Good Luck Cat

by Lissa Warren

  While Mom is at the front desk scheduling the EKG appointment, Dr. Belden takes Ting for an X-ray. It shows nothing alarming—no mass near her heart, no buildup of fluid, no shadow or enlargement. When she hands Ting back to me, she says, “Just keep an eye on her.” She knows us well, and knows we will.

  “I’m sorry about your dad,” she says, while scratching Ting behind the ears.

  “Thanks,” I say. “We miss him.”

  It’s then that I remember she too lives alone with her mom.

  I-495 is the quickest way home. It takes us past the dealership where Dad got his Honda, the movie theater where he saw Apollo 13, the Friendly’s we know he used to sneak off to for chocolate milkshakes with strawberry ice cream, and the hospital where they let him die. If it weren’t for Ting I’d take back roads, just to avoid driving by it.

  Ting’s in the backseat, her cat carrier belted in. She doesn’t make a peep. We get her home, thinking to enter by the front door so the grating sound of the garage door doesn’t scare her. When we get to the foyer and unlatch the door to her carrier, she steps out of it gingerly. I scoop her up and carry her upstairs to Mom’s room, figuring that having a cat with a really slow heartbeat try to make it two flights under her own steam wouldn’t be a good idea.

  Then Mom and I set about cat-proofing her room. We position pillows and wadded-up blankets against every hard surface, every coffee table leg and dresser corner that Ting could possibly knock into if she passed out. We move her water glass from the bathroom counter to the bathroom floor. She makes a beeline for her kitty bed on top of Dad’s armoire, but we’ve already placed it on the couch—a softer, lower surface that we worry may still be too high. I scoop her up again and put her in it.

  Ting settles in and starts cleaning herself. She begins with her two front legs, licking all the way down them in long, swift strokes. Next she licks her paws and draws them smoothly and efficiently across her head. Then it’s on to her chest and belly—little licks this time, just flicks of the tongue. And finally, she reclines and lifts one of her back legs over her head; not exactly ladylike, but you have to admire the flexibility. Nothing about her actions says “sick cat.”

  Her EKG is set for Thursday morning. The days pass, eventless. As soon as five p.m. rolls around each day, I leave the office and head right home to relieve Mom from her cat-sitting duties. I get takeout from our nearby Thai place three nights in a row so that Mom can stay upstairs with Ting instead of being down in the kitchen, cooking. I try to tempt Ting with a shrimp from my Pad Thai, but she has never been that into people food, and turns her nose up at it. The fact that it’s food from her native country is lost on her.

  Ting seems to be doing so well that we start to question whether there’s actually anything wrong with her at all. I Google how fast a dog’s heart beats: 60 to 100 beats per minute for large dogs, up to 140 for small. I Google the normal heart rate for cats: 120 to 200. According to Dr. Belden, Ting came in at a mere 65, and 60 is considered the fainting zone. It’s hard to ignore the numbers, but, of course, I’m in denial. I decide Dr. Belden must have measured wrong, and set about taking Ting’s pulse myself. I feel for it on her wrist like you’d do with a human, but I can’t find it there. Complicating this attempt, Ting curls her paws around my fingers and licks me. Then I search for it on her neck, which she interprets as a preamble to a nice hard scratch, and bites me lightly when I don’t deliver. It’s hopeless; I can’t even find her pulse, much less get an accurate reading. We’ll have to be patient, and we’ll have to take her in for the test.

  At 6:45 that Thursday morning we coax Ting into her cat carrier for her 7:00 a.m. appointment. When we get to Bulger, we go to the back entrance as instructed. A staff member ushers us right into an exam room, where the technician is already set up. He introduces himself while Mom and I undo the plastic pegs of Ting’s carrier so that we can just lift off the top. The technician is big and has a booming voice, and we know there’s no way Ting will come out the door for him like she did for Dr. Belden earlier that week.

