In light of the fact that we recently had to put down my 13 year old “love of my life”, here’s some old words that I was lucky enough to have published on KevinMD when I was in fellowship.
Today I saw a news story about Walnut, an 18-year-old whippet in the UK, who had his last “walk” on the beach with his owner who had asked social media followers to join them. Shortly after that walk, surrounded by hundreds of family, friends, and supporters (human and canine alike), Walnut was put down. His last moments were spent as near to Heaven on earth as his owner could create for him. The love for man’s best friend is almost palpable in the video.
As a veterinarian’s daughter and mom to 5 dogs, I hope I can show them all such compassion in their last days. I’ve lost many a pet along the way and miss them all terribly, and in different ways. However, I feel like they passed from this world far more freely than any family member or friend I’ve lost– free from pain, free from suffering, albeit likely still with a twinge of fear as they know not what is happening or what is on the other side. (Well, as far as we know. Perhaps they know more. Perhaps that’s why they are so generous with their unconditional love even in their dying days.)
And even I, as their caretaker, have less suffering from the passing of my best friends because I never had to watch them suffer for days, months, or even years. Someday maybe we will understand our furry friends’ requests, and understand better when they suffer and what they truly want for their last days. In the meantime, we can only allow them the dignity they deserve after years of providing examples of love, forgiveness, and acceptance … and allowing ourselves to remember them in such an admirable light that is not shaded by the guilt of their suffering.
As a physician, I wish we could treat the end of life with such dignity and celebration as Walnut was given. Doing a critical care fellowship makes me wish it all the more. If only I could have my patients “walk” the beach in a loved one’s arms, surrounded by those celebrating a life well-lived rather than breathing for them, force feeding them without the joy of tasting their food, taking care of their bedsores and stripping away the last of the few remaining mechanisms that make us human, all the while whittling away at their dignity.
Don’t get me wrong. There is a place for fighting through the pain for another day, to give it our best to not let the world’s ailments beat us at this game of life. There is a place for suffering in our lives. But it does not have to consume all of one’s last days here on this earth. There is a time and place for healing, and prolonging death simply does not always equate to that which we, as doctors, committed to do.
When that time comes, pull up a chair next to me, near a fire pit in the mountains of New England in the middle of fall with hot cocoa and s’mores, dress me in a warm woolen sweater, jeans, boots, a classy coat, maybe some mittens, and an (obviously) plaid scarf, surround me with friends, family, pets (and strangers too) that might wish to partake in celebrating all that makes us dignified as humans: the ability to breathe in the crisp fall air (without the pressure from a ventilator), the ability to smell the marshmallows roasting on the fire midst the pine trees and the smoking wood (rather than the stench of a hospital that we all so anxiously wash away at the end of our work day), the ability to tell tales about the roller coaster of life (rather than have frequent discussions about the goals of life-sustaining care), the ability to feel the softness of a blanket and the gentle touch of another human being (rather than the scratchy sheets and developing bedsore on my backside), the ability to stroke the head of man’s best friend and see the love radiate from their eyes (rather than have my hands stuck in mittens and seeing the pity in the nurses’ eyes), the ability to reminisce about the past and hope for the future (rather than wishing I could just be anywhere but confined to a hospital bed), the ability to taste the most decadent of foods and stuff ourselves beyond comfort (rather than be force-fed the worst imaginable protein shake through a tube surgically placed in my stomach), the ability to hear the loudest and softest of sounds that make up the soundtrack of our days (rather than the incessant alarming of ventilators, beds, IV pumps, and code events in the hospital).
Allow me as many of the things that make us human, that we are so very lucky to have for such a short period of time. Then, let me pass gently from this world knowing I had the ability to savor every last moment in the most glorious of ways.
And before that time comes, I’ll use my dogs’ tail wags and cozy cuddles to remind me to really breathe in those moments in the here and now because life is short, but it’s a good one — and they seem to know best.
RIP Walnut and all those furry and non-furry family and friends we will one day see on the other side of the Rainbow Bridge.
RIP Brewster Bear Jan 2006 to Jan 2019