I put Seamus’s crate in the backseat of my car and opened the door to the crate. Seamus nimbly leaped up, walked into the crate, turned around, sat, and waited for me to close it. Once I closed the back door to my car, he barked until I was in the car with him and the car was started. Then he quieted and calmly sat looking ahead at the road through the crate for the entire drive. But when the car stopped, the barking began. I’m back here! Take me with you! Is there food around? How about a burger? I smell burgers! Or the beach? Is that the beach? Take me with you! Come get me out! Get me! Let me outta here!! Noooooooooooooooooow!!!!
We were at the veterinarian oncology office, but Seamus didn’t know that. He just knew he wanted out of the car with me.
The Veterinary Cancer Center is housed in a modern facility in a gentrified Los Angeles suburb. The building has an open loft feeling to it, industrial with splashes of vivid colors—orange, magenta, lime green—and a green-tinted cement floor. The artwork is particularly attractive, including large black and white photographs of the doctors and their own animals. It’s as nice as a place that you never want to be can be.
The facility was also not far from Chris’s apartment, which made it easy for him to join me for the appointment. The three of us sat in the waiting room, Seamus sniffing, me sniffling, and Chris doing an admirable job of entertaining and distracting both of us.
“It’s like an art gallery in here almost, don’t you think?” he said.
“I like the photography.”
“And that painting,” he said, pointing to a large oil painting of three women having cocktails at a bistro table, with three dogs at their feet.
“Makes me think this is going to cost me a fortune.”
“I was thinking that, too.” Chris stood and got a dog biscuit from the bowl on the reception counter, which Seamus had been straining to reach. He gave the biscuit to Seamus, who swallowed it nearly whole and barked for another one. “May as well get your money’s worth,” Chris said as he reached for a second biscuit.
A vet tech in purple scrubs walked toward us.
“See-muss?”
“It’s pronounced Shay-mus,” I said as I rose to greet her.
The technician wrote at the top of Seamus’s chart in large letters SHAY-MUSS. (Later, when somebody mistakenly referred to Seamus as a she and I corrected her, she dutifully wrote “BOY” on the top of his chart.)
In the exam room, there was just enough time to observe more stylish animal-themed artwork and chairs covered in William Wegman–designed fabric before the oncologist joined us. Dr. Gilbert was probably in her thirties, with a bob haircut and wide mouth with large white teeth that I managed to see despite the fact that she didn’t smile.
“I’m Dr. Gilbert,” she said, apparently to the manila file folder, since that’s where she was looking.
“Hi, I’m Teresa,” I said, extending my hand in her general direction. She didn’t take it but turned her gaze to Chris instead.
“I’m Chris,” he said. “And this is Seamus.”
“Fine. I’ve reviewed the biopsy report, and I suppose you know this isn’t good.” She launched into a lengthy monologue of things I couldn’t understand, while my mind stayed stuck on “isn’t good.”
“The biopsy shows a right perineal mast cell tumor, and the margins are not clean. Blah, blah, blah…aggressive…blah, blah, more blah…surgery…blah, blah…difficult. Blah, blah, blah, blah…quality of life. Blah, blah, blah…chemotherapy…Blah, blah, blah…The prognosis is likely a year.”
I grabbed on to one of the few words I understood. “Chemotherapy for a dog?”
“Yes, it’s cancer; we treat it just like we would in a human. Dogs tolerate chemotherapy quite well actually.”
I wondered if the dogs thought so.
Chemotherapy seemed almost as frightening as cancer itself. I remembered my dad, when he’d worked in a hospital and later as well, often commenting that the treatment was worse than the disease. In my office, we’d had a client diagnosed with Stage IV breast cancer about a year previously. She continued working throughout chemotherapy, no matter how tired or pale or bald she got. I remember wondering why on earth she would keep working. I thought I’d probably quit everything if it were me. And probably refuse the chemo, too. It was all too horrible. But this doctor was telling me dogs tolerated chemo better than humans. How much better?
