t get him to eat, I couldn’t get him to drink, and I couldn’t get him to be interested in much of anything at all. K. finally came home, much to my relief; we gave him a bath, and then put him on the couch, whereupon he prompted vomited up a huge quantity of frank blood.
So we went back to the hospital. He was limp in my arms; a dog, who hated more than almost anything to be picked up, allowed me to throw him over my shoulder to get him back into the car. Goblin’s blood pressure on arrival, previously ok, was now unmeasurable. I’m very sure that, had we not gone back, Goblin would have died that night. The (different) vet admitted him to the ICU, put him on oxygen, started resuscitation. It was a horrible night; I barely slept. I was back at the hospital early the next morning, and he came out to meet me, but was weak and not terribly interested. The diarrhea and vomiting continued throughout the day: they pumped fluid and drugs into him, I ran errands and fixed plumbing and tried to buy new carpet, and mostly tried not to think about what was happening. I worried constantly about his kidneys — they don’t do well in hypoperfused states in the elderly.
I worked a horrible, horrible night shift. It was quiet and uneventful, but I found myself sneaking off into a small room, away from my colleagues, to have a good hard cry several times that night. Mercifully I saw very few patients. Wednesday brought a morning full of appointments, including one specialist that ran an hour and forty minutes late. (Note to specialists: don’t do this, ok?) By the time I got to bed, it was quarter to one in the afternoon, and I’d been up since seven the morning before. I got three hours before going back over to the hospital and then back in for another night, which was also awful. K. and I had a series of tearful conversations about what we wanted to do — about futility, about the need to keep up hope, about the need to be realistic… these are hard for everyone, and even though we both have language and an ability to talk about these things, they’re still difficult to think about; objectivity is tough.
The bill was also another consideration. It’s different for humans here: we’ll throw everything as long as there’s a reasonable hope of recovery, and not worry about the price. With Goblin I was acutely aware, every time I saw him on an infusion pump ($26/day), every time I saw him getting another 60 ml of Pentaspan ($340 total), every time they tested his urine specific gravity ($14 — for a dipstick test!), even every time I saw his IV catheter poking out ($160), I saw more money flying out of my wallet. It made me think about that scene from the Simpsons where Homer is being his boneheaded self: “We’ve never had a problem with a family member we could give away before.”
I realized that what I was buying, beyond veterinary care, was freedom from guilt: the last thing I wanted to feel was that I hadn’t done enough, that I’d given up too soon on a patient who was salvageable. Quitting too soon is just as bad as quitting too late, and I didn’t want that kind of guilt on my conscience. By late Wednesday evening, K. and I had more or less decided that we’d give him another 24 hours in hospital, and then we were going to take him home. One way or the other, I wanted him home. I told the veterinary techs of my plan, and they said they’d get him ready for discharge on Thursday night.
If Goblin was going to die, I reasoned, I wanted it to be at home, with me. I wanted him to be able to lie in his yard, with the sun on his face, one last time, and to be with him while it happened. A proud, strangely sensitive dog, I could see what I thought was sadness on his face: sadness at being left alone, sadness at being trapped in a pen on the floor of a room where the lights never went out, sadness at not feeling well. I’d had enough of going to the hospital, and had enough of watching him suffer: he was going to come home with me, and he was either going to get better or not.
So K. and I set about organizing the ground floor: making sure he had straight access to the outside, creating a soft, padded den for him between some cupboards, giving him a way to get into his kennel. We got waterproof blankets and IV fluids, line sets and catheters and syringes. It looked like an ICU. Functionally it was an ICU. We brought him home Thursday night — he walked out of the hospital under his own power, was lifted into the car, and laid down for the ride home. Once home, he walked around his yard, sniffing the bushes as if to say, “Yes, this is my house.” He hadn’t eaten all day at the hospital, but ate readily with only mild encouragement for K. and I.
I slept downstairs on the couch, waking up every three hours to infuse saline and let him outside. His kidneys apparently started to work again, because he needed those breaks. By the morning, he was brighter, perkier, and interested in breakfast (which he ate at high speed). It’s all been uphill from there: he’s been getting stronger, more interactive, more interested in his food. He has spent the past couple of years, and particularly this past summer, trying to convince my wife and I that he’s really an outside dog (much happier outside than in) — when the sun came out on Sunday, he spent most of the day outside, lying in the sunshine. He looked happy, and I’d like to think he was.
I don’t for a moment think we made a mistake in bringing him home when we did. In the words of the immortal Dr. McCoy, “It’s worked so far, but we’re not out yet” — he’s still on oral medications, and I’m still watching his fluid consumption like a hawk. But we took the IV out on Saturday, made a big fuss of him losing his plastic tail, and during the cuddling he came over and licked my face, wagging his tail. It was a $3k kiss, and made the entire week worth it.
It’s impossible to say how much longer he and I have together: maybe months, maybe another year. Maybe not. He’s getting stronger every day, but he still tires easily. Between the blood loss and his sleep debt — I don’t think he slept at all while he was in the hospital — I don’t blame him. He may yet not make it out of this episode. But I now know, in my heart of hearts, that I’ve done everything I can for him, and that he’s now comfortable, happy, and content. He’s not scared, and he knows we didn’t leave him in a cold, fluorescent-lit room.
He’s home. And that’s where he’s going to stay. One way or the other.