Saturday, July 17, 2010

Vigil

I cannot believe I am writing these words. Alec and I are nearing the end of our time together. Incredibly, unbelievably, tragically, I am saying good-bye to my partner, my best friend, the love of my life: Alec. How can I? Well, I don’t have a choice. My wishes have gone unfulfilled. Our miracle didn’t come.

At the end of my last post, I mentioned Alec’s cancer had come back. Two weeks ago, he had another bleed and the ultrasound showed the cancer had spread through his liver. We immediately tried a new chemo protocol and a little more than one week later, this past Monday, he started feeling badly again, lethargic and intermittently nauseous. I wasn’t sure if it was a reaction to the chemo, perhaps an infection due to lowered white blood count, or the cancer coming back. I fervently hoped for the former and that the antibiotic would help. It did not. Late Thursday night our wonderful vet came over to see him and although she did not see immediate evidence of bleeding (which was our first concern), while she was examining him he gave a little growl when she touched his tummy, which surprised us both. Upon further, very gentle, examination, she found a large mass in his abdomen. Not a bleed but a new tumor - she estimated it was the size of a round watermelon - which means the end of the road.

She said it is pressing against his tummy which is why he was nauseous and the tumor is secreting hormones that are making him feel weak and maybe like he has the flu. Also the fact that his abdomen is painful made him not want to move much. Although she said she didn’t think the pain was too bad because his heart rate was so regular, that made me feel terrible because I could not tell he was in pain. I know dogs are good at hiding this, but still…ugh. I had some tramadol (painkiller) on hand from his surgeries and we gave him those right away along with a stronger anti-nausea medication, which seemed to make him feel better and he drifted off while we talked about options, or rather lack thereof.

A third surgery is not an option (we can’t remove his liver like we did his spleen), nor is more chemotherapy. The cancer already resisted the first protocol, and now has come back despite using a second “rescue protocol” with a new drug. If you know anything about cancer – and I am happy for you if you don’t – the cancer cells come back stronger every time. He is not going to get better from this. It is hospice now, meaning I make him as comfortable as possible until the time comes, which can be anytime. It will be soon. Of course, I will help him with his transition if need be (although my fervent last wish is that he painlessly and peacefully drift off…don’t we all wish that; don’t worry, I know it rarely happens that way), but I want it to be done at home. He does not want to move and the thought of trying to get him to the emergency hospital where he has not had happy times, with doctors he doesn’t know, and all those horrible fluorescent lights…that is not where I want it to happen.

I tried to make a plan a few weeks ago, just so I was prepared, and both his vets agreed to be on call after hours should I need them. But as bad luck would have it, they are both out of town this weekend. His oncologist is also out of town. His vet gave me the numbers of two mobile vets who do home euthanasia, but one of them is out of the country on a family emergency and the other is especially busy this weekend and can’t promise anything. I am hoping he stays stable until Sunday (or longer) when his vet, whom I love, is back. But I need to be prepared for anything. If his condition worsens I will not let him linger. There is another wonderful vet filling in for my two regular vets this weekend and she gave me her number and said I could call if I need her. I hope I don’t have to call before tomorrow, but thank goodness I have an option. Although she did say her car is in the shop so it could be tricky for her to get here. What is up with this weekend?? Even my closest friend in Portland left town a couple days ago. Can you say ALONE? I don’t mind being alone with Alec. This is the purpose of these last few hours, minutes, days, however long we have left together. But the scary part is everyone on our veterinary support team being gone at once. Hopefully he will stay stable until at least tomorrow. After everything, I can’t believe this is good-bye.

Alec has a big kennel with a bed and pillows called his “little house,” which is his safe spot where he loves to rest. This is where he has been hanging out. He is eating some snacks here and there but is not much interested in food (believe me, I have tried everything), he is drinking lots of water, and sleeping and dreaming intermittently. He is not flat-out or anything. He sits up occasionally and when I leave his side he turns his head and follows me around the room with his eyes, which are bright and alert. I am camped out next to him as I type this. He is napping. I have been alternately journaling and crying into his fur (I gave up the trying to act positive stuff) and telling him how much I love him and how being with him has been a dream come true and how sorry I am I can’t fix this. I have thanked him for making my life so good these last seven years. I have let him know I have never loved anything or anyone the way that I love him. I have been saying a lot of things. I also smile and laugh. There has been some music and singing. It is not all dirge-like. He is still smiling at me, too.