  He positions Ting on her side and proceeds to squirt her with alcohol—for better conduction, he explains—using the kind of long-nozzled bottle football players use when they’re wearing their helmets. Ting doesn’t like it one bit, but shows tolerance. While I stroke her head the technician affixes clamps to her belly and chest. They look like miniature jumper cables but don’t seem to hurt her—or perhaps she’s just too scared to show it. Once they’re all in place, the technician asks Mom, who’s standing next to the switch, to turn off the overhead lights, and then he pushes a button on his computer. Ting’s heartbeats spread across the screen like stalagmites. Mom and I both look away. We’ve seen enough of these readings this year.

  The room is unnaturally quiet; no bleeps or blips accompany the readout, just the sound of our breathing. Almost immediately he identifies the problem: second-degree AV block. We know bypasses, grafts, and stents. We know arterial stenosis and cardiac catheterization. We surmise that AV means “atrioventricular.” We know the language of heart disease, but this “AV block” is a new one for us.

  “What is that?” Mom asks.

  We’re told in layperson’s terms that the electrical impulses in one part of Ting’s heart aren’t making it to the other; that means it’s not receiving instructions to pump, which is why she has become “syncopal.” I turn the word around in my head. As an English major, I learned it referred to sounds or letters left out of the middle of a word—in-ter-est-ing pronounced in-trest-ing instead. But to doctors, it means a loss of consciousness caused by lack of blood to the brain. I like my definition better. I don’t want to be here.

  “What causes AV block?” Mom asks. We’re told it could be due to aging, or a type of heart muscle disease called cardiomyopathy.

  It’s good to have a diagnosis, but it’s a frightening-sounding one. Cutting to the chase, Mom asks the technician how it’s treated—if Ting will have to be on some sort of medication for the rest of her life. He tells us Dr. Belden will explain the options. Good, we think. There are options.

  We blot Ting off with paper towels as best we can, put her back in her carrier, and take her to the lobby to wait while Dr. Belden pores over the EKG results. About fifteen minutes later we’re escorted into another exam room. Soon after, Dr. Belden comes in, looking more serious than I have ever seen her.

  “I’m referring you to Angell Animal Medical Center in Boston,” she says. “They’re one of the few places in the country that have successfully implanted a pacemaker in a cat.”

  Chapter Fourteen

  Monitoring

  Time spent with a cat is never wasted.

  —Colette

  The cat with five hearts needs a new one—or, rather, an engine for her old one.

  The following Monday I chauffeur Ting to Angell. It’s an hour’s drive from home, most of it highway. We transport her in her cat carrier, seat-belted into the driver’s-side backseat, and positioned so that the front door faces the passenger-side backseat, where Mom sits so she can keep an eye on Ting and soothe her as necessary.

  To get to Angell, we have to pass through the Longwood Medical Area, home to Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center; home to Dana-Farber Cancer Institute and the Joslin Diabetes Center. Even just being near a hospital makes me nervous after what happened to Dad, but I don’t say anything, and Mom doesn’t either. I don’t say I wish we’d brought him to a Boston hospital instead.

  We pull into the parking lot at Angell and see dogs being walked by people in scrubs: a dachshund waddling in a front-leg cast; a German shepherd trotting with gauze wrapped around his belly; a shih tzu or Lhasa apso (I can never tell the difference) propelling himself forward at a pretty good speed, even though his hind legs are in some sort of wheelchair contraption; a golden retriever who looks perfectly healthy but who walks with so much hesitance, I wonder if he’s blind. I find a spot near the ­sliding-glass front door, park, and pop
out so I can unbuckle Ting’s carrier. She doesn’t make a peep—wants to remain invisible.

  The lobby of Angell is impressive—as big as that of any human hospital. The waiting area is thoughtfully sectioned off for dogs, cats, and “other,” which I assume means rabbits, ferrets, and guinea pigs, perhaps the occasional sugar glider or other small exotic. While Mom goes and checks us in, I hunker down in the “cats” section, Ting’s carrier on my lap with her pale-yellow towel draped over the top, just the way she likes it.

  After a few minutes, we’re greeted by a young woman who introduces herself as Sara, the cardiology assistant. She brings us back to an exam room. I open the door to Ting’s carrier to see if we can coax her out. No dice, of course—new place, new people—so one by one I undo the plastic pegs that hold the case in place, remove the cover, hand it to Mom, and lift Ting out. She’s too scared to meow in protest. The room is very bright and smells of antiseptic.