“What do I need to do?” My brain was scrambling to process information, and her mannerisms weren’t helping. She continued making notes in her file and not making eye contact. She had yet to look at Seamus. I didn’t think she knew if the dog was a beagle or a Rottweiler or, for that matter, a cat.
This was her business, I supposed. And she probably needs emotional distance. But this wasn’t business to me. This was my dog. He shared my life. He was a vital part of the alphabet of my life. And I think I was still hoping there’d been some terrible mistake. A two-year-old dog could not have cancer. I needed empathy.
“You can do the surgery consult today with Dr. Tracey. We’ll get an estimate of the cost of the recommended treatment. If that’s acceptable to you, we can schedule the surgery here or in our Tustin clinic.”
“If it’s acceptable to me? Okay. Well, what other options are there?”
“Well, not everyone can afford surgery, so we try to give other options. In his case, without surgery and treatment, we would be discussing how to keep him most comfortable for the remainder of his life, for however long that might be. It would be a matter of sustaining a quality of life for the time we could.” She was without sympathy for me or the dog. Maybe that’s why she hadn’t even looked at Seamus, let alone petted him like everyone else had done. Maybe that’s how she got through her day—Rule Number One: no sympathy.
My dog is going to die. He’s two years old, and he’s going to die. I wanted to cry, but I was fighting it back. Something told me not to cry in front of this woman. Rule Number Two was probably “no crying.” I quickly replaced the urge to cry with the urge to slap her. To blame her. I couldn’t slap her, of course, so I was out of options. No crying, no slapping…and I wasn’t comprehending much either. I looked to Chris.
“Is surgery what you recommend?” Chris said.
“Yes. Absolutely. We have to do at least that,” Dr. Gilbert said to Chris. To me she said, “If you can’t afford it, we understand. Not everyone can afford the care that’s required. You just need to let me know what you want to do.”
We’d been in the room with her for all of five minutes, and she seemed to feel I was wasting her time. Was I supposed to have signed papers, given my dog anesthesia myself on the drive in, and wheel him into the surgery now? Was I allowed no time to consider options? Were there options? “I want to do whatever I need to do for him,” I said. “Just tell me what the best thing to do is. The cost isn’t the issue.” Cost was an issue, but not the issue.
“I’ll set up the surgery consult,” she said. And she left, without ever looking at Seamus. I handed him another biscuit to make up for her neglect.
Chris and Seamus and I waited alone in the exam room to meet with the surgeon for the consultation.
“I hate that doctor,” I said.
“She’s not very warm, that’s true. But it’s a hard job. Maybe she’s having a bad day. Anyway, she’s not doing the surgery.”
“Thank God for that. She’s like a bitchy sorority girl. Like we’re in rush and not everybody gets a bid. As though anybody wants to rush this kind of sorority.” I mimicked the “Well, if you can’t afford it” speech but was cut short when another doctor walked in.
The surgeon, Dr. Tracey, was a tall, thin woman with short, curly, light brown hair and a demeanor that conveyed confidence and compassion in equal measure. As soon as she entered the exam room, she sat on the floor, calling Seamus to her and pronouncing his name correctly. He
gladly went to her and put his face right up to hers, sniffing her in, wagging his tail. She scratched his ears, petted his head, and only then, having won over the dog, did she address Chris and me, continuing to pet Seamus as she talked.
“Seamus is a sweetie. He reminds me of a hound I used to have. Great, great dog.” Seamus crawled into her lap and turned to face me, sitting calmly. He approved.
I exhaled, relaxing slightly. This was good. She was good—a nice contrast to Dr. Sorority Chick. If someone’s going to be operating on my dog, I wanted her thinking of a dog she had loved. I wanted her doing everything she’d do for her own loved one. I wanted her to save us both.
Dr. Tracey explained the cancer, the surgery, and the need for clear margins. A mast cell tumor is like a skin cancer and is common in some breeds, like boxers, but not beagles. Mast cell tumors can have a high survival rate, but can also be aggressive and terminal, particularly when the tumor is located in a highly vascular area, such as where Seamus’s was, which increases the risk it has metastasized. When the tumor was excised, the pathologist would check to see if there were cancer cells in the margins of the tumor—if there were, that meant cancer cells were still left behind in the body. If the margins were clear, that meant no signs of the cancer, at least at that point.