But the end is near. And as my vet put it Friday morning, I am holding vigil at his death bed. There is nothing beautiful about this. I want so badly to wrench meaning out of it, but it is nothing but sadness. It hurts so much. There aren’t words to describe the awfulness of my heart breaking, of the air slowly being sucked out of the world. No, it’s not my heart breaking…it’s ME breaking. I can’t think too deeply about what is happening beyond the immediate or I will go crazy.

I know I did my best, but nothing helped. The oncologist told me she was seeing remissions of 2-3 months to a year with this chemo protocol, in dogs with Alec’s cancer who were sicker than he was when they started. How I hoped Alec would be at the long end of the average remission! How I hoped the fact that it took so long to find it (43 sections!) meant something optimistic. The news of the cancer, of the multiple false biopsies, was crushing, but still I kept relentlessly hoping for the best. It seemed too unfair after everything Alec had been through. And here he barely made it to the lowest point in the range: 2 months. I have tried to keep positive, but knowing I lost 1.5 months of treatment time because of the false “benign hematoma” results just hurts so badly, even though I know there was nothing I could have done. Two additional benign biopsies followed. The cancer was hiding. It seems this cancer was determined to take him.

This all feels so familiar. Caring for Alec and tending to him. He is even wearing his Walkabout Harness again to help me get him outside, just like when he was paralyzed and recovering from his spinal surgeries. He is a good and sweet patient. I know this from before when I monitored him so closely for depression when he was on crate/bed rest for 6 weeks. I was amazed how well he adapted. But this time he will not get better. My love for him is so deep. I would bargain away anything to keep him here with me, anything, if only someone would take it. I feel so fiercely protective of him, as I know he protects me. It sucks to be so helpless, to be unable to keep him safe. Someone said that the hardest part of loving someone is being unable to prevent their suffering. Not that Alec is suffering – I would not willingly let that happen. The person relaying this quote (a psychiatrist and author who was paralyzed in a car accident many years ago) was talking about how his quadriplegia was harder on his mother than it was on him. I can understand that completely. Indeed, pure love could not exist without the potential for the most unfathomable pain. I guess that’s what the rose and thorn metaphor is all about.

I regret that I didn’t take him swimming the week before last on the oncologist’s instructions. She said there was too much of a risk of infection given the chemo treatment he had just had (potential bacteria in the water). If I had known what the next week would bring, I would have taken him. The indoor pool where Alec always loved to swim just reopened after being closed for renovations the last couple weeks, and I regret Alec will not get to swim in the new and improved pool. But I was told with his immune system compromised he could easily get an infection and become septic, which would be bad. I tried to make the right decisions. I still had my faith in the new chemo protocol at this point, and we only had to wait a week. I didn’t know that week was all we would have.

I also regret that I had to keep Alec from playing his favorite games “stick” and fetch, after his back injury, and that I had to keep him from rough housing with other dogs. But I did this for his protection, on the recommendation of several veterinarians and rehab therapists (I got fourth and fifth opinions on that). I really tried to make up for it by taking him swimming all the time, which I thought was a good compromise because he could chase the ball in the water, and taking him to special places and new parks on a regular basis. After he was paralyzed, I vowed never to dwell on the things he couldn’t do. I said I would only focus on the positive - all the things he could still do - and that I would make the most of those. He wasn’t even supposed to be walking, and I tried never to lose sight of that or let anyone feel sorry for him. When people would see him limping along with his little shoe and say “awww, poor dog” I would always say “actually, he is doing great!”