  Sara pulls out a scale on which I set Ting. Seven pounds, ten ounces—just like at Dr. Belden’s. Then, while Mom holds Ting in her arms and sways back and forth with her like she did with me when I was a baby, we answer a bunch of questions. Is she eating normally? Yes. Any bathroom problems? No. Vomiting? Occasionally, when she scarfs her food—the usual cat throw-up stuff. Is she on any medication? No. How long has she been fainting? First time was last week. How many spells since then? Exactly three. What happens when she faints? She goes out cold and falls. How long is she out? Just seconds.

  The basics covered, we chat with Sara while we wait for the cardiologist to arrive. It turns out Sara recently graduated from Emerson with a degree in creative writing. She rattles off the names of professors with whom she studied, and I nod my head; I know all of them. The school is well respected for its liberal arts program—with emphasis on the liberal—and I’m surprised to find someone who studied there working in the medical field. I like her instantly for being different; plus, she was gentle with Ting.

  The door opens, and a white-coated Dr. Nancy Laste, the “cat cardiologist,” walks in, followed by a couple of white-coated interns. Like the places we passed on the way here, this is a teaching hospital.

  Mother of three (including newborn twins, we later find out), Dr. Laste is head of the cardiology department, having obtained her veterinary degree from Cornell University. She exudes competence and confidence and, after looking over Ting’s chart, listening to her heart for what seems like ages, and asking us a bunch more questions, she declares Ting an excellent candidate for a pacemaker. She tells us that cats with pacemakers generally live to whatever age they would have lived to without heart block.

  We’re encouraged, but still, we ask a zillion questions: Is she certain a pacemaker is necessary (yes); at fourteen, is Ting too old for the operation (not if she’s otherwise healthy, no); how long will Ting have to stay in the hospital (a week at most); will she be able to feel it each time the pacemaker fires (no); how long will the pacemaker last (long enough). But it’s her answer to our last question that scares us. “When’s the last time you’ve successfully paced a cat?” Her response: “Probably ten years ago.”

  Seeing our faces, she goes to a drawer and pulls out a metal disk wrapped in plastic and sets it on the table. “We do them all the time for dogs,” she says. “Just not so much for cats.” Looking at the size of the pacemaker, it’s easy to see why—and hard to imagine the thing actually fitting inside Ting, much less the intricate stitching it’d take to attach the giant device to her heart. It’s the size of a silver dollar, and at least ten times thicker.

  “You’d use a smaller one for Ting, right?” asks Mom. “They make them smaller for cats?”

  “It’s one size fits all,” says Dr. Laste. “Same for dogs and cats and humans.”

  It’s then that we realize Ting will be receiving a human pacemaker. Apparently, the demand for animal-size pacemakers isn’t such that any company would find it lucrative enough to produce them.

  Mom lifts the pacemaker off the table and puts it in her palm, weighing it as if it were a piece of fudge. She hands it to me and we look at each other, both of us thinking This is crazy, but knowing we have no other option—knowing that any one of Ting’s fainting spells could be fatal. We don’t need to discuss it. Ting deserves to live. We’re going to proceed, despite the odds. We’ve lost enough this year.

  To know how to pace her properly, Dr. Laste needs to get a recording of one of Ting’s episodes. She tells us Ting will need to stay overnight with a heart monitor in place. They take her away to attach the sensors and hook them up, then allow us to go back and see her. She’s miserable, and scared. They have her in a large ground-floor cage, with dogs on either side of her. The walls between them are solid so she can’t see them, but no doubt she can smell them and hear them panting.

  I see a woman a few cages down who has crawled into the cage with her Chihuahua. Seeing me look at her, she simply says, “They’ll let you get in, too.” I hand my purse to Mom and undo the latch, gingerly sliding myself in so as not to disturb Ting. She tries to stand up but is wobbly and tethered. I pick her up and place her against my chest, wrapping her in my cardigan. She nestles against me and settles a bit, but there’s too much going on for her to sleep. It’s cramped in here, and after a few minutes my feet go numb. All I can do is let them.

