by Barbara Ebel
“I may need help.”
“He’s not going anywhere and we can assist.”
The girl relented and planted herself at their level. She took a portable shaver from her pocket and selected fur on Dakota’s right foreleg. As soon as she leaned in, he began trembling. Emotion rose in Annabel’s throat; Dakota sensed what was coming.
When the tourniquet went around the dog’s leg, Annabel pointed out a bulging vein and the technician easily slid the IV in, capped it, and taped it in place. The woman opened the door and left.
“Dad,” Annabel said. “I don’t know about anyone else, but I feel like a heel bringing him here to do this. With his spirit intact, he is not desperate to die. It’s like we are playing God and snuffing his life away from him. Maybe this isn’t right. On the other hand, my team just had a patient that was so fed up with his terminal medical problems and the way he was living, that he took his own life. This is all so confusing.”
“With our pets,” Danny said, “it is unfair when we have to make their final life or death decision. They can’t make or carry out a verdict themselves like what your patient decided for himself, whether he was right or wrong. But we are more informed than dogs. We foresee what is going to happen to Dakota in the next few days. Do we want him to suffer over time or do we make death easier for him? Should we let him go further downhill in the house with his family giving him more hugs and love or let him go sooner? If he could talk, what would he tell us? This is a moral dilemma and there is no satisfactory answer to appease our souls. As a neurosurgeon, I have been through this with patients and their families too many times. Mankind doesn’t possess a solution. We only have laws relative to the subject and laws are written by men. So we end up back where we started from. In a gray zone.”
The tears started to stream down Annabel’s face, and with one hand, she pulled a tissue from her pocket and wiped her cheek. Even her father didn’t know the answers. She dug her fingers deeper into Dakota’s neck and savored the moments before he would take his last breath.
The door opened and Annabel quivered like Dakota. “I was wondering when you all would be back,” the vet said. He smiled with understanding; comprehension of a situation he’d been in many times before. Like her father with neurosurgical head cases, she wondered, when do doctors give up on patients and let them go?
“Dakota’s stridor and difficulty eating is the last straw,” Danny said to the vet, jolting Annabel back to reality.
“I understand, Dr. Tilson,” the man said.
The young veterinarian assumed a position on the floor and injected a few cc’s of propofol into Dakota’s vein. The dog’s head slumped further on his front legs with contentment from the sedation. The man wasted no further time. He pulled out the first syringe, inserted the next one, and followed with a lethal dose of barbiturates.
Their beautiful Chesapeake’s tongue partially protruded, it drained of oxygen, and turned a deep, dark purple.
CHAPTER 15
“I’ll give you all a moment with him,” the vet said when Dakota stirred no more. “I’m sorry for your loss.”
“Can we leave him here for cremation?” Danny asked.
“Yes. That service is in the separate building in the back. We’ll call you in a few days when he’s ready.”
The vet left and Annabel and Nancy both continued to linger over Dakota. “Dad, I didn’t know you were going to do that,” Nancy said.
“I never brought the subject up at home because my decision to cremate him was firm; he’s going back home where he belongs.”
“I like the idea.”
“Just know that one of you is going to bury his ashes with me when I go.”
Where did her father come up with these ideas? Annabel thought. “I’ll do it if Nancy doesn’t,” she said. “He’s been your faithful buddy.”
“No matter what time I rolled into the house from some horrendous cranial case in the middle of the night,” Danny said, “he was the one who would wake up, greet me, and comfort me in his own way from the traumatizing circumstances I would leave at the hospital.”
Danny pushed himself off the couch and covered his eyes with his hands. “Come on, girls. We better let them put him on ice.” He stepped over, placed his hand on Dakota’s fur, and kissed him good-bye.
“On ice?” Nancy asked.
“Sure,” Annabel said, looking back one more time from the door. “You can’t believe how fast bodies decompose. Bye, boy,” she said blowing over a kiss.
“You all can leave,” the woman at the desk said. “We’ll bill you when you come back for Dakota.”
