"It's as if a great bird lives inside the stone of our days and since no sculptor can free it, it has to wait for the elements to wear us down, till it is free to fly." Mark Nepo

Monday, May 18, 2020

Toby's Last Morning

When I got up Saturday morning, Toby was lying against the wall in the dining room, as I’ve often found him these last weeks. Neither of us had gotten much sleep the night before as he moved around trying to get comfortable and as his breathing sounds shifted. He opened his eyes to look at me, but there was no flop of his tail or lift of his head. I bent down to pet him and to clean up the leakage that had accumulated under his muzzle. Compassionate Care was scheduled to arrive sometime between 8 and 10, although we’d been told it would be closer to 8. I went about my morning routine, feeding the cats, emptying the dishwasher, sitting with my coffee and the NY Times puzzles, pushing away doubts. Toby didn’t move any of the many times I stopped to talk to him and pet him.

For days I had been agonizing whether it was finally time to release Toby from the last several months of struggle with cancer. He was still eating and drinking, and peeing and pooping. He ate regularly, sometimes with remnants of his usual enthusiasm. Granted we were feeding him by hand, and just days before had to resort to hiding his twice-daily pill in cheese to get him to take it. But he loved his chicken and his dog cookies and seemed thrilled with the addition of cheese to his diet. 

Just a week earlier he came out to the front yard while I worked in my flowerbed. At one point he plopped himself down in the middle of the flowers and I didn’t have the heart to make him move. A neighbor came up our driveway to chat, and Toby leapt up and ran barking at him, tail wagging the whole way. The run was wonky and the barking was hoarse, but the greeting was clear. 

A day or two after that Toby’s face swelled up to the point he couldn’t see out of one eye. His breathing grew more labored and much louder. He was restless at night, and had a hard time getting comfortable. He had had spells previously, but seemed always to recover after a couple of days. So three days became my standard. If he didn’t get better after three days, I would consider that it might be time. 

He didn’t get better, although the swelling went down after it burst open under his eye. His breathing was liquid and glurpy and he was lethargic. He’d eat, but the inside of his mouth bled after every meal. He’d get up only if I nudged him. Walt and Toby had been going for evening strolls around the yard, and now he got outside the gate and stopped, wanting to go back before they’d even got to the front yard. 

I couldn’t remember the last uninterrupted night’s sleep I’d had, and my daytime hours were now spent managing the leakage from his face, getting him to eat, and trying to get him moving. Somewhere in my determination to not end his life too soon, I’d forgotten that joy was one of the criteria for whether to continue on. And none of us were feeling joy in Toby’s life any more, most especially Toby. 

So the call was made, and the appointment set, and I started Saturday knowing we had only hours left together. 

I decided to see if he would go outside with me one last time before the vet arrived. His absolute favorite thing in the world had always been being outside with his humans. Whether it was walking or fetching or simply lying at our feet, he lived for the hours we spent together under the sky.

After a little nudge, he pulled himself to his feet and went out with me easily. He headed for the grass and peed, then over to the birdbath to drink, all part of his usual morning routine. I stood on the patio talking to him as he wandered a bit in the gentle rain, sniffing the grass. The next thing I knew, he was doing his best version of running to the back fence, barking, his once deep voice now a raspy seal croak. He had spotted the deer on the other side, and as he had done his whole life, gave chase. He then pooped and came back to me on the patio. Instead of heading to the door, however, he moved to the gate, looking back at me expectantly.

This is the gate from which all of our walks began, from which he would be invited to join me working in the front yard, at which he always greeted us when we came home from time away. It was raining and I was barefoot and I knew he wouldn’t be able to go far, but I opened the gate anyway. We walked out together. We didn’t get more than a few yards from the gate before he stopped. It made me think of the very last time we headed out to do our daily walk so many weeks before, when he stopped and leaned against me. His body was no longer able to carry his spirit where it longed to go. 