No cancer. That would be good, I thought. He might not be terminal.
“That doesn’t necessarily mean we’ve got it all. Cancer cells are extremely small and difficult to detect until there’s a mass of them. But if we aren’t seeing any cancer on the edges of the tumor, we’re at least hopeful the cancer has been removed.”
Okay, hopeful. I’d settle for hopeful. “And if it isn’t? If the margins aren’t clear, do you do another surgery?” I said.
Dr. Tracey, still sitting on the floor, petted Seamus and gave him a green dog-bone shaped cookie, which she’d pulled from the lab coat pocket he’d been sniffing. “Not in this case. I will cut as much as I can, but there’s a limit to how much we can excise because of where this tumor is. If I cut too wide, he’ll lose some bodily functions and it becomes a quality of life issue. This is a highly vascular area. It’s very delicate.” She looked directly at me. “I will do everything I can for him.”
I watched as she petted Seamus gently. I could see she cared, and in that moment I believed her. I believed in her, and I’d trust my dog to her care.
“Thank you,” I said. “When can we do the surgery?”
With Dr. Tracey’s patient assistance, we made arrangements for the surgery. For me this meant paperwork and a discussion with Chris as to whether I could skip out on the family Thanksgiving if Seamus’s recovery necessitated it. For Seamus this meant sedation, an ultrasound, a blood draw, bone marrow aspiration, and a few other pre-op procedures and tests that were not clear to me. The bill for the day: $2,035.68. And this was before the surgery.
Chris and I went to lunch and waited together, quietly for the most part, while Seamus was tested. I grabbed tissues and wiped my eyes and blew my nose, while Chris rubbed my back. I called my mom to see if she would be able to watch Seamus on Thanksgiving Day as he recovered from the surgery, if need be.
Later, on the way back home, with Seamus sleeping soundly in the backseat of my car, I asked Chris what I’d been afraid to ask Dr. Sorority Chick.
“Did she say Seamus has a year to live even if I do the surgery and chemo? Or is it a year if I do nothing?”
“I think it’s a year even with the surgery and chemo. But we can make it a really good year for him.” He reached over and rested his hand on my leg.
I cried the rest of the sixty-mile drive home.
That night Chris and I sat out in the hot tub on my back patio overlooking the city. The hot tub was our new “tub talk” locale, befitting a sleek and elegant cougar den.
“I need to do this. I know it’s crazy expensive, but I can’t just let him die,” I said.
“I know. It’s okay. I think you should do it.”
“You don’t think I’m crazy for spending that much money on a dog?”
“No. I know how much that dog means to you. And you can afford it, right?”
I wasn’t sure I could. No one gets a divorce, let alone two of them, and doesn’t see their finances take a hit. And all the traveling I’d been doing was not cheap. And I was missing work while taking the dog to his appointments. My law partnership worked on what we’d lovingly called an “eat what you kill” system. In other words, if I wasn’t working, I wasn’t earning. But I didn’t discuss my finances with Chris yet. “I think I can afford it. I don’t really know. I just know I have to try.”
“I know. He’s your baby. You know I support you both.”
“Thanks.”
We were quiet for a few moments, our legs entwined under the hot water, each of us leaned back relaxing into the soothing jet streams of bubbles.
“It’s funny, though. You’d do anything for this dog and you take really good care of him. But…” He paused and sat up, moving toward me, his hand coming to rest on my knee. “…you never wanted to have kids?”
I sat up. We’d had this conversation before. It was probably the biggest hurdle to our “is this long term?” discussions. I was maybe technically still of childbearing age physically, but I was never of a childbearing mentality. I’d been clear about that from the beginning of my relationship with Chris, as I had with my second husband. (I’d been less clear with my first husband; he, actually, probably crystallized the “no children” decision for me with his own childish behavior.) I didn’t have nor did I want children. There were a lot of reasons for this, including a long line of ancestors who did not seem to have any natural maternal instincts. I felt sure I shared that much DNA. Besides, one should not have to go searching for reasons or be talked into having kids. My biological time clock never went off. I doubt it ever even existed, let alone ticked.