“Thanks,” Danny said. Outside, they piled into Danny’s Lexus and turned on the heat.
“This is too difficult,” Annabel said, emotion welling up all over again. “We just had him in the car and now he’s gone.”
Danny pulled away from the building. “I can tell you some insane stories. I don’t think I ever told you of the night I spent with Dakota in the beginning when I was being unfaithful to your mother and she kicked me out of the house. I was staying in a rental apartment with him, but I didn’t know dogs weren’t allowed. Long story short, they tried to contact me to tell me to remove the dog from the premises, but I never received the messages. My hours and life were so complicated, I couldn’t see straight.”
“You made it more complicated with an affair, Dad,” Annabel said.
“Yes, well, I admit I was an idiot. Anyway, it was late at night and the management company had changed the locks on me so I was locked out of my own place. I couldn’t find a hotel that would take dogs, Mary was out of town and the big house was locked, so I ended up sleeping in my car with Dakota at the Caney Fork River and still needed to be at work in a few hours.” He slowed down his words and continued. “It was one hell of a mess and Dakota was part of the fiasco. When I arrived at the office looking like a homeless person – which, theoretically I was - Dr. Garner put me on leave.”
“I never knew all that, Dad,” Annabel said. “Nancy and I were aware stuff was going on, but that’s pretty bad. I can see you and Dakota now. I’m glad you had his faithful companionship during those trying times. You were messed up; I bet he helped you realize again what was more important in life.”
“I don’t think I have to worry about you girls in this regard, but never let sex or a hot romance cloud your judgment.”
Annabel froze in her seat. She couldn’t believe what he said. If he only knew of her indiscretions due to Findar, her social dating app. She had been doing far worse than her father had ever done except that he had gotten ensnarled by a woman wanting to charge him child support. All for a child she wanted to brainwash, raise herself, and keep from him.
The complexities of his situation boggled her mind. She had better learn from him and use more caution in the future, especially if she continued to find men on social media. Of course, however, there was Robby to consider. Her dad would certainly whole-heartedly approve of him.
“Wasn’t tonight your date with the heartthrob?” Nancy asked from the back seat, as if reading her sister’s mind.
“Heartthrob?” Danny asked.
“I told you about my chief resident during surgery,” Annabel said to him. “He asked me out. Unfortunately, this is the second scheduled date we’re missing.”
“Ouch,” Nancy said, leaning forward.
“Hmm,” Danny commented.
“Dad, whenever you make that noise,” Annabel said, “you know something I don’t know.”
Danny shrugged. “Perhaps.”
“If you don’t care,” Nancy said, “I think your friend, Bob, is a hunk. Does he have a girl friend or can I somehow keep in contact with him?”
“He has a girlfriend, but he says they’re not serious.
Nancy leaned back, satisfied with the answer.
“Has anyone eaten?” Danny asked.
“No,” Annabel said. “But I’m not really hungry.”
He pulled into a chain pi
zza place. “Someone else may want a bite,” he said. “Even your guest. Let’s bring home a pie.” They went in and soon continued home with two boxes of piping hot cheese pizzas.
“Dad,” Annabel said. “In a way, I’m glad I’m going back to Ohio tomorrow. The emptiness in the house without Dakota is going to be too distressful. It would continue to break my heart if I was living here.”
“I can understand,” he said. “I’m glad your friend came with you and is supportive. Just be sure to keep focused on the wards next week. Now that you’re in medicine, your personal life will continue to have upsets, and you must always do your best to not let it affect your care of others.”
-----
“How’d it go?” Sara asked tentatively when Annabel, Nancy, and Danny walked into the house. They put down the pizzas and Nancy grimaced.
“Dakota sensed exactly why he was there,” Annabel said. “The situation could not have been any worse than that.”
“I’m having him cremated,” Danny said.
“Excellent plan. Now let’s open these boxes and be hospitable to our guest. Plus, Casey is working the eleven to seven shift and needs to eat. We’ll have plenty of time to mourn over Dakota. I only hope I am over it in a year.”