We turned around and went back into the house. We stopped in the kitchen where I offered him some chicken, which he ate carefully, and some cheese, which he consumed eagerly. I fed him until he turned away. Then I walked him into the living room where his bed has been for months. I had pulled it into the middle of the floor and covered it with his favorite blanket. He plopped down, clearly tired from our outside adventure. I sat with him and petted him and talked to him. Walt joined us. A little before 8, a car pulled into the driveway. 

Dr. Beth, as she introduced herself, was calm and kind and gentle from the beginning. When she first came in she asked if Toby was snarling. For a second I wondered why she thought that, and then I realized his breathing was that loud. When I reassured her that we’d never heard Toby snarl, that it was his breathing, she came and knelt in front of him. I was at his head. Walt was behind him. She asked questions and filled out paperwork and petted Toby when he lifted his head toward her as greeting.

She explained the entire process while preparing, and again as she carried it out, petting Toby the whole time. At one point I heard her humming what sounded like a lullaby. Toby was calm and completely relaxed into the love that Walt and I were pouring over him. The only time he showed any reaction at all, and that was just a raised head, was when she swabbed the newly shaved spot on his hind leg with alcohol. 

Bunkie, the older of our two cats and the one who often sat in doorways for the express purpose of keeping Toby from going through, was with us through it all. He kept going between me and Toby, stopping for pets, and then gave the vet’s equipment and coat a thorough inspection. In the last minutes of Toby’s life, as we talked him over to the other side, Bunkie sat at the edge of the blanket and kneaded a steady beat until it was over. 

Mimsy, the cat who adored Toby and who often curled up against his belly, didn’t come out at all. When Toby’s great heart finally stilled and Dr. Beth went out to her car to get the stretcher, I went looking for Mimsy. I brought her out and set her on the floor next to Toby. She sniffed and walked away. However, when the vet came back in and knelt again in front of Toby with the stretcher to prepare him to go, Mimsy came back in the room. She marched up to Toby’s back feet and rubbed her face and body against them like she had rubbed against his legs so many times before.

The three humans enshrouded Toby and then carried him out to the vet’s car. She drove him away to be cremated and returned to us so we can return him to the ground of the place that became a sanctuary because of his presence. There will be a dogwood tree to shade and bloom over him in the years to come.

Dr. Beth was gone by 9. Walt and I went back into a deeply quiet house to begin the long journey of learning to live without our boy. My heart is broken, but it is a larger and softer heart with a much greater capacity for love than it was before Toby. Recalling the gift of Toby’s life and the gift of his dying in the time ahead will help weave the pieces back together into a heart that reflects the greatness of his own. 

Monday, February 24, 2020

The Gift of a Long Goodbye

It’s a dark wet February morning. I’m the only one awake. Toby, in what has become a new normal, came into the bedroom at 3:00 a.m. and woke me up.  In this new routine I pet him and talk to him and try to convince him to lie back down, but he isn’t having it. He needs to go out. Exhausted as I am, I soak up the warmth of his coat, the sweetness of his face, the special toasty smell that has always been his. I get up and let him out, feed him, let him back in. He goes back to sleep, along with the cats. I am wide awake. 

As I have so many times this winter, I consciously accept the gift of his presence and of this early morning time with him. 

At the end of November, just a month after he turned 12, Toby sneezed himself into a nosebleed. A week later we knew for certain he had a mass in his nasal cavity that was cancerous. After a lot of research and a long conversation with our vet, we decided not to pursue treatment, but instead to take him home and enjoy our remaining time together. Three months was the number I found: the time after diagnosis without treatment that we might expect to have with him. 

We cancelled the February trip to Hawaii with friends that we’d been planning for two years. I gave up tentative March plans, unwilling to commit to an assumption that he might be gone by then. For a while after the diagnosis, I cancelled a number of outings because I needed time and space to absorb this new reality of our lives. 