“No. I never did. I’ve always been good with dogs and never with children. It’s not the same thing. I have vastly different feelings about dogs and children. I wouldn’t be good being a mother.”
“Oh, I think you would be. But I understand.” We fell quiet again, and both of us leaned back. I watched Chris though. I could see he was thinking deeply, and I was certain I didn’t want to know more just then. I had the dog to think about.
Chris and I stayed at his Brentwood apartment the night before the surgery so we could drop Seamus off early in the morning. We snuck Seamus into the “no pets allowed” apartment and hoped he wouldn’t bark at each new noise or smell. He did not. He slept calmly and contentedly on the recliner in the bedroom with us, using my clothes as his pillow. He only howled when we left the apartment without feeding him. No food or water was allowed for the twelve hours preceding surgery.
We arrived at the Veterinary Cancer Center just before nine in the morning and were taken into the exam room immediately. They were certainly efficient.
Even though I’d heard it before, and Chris had confirmed it for me, I still needed to hear the prognosis again. I still hoped I’d misunderstood. When Dr. Tracey came into the room, I asked, “Did I understand correctly that even with surgery and chemo and maybe even radiation, it’s likely he only has a year to live? Is that true even if you get clean margins?”
“Unfortunately, tumors in this area are usually very aggressive. Even with clean margins, and again, that’s only what we can see with today’s technology—so it may not be clean—chances are still high that the cancer is still there. Chemo may get it. It may not. That’s what tough about these. We’ll do the best we can.”
Once again a staff person brought me an estimate for services, which was a detailed list of everything possible in the surgery. The estimate included a FedEx charge of $45 so they could ship the test results to a lab in New York. I signed and handed over my credit card. I’d begun to think of this card as Seamus’s car
d. With a lot of airline miles building up. The estimate gave a low of $2,023 and a high of $2,193. The difference was the doses of anesthesia, antibiotics, and pain relief injection. I didn’t know whether to hope for the high or the low estimate. I also signed for “advanced resuscitative efforts (primarily applies to patients weighing more than 50 lbs; including surgical & machine support; potential added cost of $150 to $400).” Seamus wasn’t anywhere near fifty pounds, but I wasn’t taking any chances. We’re giving this everything we have.
I hugged and petted and kissed Seamus until Dr. Tracey took him from the exam room and back to the hospital area. Seamus followed willingly and happily, sniffing around for more treats as he went, his nails click-click-clicking on the tinted cement as he trotted down the hall, his tail held high and swishing back and forth. Chris led me the other way down the hall.
I drove home alone and lonely, leaving Seamus at the surgery center and Chris in his apartment. At home, I sat on the couch, staring at the wall, swirling but not sipping a glass of wine. I waited.
Dr. Tracey called me at six that evening to tell me the surgery had gone well and she was hopeful for clean margins. Seamus was resting comfortably, she assured me. This brought me little comfort. I continued to hear “aggressive…one year…chemotherapy” echoing in my thoughts.
The next day, the oncology center phoned me in my office just after noon. Seamus was doing great, he was alert and eating, and I could pick him up anytime. I looked at my watch. Even if I left right then, which I was willing to do, there was no way I could get to Los Angeles and back without encountering heavy traffic. I calculated the time it would likely take. Maybe an hour and a half to get there, with a little luck. A half hour at the clinic…it would be three or later when I left. The worst possible time to get on a Los Angeles freeway. I’d be lucky if I got back home by 6:00 p.m. And Seamus, with stitches in his rear end and on pain medication, would be confined to a crate all that time.
I called Chris hoping he’d know some magic driving route that would help me avoid what I also knew was inevitable. There were not a lot of people in my life who I trusted enough to ask for advice and even fewer whose advice I’d likely take. Despite my lingering concerns about Chris’s youth, I had begun to count on and enjoy his intelligence.
Dog Lived (and So Will I) Page 7