“Or two,” Danny said.
Nancy rummaged through the pantry for paper plates. She passed them out and turned to Bob. “We hope you like it without toppings. Can I fetch you another soda?”
“Tell me where to find one,” he said. “I’m here to help, not be waited on.”
“Okay. But since my sister doesn’t tell me much, at a later date, maybe you can tell me your perspective of medical school. Like is it worth all the work?”
After dinner, Casey showed Bob where to sleep upstairs and he got ready and left for work. Annabel slept in her regular room in her parents’ place downstairs.
For Annabel, the day had been long … starting out on the wards, the phone call with bad news, and then a long drive culminating with the euthanasia of Dakota. For fifteen minutes, after settling under the covers, she stared in the dark at the ceiling and grabbed the blanket high around her neck. Robby came into her thoughts, but she successfully cleared him away. All she wanted was to purge her mind of everything but Dakota. Her mind relaxed and she went fast asleep.
-----
Annabel startled in the dark. She heard something and glanced at the alarm clock, which said 3:49. Her bedroom door was open to the hallway outside, which had faint light from a night light. She rested her head back on the pillow, but this time, the sound was unmistakable.
Annabel turned to the side to glance out the door. “Dakota?”
No, she said silently to herself. It can’t be him. The events of the evening flooded back while she had held Dakota close and he had left this world. But again, she heard a clickety-clack - his toenails on the hardwood floor. She froze and held her breath and then a few more rhythmic clicks sounded from beyond her room.
“Oh, my God,” she whispered and tossed off the blankets. She rose, tip toed to the hallway, and strained to see in the dark towards the family room. The hallway was empty and the noise of toenails had stopped. Her hand rubbed over her heart and, because she couldn’t stop herself, she walked the corridor and then glanced around in the dim room. Finding nothing, and no explanation for the sounds, she slipped back into bed.
Annabel closed her eyes; memories of Dakota swelled in her mind as she tried to sleep. Unequivocally, she thought, she was sure of what she had heard.
Finally, she went back to sleep knowing that she and Bob had a long trip back to Ohio in a few short hours.
-----
Annabel and her Aunt Mary lingered over the kitchen counter on the main floor of the house. They both sat on stools and leaned forward, stirring creamer into fresh coffee. The twins amused themselves with toys and cartoons on the television in the background.
“This is already the pits,” Mary said, “not having Dakota around. By this time, when he would sleep on this floor, I would already be letting him out the back.”
“I think he was downstairs last night,” Annabel said, thinking of her experience a few hours ago.
Mary scrunched up her forehead and tilted her head.
“No, I haven’t lost my mind,” Annabel said, “but it’s best if I don’t talk about it.”
Bob cleared his throat as he came down the stairs and showed up in a fresh, form-fitting cotton shirt and his hair groomed in his usual sculpted style. “Good morning,” he said and focused on Annabel. “Did you manage to sleep?”
“Enough to make it through the day,” she said.
“Coffee?” Mary asked him.
“I’ll get it,” he said and went to the coffeepot.
A car rolled into the adjoining garage, and in a few moments, the door opened. Casey appeared with a warm smile. “How are the two most beautiful women in the world this morning?”
“We’re hanging in there,” Mary said, “without our best buddy. How was your night?”
Bob put down his mug and Casey patted him on the shoulder to acknowledge him. He went inside, stooped down, and greeted and hugged his children.
“I’d be taking that rapscallion of a dog out right now,” Case said, stepping back in. “My routine with him after an eleven to seven shift. And work was fine; less busy than usual. I think the Arctic blast of cold air kept lots of folks off the road. We resuscitated and drove an acute heart attack patient from a hotel to the hospital and then a middle-aged woman who stroked from an aneurysm rupture. I’m sure your dad would have performed surgery on her had he been on call,” Casey said to Annabel.
“Has that ever happened?” Bob asked. “You bring a patient straight to the hospital and your brother-in-law does surgery on them?”