An accounting of sorts began the day we heard the news – a daily quality of life inventory. We knew that at some point the balance would tip and we would be making the decision to end Toby’s suffering. Our vet agreed to come to us when that day arrives, and the relief of that has helped make this journey more bearable. The question of how we will know when that day arrives is how I start every day now. It’s a terrible question to face. The weight of it threatens to crush. But I refuse that. So that our remaining time can be as joyful as possible, I cannot dwell in the darkness. So far no day has been that day. Today is not that day. And I am trusting that Toby will let me know when that day finally does arrive. 

What Toby could do in December far outweighed what he couldn’t. His symptoms, mostly sneezing that resulted in sprays of blood or drops on the carpet as he slept, were spaced so that we could go fairly long stretches without focusing on his illness. There were days when I could almost forget the diagnosis, and when I could almost believe Toby might live forever. Cleaning up after him felt purposeful and meaningful, like I was somehow in control. Every successful walk and meal eaten felt like a small battle won.

Slowly, inexorably, the disease consumes more and more of our old life. If this is a war, I won't win. The only control I really have is how I choose to walk this path. 

On what turned out to be my final walk with Toby a week ago, he stopped more than a dozen times and leaned on me to rest and be reassured. He refused to turn back then, but didn’t protest when we cut the walk in half. Often now when he hears the telltale sounds of me getting ready to walk, he doesn’t move from the floor. When he came with me eagerly to start our walk a few days ago, he stopped on the road and leaned on me before we’d even gotten out of sight of home. We turned back and he trotted  a few steps toward the house.

Sometime in January he stopped eating the kibble that he’d inhaled for his whole life. I bought canned food to add to the kibble and that got him cleaning his dish again for a bit. When that stopped working, I added chicken to the mix, and the bowl would be cupboard clean in a matter of minutes. Now it takes him all day to finish breakfast, and he usually finishes dinner just before bedtime. Even with the extra food and lack of movement, he’s losing weight.

He only goes upstairs now if we’re both up there with him. He has slept in his bed at the top of the stairs for most of his life.  With his failing eyesight and balance, he fell coming downstairs a couple of times early on. So I started escorting him up and down. I would go upstairs when I got up in the morning to bring him down to start the day. Now he sleeps at the foot of the stairs, and his bed is in the living room.

With every new loss, we regroup and adjust and keep going. 

The daily quality of life inventory has turned out to be an amazing teacher. I am a planner and an organizer. I like knowing what’s coming. And while I do know the end of this story, I don’t know the path or the timing that will get us there. This time demands being fully in the moment.  Looking backward at what no longer is, or forward at what is inevitable, are equally painful. Now is the only bearable place. Opportunities to choose gratitude and seek joy are boundless, and it’s up to me to find them. 

I look for evidence of joy in Toby’s life. It’s all little things now: a wagging tail, a meal consumed with gusto, a walk around the yard. His head rested against my lap so I can pet him. His eyes lighting up at the prospect of a treat. He’s not in pain, his breathing is still open enough, and he greets me happily when I’ve been away for a bit. 

Because I want him to feel loved and not upset, I’m choosing to be upbeat with him as much as I can. I laugh at his sneezes, hug him when he has a hard time standing up, talk to him endlessly. He gets treats often, and for no other reason than being so damned cute. Every time I walk past him lying in the hall I reach down to pet him, the contact as much for me as it is for him. There will be abundant time later to be carried on the currents of sadness that are there just below the surface. 

As hard as this time is, I am truly grateful for our long goodbye. Every day I am reminded what a magnificent companion he’s been. Our long decade together has been the best time of my life, in large part because of our relationship and the inspiration of his spirit. He has taught me lessons in loving and living, and finally dying - all done with a particular grace only dogs seem to possess. Now I get to give him the ending his life deserves, and while my heart aches, it also swells with love.  

The eastern sky is beginning to brighten. It is perfectly still outside. I hear Toby snoring in the other room. I breathe this moment in with gratitude.