Bailey
bounced into the hospital waiting room with an exuberance that I have not seen
in months. Freed from the grasp of arthritis
and constricted blood flow, she has been so energetic and enthusiastic the last
couple of weeks, since starting on the doggie equivalent to Ibuprofen. She
raced to the 7-year-old Burmese who greeted her politely, but declined her
invitation to dance. The Burmese had
completed its course of traditional chemotherapy, and was now starting
metronomic oral chemo (two of the options I would soon be offered for
Bailey). Onto the Dachshund-Beagle-Chihuahua
(?) mix—no, there is no play to be had here either. How about the Rottie-mix with the wagging tail
and the telltale injection sites? A
pleasant if uninspired sniff, but nothing more.
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| Bailey playing (Sunday 26-Jan-13) |
The
humans were far more responsive as Bailey shifted her sights to the
receptionists, techs, nurses and vets.
Hugs and smiles and verbal greetings in high-pitched voices were freely
given as Bailey exploded into their arms.
She was feeling more than well, more than happy and far more than
comfortable. She was thrilled. She was enthused. She was exuberant as she bounced from one
person to the next.
Palliative. Such a nice sounding word. Gentle and kind. Palliative--downright palatable. But I was about to discover the different
shades of palliative care, some of which are less kind and much more aggressive.
And which approach is kinder is not a priori to the concept of
palliative care, but is a judgment you make—no, a judgement I had
to make. And in a race with a very aggressive, very
fast cancer, I had to make it soon.
I
had thought the choice would be between comfort and duration, but I was
wrong. Most of the approaches that offer
the best (although small) chance of extending Bailey’s life, would likely keep
her comfortable, or at least be tolerable--as in “tolerated
reasonably well.” All of the chemo-dogs we encountered seemed comfortable and even happy.
Their humans reported little signs of pain, a satisfactory quality of
life, and only some ill effects from the
therapy. I could keep Bailey comfortable and
provide a chance (although a small chance) of extending her life a few weeks.
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| Bailey Playing (Sunday 26-Jan-13) |
It
was now clear that the choice was not between duration and comfort—they are on
the same side. The actual choice is
between duration and joy, between rolling and bouncing.
Is
it better to bounce highly and freely for a shorter time, or to roll slowly and
calmly for a longer course? Is it better
to bounce and bounce and bounce until you suddenly drop and deflate with a
frightening, likely painful, but rapid thud? Or, would it be better to roll on a
course of leveled ground, watching the surroundings slowly pass by, and losing
speed as you gradually deflate with only minor discomfort until someone kindly
ends it for you? Is it better to extract every sap of joy from a fewer moments,
greeting each with all the exuberance you have, or to more calmly receive some
unknown number of additional gentle moments, appreciating and feeling
satisfied with each.
Struggling
to keep up with Bailey as she bounded about the hospital waiting room, the
choice became clear. Realizing that this
is how she had always lived her life, that this is how she always approached
each new situation, the answer also became clear. We will bounce. We will bounce highly and freely and wildly
and exuberantly until Bailey has no bounce left. I will occasionally fear the thud that I know
could come with any of the next bounces and without any foretelling, but I will
then catch my breath, dry my tears, throw out my arms and bounce again with my very
exuberant, very happy dog.
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| Bailey Playing (Sunday 26-Jan-13) |
So,
thank you, but no to chemotherapy. No thank you to a satisfactory quality of
life. No to reasonably tolerate. And, with great sadness, no to
the 30% chance for a few more weeks of gentle rolling. For a more reserved dog that choice might be
ultimately right, but not for Bailey. I
choose to allow her to be exuberant without moderation; to get excited by the
stupidest things; to explode into each new situation with unbounded joy. I choose to watch her bounce with glee until
there is no more bounce in her. And I will be right there throughout, bouncing with her.