“A few times,” he said with a smile. “We call it tag-teaming and our patients do quite well.”
Bob nodded. “Can I pour you a coffee?”
“Sure. Since I’m going straight to bed, you can pour me my one and only cup. What time are you two leaving?”
“I’ll leave the decision to Annabel,” Bob said.
“What do you think?” she asked. “By 11 o’clock the latest?”
“Yes, if not sooner. Don’t forget we’re on Eastern Time up there, an hour later.”
“I’m glad you reminded me. You’ll have to keep me straight for a day or two. My mind may be on home and the loss of Dakota.”
“You can count on me; longer if necessary.”
The basement door opened and Danny, Sara, and Nancy came ambling over into the kitchen.
“Here you all are,” Sara said. Her hair was still damp from a shower and she fidgeted to button up a pink sweater. “How about Danny and I whip up some eggs so everyone starts the day with protein?”
“Or in my case, ends the day,” Casey said.
“Then it’s a yes,” Sara said.
They scrambled eggs, made toast and bacon, and sat down at the long table. Danny let out a big sigh. “Dakota loved eggs,” he said. “Let’s enjoy these for him.”
-----
Annabel brought her book and bag up from downstairs and placed them on the counter while Casey went to bed and Bob was quietly upstairs getting his things.
“We enjoyed meeting Bob,” Mary said as she put away dishes. “Bring him back any time you’d like.”
“Sure,” Annabel said, “but we’ll probably be going our separate ways after this rotation.”
“Aren’t you two good friends?”
“We have a fun time together and we’re forced into similar, or the same, learning situations because of our patients.” She opened the freezer and packed ice cubes into a large plastic bag for her cooler. “Do you mind if I bum some stuff out of your refrigerator? I took a few things from Mom and Dad’s, but you have a better selection of cheese.”
“Take anything you want.”
Bob came down and the rest of the Tilson family gathered in the kitchen to say their good-byes.
&nbs
p; “Here,” Bob said and took Annabel’s things. “I’ll go take these outside and start the car.” He turned to each of them. “Thank you so much for having me here and I’m sorry about Dakota.”
“You’re welcome,” Sara said. “Have a safe drive.”
“Come back any time,” Danny said and shook his hand.
“I’ll come up and visit my sister soon,” Nancy said. “I’ll pick your brain and we can all go out.”
“See you then,” Bob said. He nodded at all of them and kneeled down to say good-bye to Melissa and Tommy. He went down the hallway with their bags propped under his arm, the cooler in one hand, and disappeared out the door.
Annabel put on her jacket, gave all of them a hug, and Sara and Danny walked her to the door.
“He’s a very nice young man,” Sara said.
“Your mom is right about that,” Danny said. “Call us when you get home.”
Annabel nodded and embraced them again. “You two are the best-est,” she said. “I am going to miss Dakota like crazy, especially every time I come home in the future. Walking into this house is never going to be the same again.”
“I agree,” Danny said. “But he will be in our hearts. And his spirit will live on with each of us.”
Danny lightly massaged Sara’s back. “Down the road when the dust settles, our tears stop, and we rejoice in Dakota’s memories, let’s discuss the possibility of bringing another Chesapeake into our lives.”
CHAPTER 16
With discretion in the ICU’s kitchen, Annabel grabbed a cup of coffee and went back down to the medical floor. She chose one of the cubby-hole desk areas away from the nurses’ station and sat down with May Oliver’s chart and results she scrounged up after arriving at 7 a.m. She needed to process it all before rounds, try to make sense of the information with the little clinical experience she had, and anticipate what her resident and chief resident would recommend for her patient.
The results were terrible. The thirty-two year old’s lung cancer had metastasized before even being diagnosed. She thought of the pathophysiology going on in May’s body and felt anger at a process that humans could still not halt. Adenocarcinoma cells had broken away from May’s primary tumor – the one that the pulmonary doctor had viewed and sampled - and traveled to other parts of her body through her blood and/or lymphatic system.