  When the visiting hour is over, I place Ting on the blanket they’ve given her and extricate myself from the cage. I glance back at Ting, and she’s shaking. I look at Mom, but don’t have to say anything. This time, when we don’t like how things are being handled at a hospital, we’re going to speak up. Mom informs the nurse that we’ll be taking Ting home with us, and asks for her to be disconnected. There has to be a better way.

  And thankfully, there is. Hearing we’re determined to spring Ting from the joint, Dr. Laste comes by and fits her with a portable heart monitor—an “event monitor,” they call it—the same kind that people with suspected heart problems wear clipped to their waistband or belt; the same kind that my father wore once. For Ting, of course, the only option is to cover her midsection with gauze and then wrap the gauze with a special, self-adhesive bandage (appropriately named “pet wrap”) so that the monitor can be affixed to her back. The pet wrap is bright green, and the second the monitor is clipped to it, Mom turns to me and says “Jet pack.” Indeed, Ting looks like Boba Fett from Star Wars.

  Armed with instructions for operating the monitor, we settle up at the front desk and head to the car. Ting is still and quiet the whole way home. As soon as we get her upstairs, she makes it her mission in life to rid herself of the dreaded device, thrashing about in an effort to shake it loose. But Mom and I make it our mission to keep the darn thing on her. Every time she tries to jump off the bed, or into the rocker where she loves to nap, or onto the sink, we scoop her up and gently put her wherever she was trying to go. To further complicate matters, one of us has to be with her at all times so that, in the event she has an episode, we can push the record button on the top of the monitor so that it commences taping, then call the 800 number for the monitoring service and hit transmit. The sooner we capture an incident, the sooner she can have her surgery. The sooner she can be well.

  Mom and I develop a routine. She watches Ting all day, and I relieve her as soon as I get home from work. Mom goes to bed around nine p.m., then I stay awake with Ting for as long as I can, which is usually until two or three a.m. Mom sets the alarm for four a.m. so that, in the end, Ting is only unsupervised for an hour or two. Each morning, before I head out, I watch Ting while Mom takes a quick shower, then gathers all the food and water she’ll need for herself for the day so that she doesn’t have to leave the room. It’s depressing, stressful, lonely work for Mom, and the last thing she needs so soon after Dad’s death. But we have no other option.

  Weeks go by, eventless. Ting doesn’t have a single spell. Her skin becomes raw where the sensors are attached, and we have to take her to Bulger to have them repositioned. By then she has
gone through seven rolls of pet wrap. I ask Dr. Belden if sometimes cats who have this condition get better on their own. “Not that I’ve seen,” she says, which is her way of saying, “Never. No.” Pessimistic that this waiting game will end anytime soon, we leave Bulger with half a dozen rolls of pet wrap.

  As time passes, we start to doubt whether there was ever anything wrong with Ting in the first place—to wonder if, knee-deep in grief over Dad, we had simply imagined the worst: that we were on the brink of losing the only thing we had left except each other. In one of my crazier moments, I secretly Google “Munchausen syndrome by proxy” to see if it’s applicable to pets. Rare, but not unheard of, my computer tells me.

  As we’re monitoring Ting, we’re also monitoring each other—on the lookout for signs that the other is starting to lose it. I see a pile of unopened bills that has been sitting there for a week, and just before I say something about late fees, Mom mentions that she plans to make tomorrow “bill day.” She hears me talking to myself in my room late at night, and when she asks me about it the next day, I tell her the truth: I was rerecording the outgoing message on my voicemail at work.

  Throughout the monitoring process, we’re in constant contact with Dr. Laste, who tells us this lack of cardiac events isn’t unheard of, and encourages us to remain vigilant. Eventually, on a cloudy Wednesday in early October, it pays off: Ting passes out while I’m at work, Mom hits record, then dials the 800 number to transmit the info.

  The next day, Dr. Laste calls to tell us she got what she needed. She’s ready to schedule the surgery.

  If only Mom and I felt as ready.

  Chapter Fifteen

  Pacing

  A house isn’t a home without the ineffable contentment of a cat with its tail folded about its feet.