But now that the end is here I can’t help but mourn the fact that this poor dog has been through so goddamn much, only to have this cancer cruelly snatch him away, just when I thought things were calming down for us. He had been walking for only a year, but he was doing so well and I looked forward to many uneventful years ahead where Alec could relax and turn into a wise, old, gray, OLD shepherd, by my side, enjoying his much deserved golden years in comfort and security, surrounded with love and quiet reflection (by me) on a beautiful life well-lived. This cancer wasn’t part of the plan. I don’t care about me. I would do anything, make any sacrifice or life change, for him, but it hurts so badly to see his life cut short after all the adversity he amazingly overcame just a short time ago. With tears in my eyes, I say: it is unfair!! He deserved more. My sweet shepherd deserved a break. But we didn’t get it. Why?? Again, how badly I want to wrest meaning from this. And I know our story is not unique; we are not the only ones to go through this, or worse. This is the human condition. But I don't care. This is our story and it sucks.

Besides those, I don’t have any regrets. Alec became the center of my world when my first dog Kobi died almost exactly four years ago and it was just the two of us. Our relationship further intensified after he became paralyzed and I nursed him back to health and, eventually, mobility. There is nothing like that experience to strengthen an existing bond. And because he was still disabled, I had to pay attention to things I never did before, which further brought him to the center of my day-to-day experiences, thoughts, emotions, and plans. When Alec was in the hospital in Feb 2008, I thought he might die. When he didn’t, a simple truth came rocketing home. Something I had known abstractly now took on immediacy and became very concrete: every day is precious. And I never forgot that.

The result being the last two plus years I have known exactly how lucky I was, not in the back of my mind, but in the forefront of my consciousness. So when Alec got cancer and people would tell me to cherish every moment, all I could say was, “I have already been doing that!” Honestly. I knew what I had and gave thanks for it every day. For all intents and purposes, I structured my life around Alec. And I am glad about that, after all. I recognized - and celebrated - the profound joy and contentment I felt when spending time with him doing the most mundane things. I don’t think I could have spent much more time with him, or put his happiness more front and center (seeing him happy brought me so much joy that it was a route to my own happiness as well). So there is that. But imagine the void that is going to leave. I can’t. I am having serious trouble seeing my life without him in it. That is one big presence. As one of his vets said, "Alec is larger than life," and I could not agree more when it comes to his place in my world. All I know is everything is going to change. Just everything. He has become such a big part of me. I scarcely know myself without him anymore.

Awhile ago, before I knew Alec was sick, I was dancing with my friend Mike at a club. The song “Just like Heaven” by the Cure came on and for some inexplicable reason I thought of Alec and started crying. Yes, I had been drinking but I don’t tend to burst into tears every time I drink or anything. I cried again as I told Mike on the cab ride home what happened. Even though he is the only person I know who is as obsessed with his dog as I am with Alec, he made fun of me…as well he should have. I was being crazy. He didn't understand why I was crying and I tried to explain it was just because I loved Alec so much and I didn’t know what I would do if anything happened to him. It was this overwhelming emotion. I laughed while I was crying, knowing I was being silly. That was only a few months ago.

Here is something I scrawled in my notebook, again before Alec was sick:

blissful days
quiet nights
never wrote much before
when I was happy
never felt moved
to capture the moments
to carry the feeling with me
always
you have changed all that
you
changed everything

everything
and always a little more
the narrative never stops
it keeps pushing forward like a train and
downward like the rain
sinking into my bones
radiating out through my skin
this “we” I am in

backward like an old refrain
I try to hold onto where we’ve been
before and ever now
upward into speechlessness
and the disorientation of being found
you are my sense of time, of place, of weight
my clock, my map, my scale
you are my reason.

I would not normally share the random scribblings from my notebook with anyone, but I wanted to convey what I felt, even then, when I thought things were fine. That Alec was my anchor… my purpose. I feel that when he leaves I could just fly off into the ether. Even for someone as verbose as me, it is hard to explain. It feels like losing home.

I will close this by again saying I am grateful I cherished every moment with Alec these last few years, and I’m glad I have the scribblings to prove it, like this from two years ago:

I miss you
even when you’re right next to me
in the next room (our room)
but I’m in the bathroom
thinking about random things
and then it hits me
how much I love you!
and I suddenly, achingly
miss you – rush to your side
even though you’re right here.

In cherishing Alec I also feared I would lose him, as this is the flip side of gratitude. Gratitude exists because we know we are lucky to have something – the awareness that it could be taken away. So we try not to take for granted, but we can’t be obsessed with loss either. I tried to straddle that line but truthfully after Kobi died (my first experience with grief), I was always afraid of losing Alec, even more so after he became disabled. And it has occurred to me that my fears brought this on somehow, but I know that for every thought I had that said “What would I do without you?” I had twenty more that said “We will be together for a long, long time!” If my thoughts were so powerful as to change reality, my world would look very different right now, and Alec and I would have many more years left together, many more experiences, many more chapters to write.

But the reality is we are out of options, and all of my high hopes have dwindled to this last one: the hope for a good death. Oh, and hope for an afterlife, which I have never held much truck with before but the impossibility of me being without Alec has driven me to seriously explore this. I refuse to believe our bond can be broken. And so I won’t believe it. I am going to turn into one of those woo-woo types when he leaves me, because I have to turn into something. Who am I without Alec? This dog has been the absolute center of my world and I mean that in a really, really good way. Although I used to scoff at them, I am starting to understand people who turn to spirituality and the supernatural in times like these. The mind rails against accepting the unthinkable separation. The afterlife is too appealing. Until someone disproves it, I think I am on board.

Soon I will hug Alec for the last time. Soon the color will drain out of my world. Soon I will change forever. And I will try to keep going without him. But I am not making any promises. I love Alec desperately with every fiber of my being. He is the best thing that ever happened to me. The times I have spent with him have been the happiest of my life, hands down. He is my joy, my light, my happiness. He is my amazing shepherd, but we couldn't beat this. Alec, I am so sorry I couldn’t make you better. How can I say good-bye? I don't know how to end this. There is no good way to end this. Oh please, I don't want to end this.


We had a picnic at Mt. Tabor Park last weekend. I shared my vegan "steak n cheese" sub with Alec. He also had some kibbles and lots of treats.


It was a happy day.

These lines on my face are new. I'm surprised my hair hasn't turned white yet.

My sweet shepherd boy.

Outside our apartment, just last week. The thousand watt smile that lights up my life.

The little house.

Keeping watch on the stoop.

6 comments:

Deb said...

This is just so heartbreaking, I can't do anything but cry - for you, for Alec, for all the hope and wonder he represents (he is larger than life for me too, even though I know him only through your blog and our email conversations), for my own past (and ever current) grief for my own losses...

I'll be thinking of you both, as I have often over the past few months.

Maggie said...

Oh God, I am so sorry. I am crying as I write this because I can't imagine your pain and heartbreak. You are right, this is unfair, horribly unfair and it makes me lose faith. Please tell Alec I love him.

Eren said...

I am so sorry Vigil...Just crying after reading the post.. :(( This is unfair but Alec knows that we all love him.. Take care

Anonymous said...

Oh no ... the hardest part is saying the final goodbye. My heart is with you both. Poor Alec -- please let him go -- it's the one last gift you can give him.

-Yasmine

Reagan said...

Thinking of you and holding you both so close to my heart.

I am so, so lucky that I got to meet this special boy.

Connie, Orlando said...

Grief and loss is so very personal and your sharing of your deepest feelings and fears is further evidence of your amazing strength. Never, ever doubt that about yourself. And never doubt that you have given to Alec as much as he has given to you. Few people ever experience such deep and true love - it is a blessing and a curse. I recently received this quote, which I found uplifting and hope you will as well: “Abandon any hope of fruition. The key instruction is to stay in the present. Don’t get caught up in hopes of what you’ll achieve and how good your situation will be some day in the future. What you do right now is what matters.” ~ Pema Chödrön